Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 3 de 3
Filtrar
Más filtros

Banco de datos
País/Región como asunto
Tipo del documento
Asunto de la revista
País de afiliación
Intervalo de año de publicación
1.
BMC Psychiatry ; 17(1): 331, 2017 09 12.
Artículo en Inglés | MEDLINE | ID: mdl-28899365

RESUMEN

BACKGROUND: Depression and anxiety are prevalent and under treated conditions that create enormous burden for the patient and the health system. Internet-delivered cognitive behavior therapy (ICBT) improves patient access to treatment by providing therapeutic information via the Internet, presented in sequential lessons, accompanied by brief weekly therapist support. While there is growing research supporting ICBT, use of ICBT within community mental health clinics is limited. In a recent trial, an external unit specializing in ICBT facilitated use of ICBT in community mental health clinics in one Canadian province (ISRCTN42729166; registered November 5, 2013). Patient outcomes were very promising and uptake was encouraging. This paper reports on a parallel process evaluation designed to understand facilitators and barriers impacting the uptake and implementation of ICBT. METHODS: Therapists (n = 22) and managers (n = 11) from seven community mental health clinics dispersed across one Canadian province who were involved in implementing ICBT over ~2 years completed an online survey (including open and closed-ended questions) about ICBT experiences. The questions were based on the Consolidated Framework for Implementation Research (CFIR), which outlines diverse constructs that have the potential to impact program implementation. RESULTS: Analyses suggested ICBT implementation was perceived to be most prominently facilitated by intervention characteristics (namely the relative advantages of ICBT compared to face-to-face therapy, the quality of the ICBT program that was delivered, and evidence supporting ICBT) and implementation processes (namely the use of an external facilitation unit that aided with engaging patients, therapists, and managers and ICBT implementation). The inner setting was identified as the most significant barrier to implementation as a result of limited resources for ICBT combined with greater priority given to face-to-face care. CONCLUSIONS: The results contribute to understanding facilitators and barriers to using ICBT within community mental health clinics and serve to identify recommendations for improving uptake and implementation of ICBT in clinic settings.


Asunto(s)
Terapia Cognitivo-Conductual/organización & administración , Accesibilidad a los Servicios de Salud/organización & administración , Participación del Paciente/estadística & datos numéricos , Telemedicina/organización & administración , Trastornos de Ansiedad/terapia , Canadá , Trastorno Depresivo/terapia , Femenino , Humanos , Internet/estadística & datos numéricos , Masculino , Salud Mental , Resultado del Tratamiento
2.
J Anxiety Disord ; 42: 19-29, 2016 08.
Artículo en Inglés | MEDLINE | ID: mdl-27244278

RESUMEN

Effects of Internet-delivered cognitive behaviour therapy (ICBT) for anxiety and depression are not well understood when delivered in non-specialized as compared to specialized clinic settings. This open trial (n=458 patients) examined the benefits of transdiagnostic-ICBT when delivered in Canada by therapists (registered providers or graduate students) working in either a specialized online clinic or one of eight nonspecialized community clinics. Symptoms of depression and anxiety were assessed at pre-treatment, post-treatment and at 3-month follow-up. Completion rates and satisfaction were high. Significant and large reductions (effect sizes 1.17-1.31) were found on symptom measures. Completion rates, satisfaction levels and outcomes did not differ whether ICBT was delivered by therapists working in a specialized online clinic or nonspecialized community clinics. Differences were also not found between registered providers and graduate students, or therapists trained in psychology or another discipline. The findings support the public health potential of ICBT.


Asunto(s)
Trastornos de Ansiedad/terapia , Terapia Cognitivo-Conductual/métodos , Trastorno Depresivo/terapia , Internet , Consulta Remota/métodos , Adulto , Ansiedad/psicología , Ansiedad/terapia , Trastornos de Ansiedad/psicología , Canadá , Depresión/psicología , Depresión/terapia , Trastorno Depresivo/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento
3.
J Anxiety Disord ; 28(8): 884-93, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25445078

RESUMEN

This dissemination study examined the effectiveness of therapist-assisted Internet-delivered Cognitive Behavior Therapy (ICBT) when offered in clinical practice. A centralized unit screened and coordinated ICBT delivered by newly trained therapists working in six geographically dispersed clinical settings. Using an open trial design, 221 patients were offered 12 modules of ICBT for symptoms of generalized anxiety (n=112), depression (n=83), or panic (n=26). At baseline, midpoint and post-treatment, patients completed self-report measures. On average, patients completed 8 of 12 modules. Latent growth curve modeling identified significant reductions in depression, anxiety, stress and impairment (d=.65-.78), and improvements in quality of life (d=.48-.66). Improvements in primary symptoms were large (d=.91-1.25). Overall, therapist-assisted ICBT was effective when coordinated across settings in clinical practice, but further attention should be given to strategies to improve completion of treatment modules.


Asunto(s)
Ansiedad/terapia , Terapia Cognitivo-Conductual/métodos , Depresión/terapia , Internet , Adulto , Anciano , Trastornos de Ansiedad/psicología , Trastornos de Ansiedad/terapia , Depresión/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Calidad de Vida , Autoinforme
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA