Predicting the Effectiveness of Work-Focused CBT for Common Mental Disorders: The Influence of Baseline Self-Efficacy, Depression and Anxiety.

Purpose This study examined who benefits most from a cognitive behavioural therapy (CBT)-based intervention that aims to enhance return to work (RTW) among employees who are absent due to common mental disorders (CMDs) (e.g., depression, anxiety, or adjustment disorder). We researched the influence of baseline work-related self-efficacy and mental health (depressive complaints and anxiety) on treatment outcomes of two psychotherapeutic interventions. Methods Using a quasi-experimental design, 12-month follow-up data of 168 employees were collected. Participants either received work-focused cognitive behavioural therapy (W-CBT) that integrated work aspects early into the treatment (n = 89) or regular cognitive behavioural therapy (R-CBT) without a focus on work (n = 79). Results Compared with R-CBT, W-CBT resulted in a faster partial RTW, irrespective of baseline self-efficacy. Among individuals with high self-efficacy, W-CBT also resulted in faster full RTW. The effectiveness of W-CBT on RTW did not depend on baseline depressive complaints or anxiety. The decline of mental health complaints did not differ between the two interventions, nor depended on baseline self-efficacy or mental health. Conclusions Considering the benefits of W-CBT for partial RTW, we recommend this intervention as a preferred method for employees with CMDs, irrespective of baseline self-efficacy, depression and anxiety. For individuals with high baseline self-efficacy, this intervention also results in higher full RTW. For those with low self-efficacy, extra exercises or components may be needed to promote full RTW.

Speed Matters: Relationship between Speed of Eye Movements and Modification of Aversive Autobiographical Memories.

Eye movement desensitization and reprocessing (EMDR) is an efficacious treatment for post-traumatic stress disorder. In EMDR, patients recall a distressing memory and simultaneously make eye movements (EM). Both tasks are considered to require limited working memory (WM) resources. Because this leaves fewer resources available for memory retrieval, the memory should become less vivid and less emotional during future recall. In EMDR analogue studies, a standardized procedure has been used, in which participants receive the same dual task manipulation of 1 EM cycle per second (1 Hz). From a WM perspective, the WM taxation of the dual task might be titrated to the WM taxation of the memory image. We hypothesized that highly vivid images are more affected by high WM taxation and less vivid images are more affected by low WM taxation. In study 1, 34 participants performed a reaction time task, and rated image vividness, and difficulty of retrieving an image, during five speeds of EM and no EM. Both a high WM taxing frequency (fast EM; 1.2 Hz) and a low WM taxing frequency (slow EM; 0.8 Hz) were selected. In study 2, 72 participants recalled three highly vivid aversive autobiographical memory images (n = 36) or three less vivid images (n = 36) under each of three conditions: recall + fast EM, recall + slow EM, or recall only. Multi-level modeling revealed a consistent pattern for all outcome measures: recall + fast EM led to less emotional, less vivid and more difficult to retrieve images than recall + slow EM and recall only, and the effects of recall + slow EM felt consistently in between the effects of recall + fast EM and recall only, but only differed significantly from recall + fast EM. Crucially, image vividness did not interact with condition on the decrease of emotionality over time, which was inconsistent with the prediction. Implications for understanding the mechanisms of action in memory modification and directions for future research are discussed.

A trial of parent training for mothers being released from incarceration and their children.

Children of incarcerated mothers are considered at risk for disruptive behavior problems and later delinquency. Parenting may play a key role in this intergenerational transmission of delinquency. The present study aimed to evaluate the effectiveness of the Incredible Years parent training, enhanced with home visits, for (formerly) incarcerated mothers to prevent disruptive behavior problems in their 2- to 10-year-old children, by means of a nationwide randomized controlled trial. Mothers of 133 children (M age = 76.91 months; 48.9% boys) were assigned to an intervention, consisting of group sessions and individual home visits, or a no-intervention control group. The intervention yielded significant effects on parenting and child behavior for maternal report. Marginally significant effects on child behavior were found for teacher report. The results show short-term effectiveness of parent training for the high-risk and hard-to-reach population of (formerly) incarcerated mothers and their children.