The Lancet Psychiatry Commission on psychological treatments research in tomorrow's science

Holmes, Emily A.; Ghaderi, Ata; Harmer, Catherine J.; Ramchandani, Paul; Cuijpers, Pim; Morrison, Anthony P.; Roiser, Jonathan P.; Bockting, Claudi; O’Connor, Rory C.; Shafran, Roz; Moulds, Michelle L.; Craske, Michelle G.

doi:10.1016/s2215-0366(17)30513-8

Cited by 475 publications

(442 citation statements)

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“…The randomized controlled trials (RCT) play the most important role in this process, even though also other forms of investigation may yield valuable information [3][4][5][6][7][8][9]. The methodology for psychological interventions of trials has been discussed in the literature [3,5,6,8,[9][10][11][12][13]. In Psychotherapy and Psychosomatics, specific reference to the selection and design of control conditions has been made [14].…”

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confidence: 99%

Methodological Recommendations for Trials of Psychological Interventions

Guidi

Brakemeier

Bockting

et al. 2018

Psychother Psychosom

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Recent years have seen major developments in psychotherapy research that suggest the need to address critical methodological issues. These recommendations, developed by an international group of researchers, do not replace those for randomized controlled trials, but rather supplement strategies that need to be taken into account when considering psychological treatments. The limitations of traditional taxonomy and assessment methods are outlined, with suggestions for consideration of staging methods. Active psychotherapy control groups are recommended, and adaptive and dismantling study designs offer important opportunities. The treatments that are used, and particularly their specific ingredients, need to be described in detail for both the experimental and the control groups. Assessment should be performed blind before and after treatment and at long-term follow-up. A combination of observer- and self-rated measures is recommended. Side effects of psychotherapy should be evaluated using appropriate methods. Finally, the number of participants who deteriorate after treatment should be noted according to the methods that were used to define response or remission.

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confidence: 99%

Methodological Recommendations for Trials of Psychological Interventions

Guidi

Brakemeier

Bockting

et al. 2018

Psychother Psychosom

Self Cite

172

178

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“…As such, it raises questions about adherence to digital treatments. Although it is unknown whether these patients dropped-out as a result of the intervention or because they get worse and cannot be followed-up (Holmes et al, 2018; Karyotaki et al, 2018), nonadherence constitutes a significant barrier that should imperatively be considered before promoting the global dissemination of digital treatments, especially given the existence of a strong link between treatment adherence and outcomes (e.g., Kane, 2007; Donkin et al, 2011). Of critical importance, nonadherence increases risk for chronification and development of subsequent health problems (e.g., Martin et al, 2005).…”

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confidence: 99%

Commentary: The Impact of Digital Technology on Psychological Treatments and Their Dissemination

Heeren

2018

Front. Psychol.

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“…It has been estimated that of the primary care patients treated for depression, about 70% are treated with antidepressants (Olfson, Blanco & Marcus, 2016;Sleath, Rubin & Huston, 2001;Verhaak, van Dijk, Nuijen, Verheij & Schellevis, 2012). In the field of psychological treatment, initiatives focused on how treatments can be scaled up to reduce the treatment gap for depression and other mental disorders are a top priority (Holmes et al, 2018).…”

Section: Treatment Gapmentioning

confidence: 99%

“…The blended treatments were developed with the current treatment shortages and need for scalability of psychological treatment in mind (Holmes et al, 2018).…”

Section: Therapist Time In Blended Treatmentmentioning

confidence: 99%

“…Considerable focus has been put on the novel technologies and their possibilities, and less focus on the active mechanisms, strategies and goals of the interventions delivered (Mohr, Riper & Schueller, 2018). A critical responsibility for mental health experts is to develop and evaluate digital psychological interventions in relation to sound psychological theory and make them visible and available where they are expected and needed (Hill et al, 2017;Hollis et al, 2015;Holmes et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Blended cognitive behavior therapy : efficacy and acceptability for treating depression in the adult and adolescent population

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Depression is the most burdensome disorder worldwide in terms of health loss. The potential of internet and technologies to scale up psychological treatment resources is substantial. A blended treatment approach, reducing therapist time and combining sessions with online self-help components, could enhance availability of psychological treatment, while maintaining and possibly enhancing effect of treatment. The aim of this thesis was to develop and investigate the blended treatment approach, in terms of acceptance among key stakeholders, and clinical effect in treatment of depression in the adult and adolescent population.Study I investigated acceptance of the blended treatment approach among mental health care stakeholders by means of a European survey. The results demonstrated that the majority readily accepted blended treatment for management of mild and moderate depression.Study II evaluated blended treatment compared to standard face-toface psychotherapy in treatment of adult depression in a controlled non-inferiority trial. The results showed a similar decrease in depression from both interventions at post-treatment, with decreased levels maintained over six months. Non-inferiority for the blended treatment could not be statistically established.Study III was a controlled non-inferiority trial evaluating blended treatment compared to treatment as usual. The results indicated superiority for the blended treatment at post-treatment and partly at six months. After twelve months the outcomes in the two conditions were similar.Study IV evaluated blended treatment for adolescent depression in a controlled superiority trial, where the therapist time was not reduced, but sessions delivered via chat for improved reach and efficiency. Compared to attention control, the blended treatment significantly reduced depression symptoms, with effects indicated to be maintained over six months.Study V was a controlled superiority trial, evaluating an improved version of the blended treatment used in Study IV to similar methods and in a similar population. In comparison to minimal attention control, the blended treatment significantly reduced depression symptoms at post-treatment, corresponding to a large treatment effect.Across Study II to V, estimates indicated that the amount of therapist time that could be saved in blended treatment, compared to standard psychological treatment, was around 40%.In conclusion, a gradual, blended integration of technology into psychological treatment i) performed well in treatment of adult and adolescent populations, ii) could substantially reduce therapist time in comparison to standard face-to-face psychological treatment, and iii) was accepted by patients as well as other mental health care stakeholders.The thesis demonstrates the potentials of technology-assisted blended treatment models to deliver treatment of depression in the young and adult population in accordance with the current, urgent need to increase availability of psychological treatment as well as increase acceptance ...

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The Lancet Psychiatry Commission on psychological treatments research in tomorrow's science

Cited by 475 publications

References 295 publications

Methodological Recommendations for Trials of Psychological Interventions

Methodological Recommendations for Trials of Psychological Interventions

Commentary: The Impact of Digital Technology on Psychological Treatments and Their Dissemination

Blended cognitive behavior therapy : efficacy and acceptability for treating depression in the adult and adolescent population

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