Predicting response to transdiagnostic iCBT for emotional disorders from patient and therapist involvement

Background Transdiagnostic iCBT has been shown to be effective for the treatment of emotional disorders. Less is known about the optimal level of therapist and patient involvement in these interventions. Specific characteristics of Internet-delivered interventions include treatment adherence (e.g.,...

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Autores: González Robles, Alberto, Suso Ribera, Carlos, Díaz García, Amanda, García Palacios, Azucena, Castilla, Diana, Botella, Cristina
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Universidad de Zaragoza
Repositorio:Zaguán. Repositorio Digital de la Universidad de Zaragoza
OAI Identifier:oai:zaguan.unizar.es:108371
Acceso en línea:http://zaguan.unizar.es/record/108371
Access Level:acceso abierto
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spelling Predicting response to transdiagnostic iCBT for emotional disorders from patient and therapist involvementGonzález Robles, AlbertoSuso Ribera, CarlosDíaz García, AmandaGarcía Palacios, AzucenaCastilla, DianaBotella, CristinaBackground Transdiagnostic iCBT has been shown to be effective for the treatment of emotional disorders. Less is known about the optimal level of therapist and patient involvement in these interventions. Specific characteristics of Internet-delivered interventions include treatment adherence (e.g., amount of review of the materials) and guidance (e.g., amount of therapist support). Exploring the importance of these elements in treatment outcome may help to maximize the efficiency of Internet-delivered psychological interventions. Aim In this study, we aimed to analyze the relationship between patient and therapist involvement (i.e., platform usage and amount of therapist guidance) in a sample of patients with emotional disorders who received transdiagnostic iCBT in Spanish public specialized mental healthcare services. Method This is a secondary analysis of a randomized controlled trial. The sample included 63 patients who completed transdiagnostic iCBT for emotional disorders. Platform usage metrics included number of logins into the platform and number of times the participants reviewed the modules. Therapist guidance was measured as the number of support phone calls with a therapist and their total duration (minutes). Logistic regressions and ROC analyses were performed to explore the predictive value of platform usage and therapist guidance in symptom reduction. Clinical outcomes included depressive and anxiety symptoms assessed at baseline and post-intervention. The bivariate relationship between the platform usage and therapist guidance variables was also explored. Results Overall, platform usage and therapist guidance were not associated with symptom improvement. However, the patient and therapist involvement parameters were intercorrelated. Specifically, the number of calls and their duration were associated with a greater number of logins (r = 0.61; p < .001) and more frequent reviews of the modules (0.46 ≤ r ≤ 0.60; p < .001). Higher baseline depression and anxiety were, respectively, associated with greater improvements in depression (r = −0.37, p = .003) and anxiety after treatment completion (r = −0.48, p < .001). Discussion The results suggest that there is no reliable cut-off point for platform usage and therapist guidance in predicting optimal symptom reduction. However, significant associations were found between platform usage and guidance variables that warrant additional research. More research on this topic is necessary to further clarify the role of these and other platform usage and guidance variables in Internet-delivered iCBT outcomes.2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttp://zaguan.unizar.es/record/108371reponame:Zaguán. Repositorio Digital de la Universidad de Zaragozainstname:Universidad de ZaragozaInglésinfo:eu-repo/grantAgreement/ES/ISCIII/CB06-03-0052info:eu-repo/grantAgreement/ES/MEC/FPU13-00576info:eu-repo/semantics/openAccessoai:zaguan.unizar.es:1083712026-05-29T13:59:51Z
dc.title.none.fl_str_mv Predicting response to transdiagnostic iCBT for emotional disorders from patient and therapist involvement
title Predicting response to transdiagnostic iCBT for emotional disorders from patient and therapist involvement
spellingShingle Predicting response to transdiagnostic iCBT for emotional disorders from patient and therapist involvement
González Robles, Alberto
title_short Predicting response to transdiagnostic iCBT for emotional disorders from patient and therapist involvement
title_full Predicting response to transdiagnostic iCBT for emotional disorders from patient and therapist involvement
title_fullStr Predicting response to transdiagnostic iCBT for emotional disorders from patient and therapist involvement
title_full_unstemmed Predicting response to transdiagnostic iCBT for emotional disorders from patient and therapist involvement
title_sort Predicting response to transdiagnostic iCBT for emotional disorders from patient and therapist involvement
dc.creator.none.fl_str_mv González Robles, Alberto
Suso Ribera, Carlos
Díaz García, Amanda
García Palacios, Azucena
Castilla, Diana
Botella, Cristina
author González Robles, Alberto
author_facet González Robles, Alberto
Suso Ribera, Carlos
Díaz García, Amanda
García Palacios, Azucena
Castilla, Diana
Botella, Cristina
author_role author
author2 Suso Ribera, Carlos
Díaz García, Amanda
García Palacios, Azucena
Castilla, Diana
Botella, Cristina
author2_role author
author
author
author
author
description Background Transdiagnostic iCBT has been shown to be effective for the treatment of emotional disorders. Less is known about the optimal level of therapist and patient involvement in these interventions. Specific characteristics of Internet-delivered interventions include treatment adherence (e.g., amount of review of the materials) and guidance (e.g., amount of therapist support). Exploring the importance of these elements in treatment outcome may help to maximize the efficiency of Internet-delivered psychological interventions. Aim In this study, we aimed to analyze the relationship between patient and therapist involvement (i.e., platform usage and amount of therapist guidance) in a sample of patients with emotional disorders who received transdiagnostic iCBT in Spanish public specialized mental healthcare services. Method This is a secondary analysis of a randomized controlled trial. The sample included 63 patients who completed transdiagnostic iCBT for emotional disorders. Platform usage metrics included number of logins into the platform and number of times the participants reviewed the modules. Therapist guidance was measured as the number of support phone calls with a therapist and their total duration (minutes). Logistic regressions and ROC analyses were performed to explore the predictive value of platform usage and therapist guidance in symptom reduction. Clinical outcomes included depressive and anxiety symptoms assessed at baseline and post-intervention. The bivariate relationship between the platform usage and therapist guidance variables was also explored. Results Overall, platform usage and therapist guidance were not associated with symptom improvement. However, the patient and therapist involvement parameters were intercorrelated. Specifically, the number of calls and their duration were associated with a greater number of logins (r = 0.61; p < .001) and more frequent reviews of the modules (0.46 ≤ r ≤ 0.60; p < .001). Higher baseline depression and anxiety were, respectively, associated with greater improvements in depression (r = −0.37, p = .003) and anxiety after treatment completion (r = −0.48, p < .001). Discussion The results suggest that there is no reliable cut-off point for platform usage and therapist guidance in predicting optimal symptom reduction. However, significant associations were found between platform usage and guidance variables that warrant additional research. More research on this topic is necessary to further clarify the role of these and other platform usage and guidance variables in Internet-delivered iCBT outcomes.
publishDate 2021
dc.date.none.fl_str_mv 2021
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dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv info:eu-repo/grantAgreement/ES/ISCIII/CB06-03-0052
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