Background: Cognitive Behaviour Therapy (CBT) is one of the most successful therapeutic approaches for treating anxiety and depression. Clinical trials show that for some clients, internet-based CBT (eCBT) is as effective as other CBT delivery modes. However, the fidelity of these effects may be weakened in real-world settings where clients and providers have the freedom to choose a CBT delivery mode and switch treatments at any time. The purpose of this study is to measure the CBT attendance rate and identify client-level characteristics associated with delivery mode selection and having reliable and clinically significant improvement (RCSI) of treatment in each delivery mode in a real-world CBT outpatient program.
Methods: This is a retrospective cohort analysis of electronic medical records collected between May 1, 2019, and March 31, 2022, at Ontario Shores Centre for Mental Health Sciences. Regression models were used to investigate the impact of individual client characteristics on participation and achieving RCSI of different CBT delivery modes.
Results: Our data show a high attendance rate for two and more CBT sessions across all modalities (98% of electronic, 94% of group, 100% of individual, and 99% of mixed CBT). Individuals were more likely to enter mixed and group CBT modality if they were younger, reported being employed, and reported higher depression severity at the baseline. Among the four modalities of CBT delivery, group CBT clients were least likely to have RCSI. Of those who started sessions, clients were significantly more likely to experience RCSI on the Patient Health Questionnaire (PHQ)-9 and the Generalized Anxiety Disorder (GAD)-7 if they were employed, reported more severe symptoms at baseline, and were living in the most deprived neighborhoods.
Conclusions: This study will contribute to the body of knowledge about the implementation and treatment planning of different CBT delivery modes in real-world settings. With the changing clinical environment, it is possible to advocate for the adoption of the eCBT intervention to improve therapy practices and achieve better treatment success. The findings can help guide future CBT program planning based on client socio-demographic characteristics, allowing the optimal therapy type to be targeted to the right client at the right time.
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http://dx.doi.org/10.1186/s12888-024-05817-w | DOI Listing |
J Med Internet Res
January 2025
NOCD, Inc, Chicago, IL, United States.
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View Article and Find Full Text PDFPsychooncology
January 2025
West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Trials
January 2025
Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.
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View Article and Find Full Text PDFBioconjug Chem
January 2025
School of Chemistry and Materials Science, University of Science and Technology of China, Hefei 230026, China.
Positron-emission tomography (PET) offers high sensitivity for cancer diagnosis. However, small-molecule-based probes often exhibit insufficient accumulation in tumor sites, while nanoparticle-based agents typically have limited delivery efficiency. To address this challenge, this study proposes a novel PET imaging probe, Ga-CBT-PSMA, designed for prostate cancer.
View Article and Find Full Text PDFClin Psychol Rev
January 2025
Department of Experimental Psychology, University of Oxford, Oxford, UK.
Previous studies have indicated wide variation in the effectiveness of cognitive and behaviour therapies (CBTs) for preventing and treating anxiety disorders in children and adolescents, indicating the presence of moderators influencing outcomes. This meta-analysis investigated whether sample characteristics (child age, child baseline anxiety levels, parental baseline anxiety levels) and intervention characteristics (intervention duration, facilitator contact time, facilitator background, delivery formats, parental involvement) moderate the effectiveness of CBTs for universal prevention, targeted prevention, and treatment of anxiety disorders in children and adolescents. We identified 86 eligible randomized controlled trials (RCTs) assessing the effectiveness of 98 CBTs versus non-active controls.
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