Predicting response to transdiagnostic iCBT for emotional disorders from patient and therapist involvement
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González-Robles, Alberto; Suso Ribera, Carlos; Díaz García, Amanda; García Palacios, Azucena; Castilla López, Diana Virginia; Botella Arbona, Cristina
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Aquest document és un/a article, creat/da en: 2021
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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 character-istics 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 trans-diagnostic 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).
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