Transdiagnostic, psychodynamic web-based self-help intervention following inpatient psychotherapy: Results of a feasibility study and randomized controlled trial

JMIR Mental Health

Volumn 4, Issue 4, 2017, Pages

  Zwerenz, Rüdiger ^a   Becker, Jan ^a   Johansson, Robert ^b   Frederick, Ronald J ^c   Andersson, Gerhard ^b,d   Beutel, Manfred E ^a  

^a UNIVERSITY MEDICAL CENTER MAINZ   (Germany)

^b LINKÖPING UNIVERSITY   (Sweden)

^c Center for Courageous Living   (United States)

^d KAROLINSKA INSTITUTE   (Sweden)

Author keywords

Aftercare; Clinical trial; Emotion focused therapy; Inpatients; Internet; Psychoanalytic psychotherapy

Indexed keywords

EID: 85041037532     PISSN: None     EISSN: 23687959     Source Type: Journal    
DOI: 10.2196/mental.7889     Document Type: Article

References (51)

1. Jacobi F, Höfler M, Strehle J, Mack S, Gerschler A, Scholl L, et al. Mental disorders in the general population. Study on the health of adults in Germany and the additional module mental health (DEGS1-MH). Nervenarzt 2016;87(1):88-90. [doi: 10.1007/s00115-013-3961-y] [Medline: 24441882]
2. van Beljouw I, Verhaak P, Prins M, Cuijpers P, Penninx B, Bensing J. Reasons and determinants for not receiving treatment for common mental disorders. Psychiatr Serv 2010 Mar;61(3):250-257. [doi: 10.1176/ps.2010.61.3.250] [Medline: 20194401]
3. Gieselmann A, Böckermann M, Pietrowsky R. Internetbasierte Gesundheitsinterventionen. Psychotherapeut 2015 Jun 20;60(5):433-440. [doi: 10.1007/s00278-015-0038-3]
4. Barak A, Hen L, Boniel-Nissim M, Shapira N. A comprehensive review and a meta-analysis of the effectiveness of Internet-based psychotherapeutic interventions. J Technol Hum Serv 2008 Jul 03;26(2-4):109-160. [doi: 10.1080/15228830802094429]
5. Andrews G, Cuijpers P, Craske MG, McEvoy P, Titov N. Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: a meta-analysis. PLoS One 2010;5(10):e13196 [FREE Full text] [doi: 10.1371/journal.pone.0013196] [Medline: 20967242]
6. Andersson G, Cuijpers P, Carlbring P, Riper H, Hedman E. Guided Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: a systematic review and meta-analysis. World Psychiatry 2014 Oct;13(3):288-295 [FREE Full text] [doi: 10.1002/wps.20151] [Medline: 25273302]
7. Cuijpers P, Donker T, van Straten A, Li J, Andersson G. Is guided self-help as effective as face-to-face psychotherapy for depression and anxiety disorders? A systematic review and meta-analysis of comparative outcome studies. Psychol Med 2010 Dec;40(12):1943-1957. [doi: 10.1017/S0033291710000772] [Medline: 20406528]
8. Richards D, Murphy T, Viganó N, Timulak L, Doherty G, Sharry J, et al. Acceptability, satisfaction and perceived efficacy of "Space from Depression" an internet-delivered treatment for depression. Internet Interv 2016 Sep;5:12-22. [doi: 10.1016/j.invent.2016.06.007]
9. Johansson R, Björklund M, Hornborg C, Karlsson S, Hesser H, Ljótsson B, et al. Affect-focused psychodynamic psychotherapy for depression and anxiety through the Internet: a randomized controlled trial. PeerJ 2013;1:e102 [FREE Full text] [doi: 10.7717/peerj.102] [Medline: 23862104]
10. Becker J, Zwerenz R, Johansson R, Frederick RJ, Andersson G, Beutel ME. Using a transdiagnostic, psychodynamic online self-help intervention to maintain inpatient psychosomatic treatment effects: study protocol of a feasibility study. Internet Interv 2016 Sep;5:30-35. [doi: 10.1016/j.invent.2016.07.003]
11. Ebert D, Tarnowski T, Gollwitzer M, Sieland B, Berking M. A transdiagnostic internet-based maintenance treatment enhances the stability of outcome after inpatient cognitive behavioral therapy: a randomized controlled trial. Psychother Psychosom 2013;82(4):246-256. [doi: 10.1159/000345967] [Medline: 23736751]
12. Zwerenz R, Gerzymisch K, Edinger J, Holme M, Knickenberg RJ, Spörl-Dönch S, et al. Evaluation of an internet-based aftercare program to improve vocational reintegration after inpatient medical rehabilitation: study protocol for a cluster-randomized controlled trial. Trials 2013 Jan 25;14:26 [FREE Full text] [doi: 10.1186/1745-6215-14-26] [Medline: 23351836]
13. Klein JP, Berger T, Schröder J, Späth C, Meyer B, Caspar F, et al. Effects of a psychological Internet intervention in the treatment of mild to moderate depressive symptoms: results of the EVIDENT study, a randomized controlled trial. Psychother Psychosom 2016;85(4):218-228. [doi: 10.1159/000445355] [Medline: 27230863]
14. Gilbody S, Littlewood E, Hewitt C, Brierley G, Tharmanathan P, Araya R, REEACT Team. Computerised cognitive behaviour therapy (cCBT) as treatment for depression in primary care (REEACT trial): large scale pragmatic randomised controlled trial. Br Med J 2016;351:h5627 [FREE Full text] [Medline: 26559241]
15. Knowles SE, Lovell K, Bower P, Gilbody S, Littlewood E, Lester H. Patient experience of computerised therapy for depression in primary care. Br Med J Open 2015 Nov 30;5(11):e008581. [doi: 10.1136/bmjopen-2015-008581] [Medline: 26621513]
16. Zipfel S, Herzog W, Kruse J, Henningsen P. Psychosomatic medicine in Germany: more timely than ever. Psychother Psychosom 2016;85(5):262-269. [doi: 10.1159/000447701] [Medline: 27509065]
17. Franz M, Seidler D, Jenett D, Schäfer R, Wutzler U, Kämmerer W, et al. Psychodynamically oriented inpatient psychotherapy of depressive disorders - First findings from a naturalistic, multicenter study. Z Psychosom Med Psychother 2015;61(1):19-35. [doi: 10.13109/zptm.2015.61.1.19] [Medline: 25831982]
18. Zeeck A, Wietersheim JV, Weiss H, Beutel M, Hartmann A. The INDDEP study: inpatient and day hospital treatment for depression - symptom course and predictors of change. BMC Psychiatry 2013 Mar 26;13:100 [FREE Full text] [doi: 10.1186/1471-244X-13-100] [Medline: 23531019]
19. Leichsenring F, Leibing E. Psychodynamic psychotherapy: a systematic review of techniques, indications and empirical evidence. Psychol Psychother 2007 Jun;80(Pt 2):217-228. [doi: 10.1348/147608306X117394] [Medline: 17535596]
20. Buntrock C, Ebert DD, Lehr D, Smit F, Riper H, Berking M, et al. Effect of a web-based guided self-help intervention for prevention of major depression in adults with subthreshold depression: a randomized clinical trial. J Am Med Assoc 2016 May 3;315(17):1854-1863. [doi: 10.1001/jama.2016.4326] [Medline: 27139058]
21. Hedman E, Ljótsson B, Kaldo V, Hesser H, El Alaoui S, Kraepelien M, et al. Effectiveness of Internet-based cognitive behaviour therapy for depression in routine psychiatric care. J Affect Disord 2014 Feb;155:49-58. [doi: 10.1016/j.jad.2013.10.023] [Medline: 24238951]
22. Becker J, Beutel ME, Gerzymisch K, Schulz D, Siepmann M, Knickenberg RJ, et al. Evaluation of a video-based Internet intervention as preparation for inpatient psychosomatic rehabilitation: study protocol for a randomized controlled trial. Trials 2016 Jun 13;17(1):287 [FREE Full text] [doi: 10.1186/s13063-016-1417-y] [Medline: 27296249]
23. Patel V, Maj M, Flisher AJ, De Silva MJ, Koschorke M, Prince M, WPA Zonal and Member Society Representatives. Reducing the treatment gap for mental disorders: a WPA survey. World Psychiatry 2010 Oct;9(3):169-176 [FREE Full text] [Medline: 20975864]
24. Leichsenring F, Rabung S, Leibing E. The efficacy of short-term psychodynamic psychotherapy in specific psychiatric disorders: a meta-analysis. Arch Gen Psychiatry 2004 Dec;61(12):1208-1216. [doi: 10.1001/archpsyc.61.12.1208] [Medline: 15583112]
25. Fonagy P. The effectiveness of psychodynamic psychotherapies: an update. World Psychiatry 2015 Jun;14(2):137-150 [FREE Full text] [doi: 10.1002/wps.20235] [Medline: 26043322]
26. Diener MJ, Hilsenroth MJ, Weinberger J. Therapist affect focus and patient outcomes in psychodynamic psychotherapy: a meta-analysis. Am J Psychiatry 2007 Jun;164(6):936-941. [doi: 10.1176/ajp.2007.164.6.936] [Medline: 17541054]
27. Johansson R, Frederick RJ, Andersson G. Using the internet to provide psychodynamic psychotherapy. Psychodyn Psychiatry 2013 Dec;41(4):513-540. [doi: 10.1521/pdps.2013.41.4.513] [Medline: 24283446]
28. McCullogh L, Andrews S. Assimilative integration: short-term dynamic psychotherapy for treating affect phobias. Clin Psychol 2001;8(1):82-97. [doi: 10.1093/clipsy.8.1.82]
29. Kabat-Zinn J. Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life. New York City: Hachette Books; 1994.
30. Frederick RJ. Living Like You Mean It: Use the Wisdom and Power of Your Emotions to Get the Life You Really Want. Hoboken: Wiley; 2009.
31. Subic-Wrana C, Beutel ME, Knebel A, Lane RD. Theory of mind and emotional awareness deficits in patients with somatoform disorders. Psychosom Med 2010 May;72(4):404-411. [doi: 10.1097/PSY.0b013e3181d35e83] [Medline: 20223925]
32. Urbaniak GC, Plous S. Randomizer. Research Randomizer (Version 3.0) URL:https://www.randomizer.org/ [accessed 2017-09-14] [WebCite Cache ID 6tTqdAOcV]
33. Schmidt J, Lamprecht F, Wittmann W. Satisfaction with inpatient management. Development of a questionnaire and initial validity studies. Psychother Psychosom Med Psychol 1989;39:248-255.
34. Berking M, Znoj H. Development and validation of a questionnaire for standardized self-reports of emotional competences. Z Klin Psychol Psychiatr Psychother 2008 Jan;56(2):141-153. [doi: 10.1024/1661-4747.56.2.141]
35. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001 Sep;16(9):606-613 [FREE Full text] [Medline: 11556941]
36. Löwe B, Decker O, Müller S, Brähler E, Schellberg D, Herzog W, et al. Validation and standardization of the Generalized Anxiety Disorder screener (GAD-7) in the general population. Med Care 2008 Mar;46(3):266-274. [doi: 10.1097/MLR.0b013e318160d093] [Medline: 18388841]
37. Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 2006 May 22;166(10):1092-1097. [doi: 10.1001/archinte.166.10.1092] [Medline: 16717171]
38. Michal M, Glaesmer H, Zwerenz R, Knebel A, Wiltink J, Brähler E, et al. Base rates for depersonalization according to the 2-item version of the Cambridge Depersonalization Scale (CDS-2) and its associations with depression/anxiety in the general population. J Affect Disord 2011 Jan;128(1-2):106-111. [doi: 10.1016/j.jad.2010.06.033] [Medline: 20674036]
39. Brähler E, Mühlan H, Albani C, Schmidt S. Teststatistische Prüfung und Normierung der deutschen Versionen des EUROHIS-QOL Lebensqualität-Index und des WHO-5 Wohlbefindens-Index. Diagn 2007 Apr;53(2):83-96. [doi: 10.1026/0012-1924.53.2.83]
40. Roth M, Decker O, Herzberg PY, Brähler E. Dimensionality and norms of the Rosenberg self-esteem scale in a German general population sample. Eur J Psychol Assess 2008 Jan;24(3):190-197. [doi: 10.1027/1015-5759.24.3.190]
41. von Collani G, Herzberg PY. Eine revidierte Fassung der deutschsprachigen Skala zum Selbstwertgefühl von Rosenberg. Z Differ Diagn Psychol 2003 Mar;24(1):3-7. [doi: 10.1024//0170-1789.24.1.3]
42. Mittag O, Raspe H. A brief scale for measuring subjective prognosis of gainful employment: findings of a study of 4279 statutory pension insurees concerning reliability (Guttman scaling) and validity of the scale. Rehabilitation (Stuttg) 2003 Jun;42(3):169-174. [doi: 10.1055/s-2003-40095] [Medline: 12813654]
43. Gierk B, Kohlmann S, Kroenke K, Spangenberg L, Zenger M, Brähler E, et al. The somatic symptom scale-8 (SSS-8): a brief measure of somatic symptom burden. JAMA Intern Med 2014 Mar;174(3):399-407. [doi: 10.1001/jamainternmed.2013.12179] [Medline: 24276929]
44. Löwe B, Wahl I, Rose M, Spitzer C, Glaesmer H, Wingenfeld K, et al. A 4-item measure of depression and anxiety: validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population. J Affect Disord 2010 Apr;122(1-2):86-95. [doi: 10.1016/j.jad.2009.06.019] [Medline: 19616305]
45. IBM Corp. IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp; 2014.
46. Leiner D. Soscisurvey. URL:https://www.soscisurvey.de/ [accessed 2017-09-14] [WebCite Cache ID 6tTrhb5LH]
47. Weltgesundheitsorganisation. Internationale Klassifikation psychischer Störungen: ICD-10 Kapitel V (F). Diagnostische Kriterien für Forschung und Praxis. Bern: Huber; 2006.
48. Kriz D, Nübling R, Steffanowski A, Wittmann WW, Schmidt J. Patientenzufriedenheit in der stationären rehabilitation: psychometrische reanalyse des ZUF-8 auf der basis multizentrischer stichproben verschiedener indikation. Z Med Psychol 2008;17:67-79.
49. Farchione TJ, Fairholme CP, Ellard KK, Boisseau CL, Thompson-Hollands J, Carl JR, et al. Unified protocol for transdiagnostic treatment of emotional disorders: a randomized controlled trial. Behav Ther 2012 Sep;43(3):666-678 [FREE Full text] [doi: 10.1016/j.beth.2012.01.001] [Medline: 22697453]
50. Moses E, Barlow D. A new unified treatment approach for emotional disorders based on emotion science. Curr Dir Psychol Sci 2006;15(3):146-150.
51. Zwerenz R, Becker J, Knickenberg RJ, Hagen K, Dreier M, Wölfling K, et al. Enhancing inpatient psychotherapeutic treatment with online self-help: study protocol for a randomized controlled trial. Trials 2015 Mar 17;16:98 [FREE Full text] [doi: 10.1186/s13063-015-0620-6] [Medline: 25872505]