ICBT in routine care: A descriptive analysis of successful clinics in five countries
Clinical trials have demonstrated the efficacy of internet delivered cognitive behaviour therapy (ICBT) for anxiety and depression. However, relatively little is known about the context, operations, and outcomes of ICBT when administered as part of routine care. This paper describes the setting, rel...
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| Published in: | Internet interventions : the application of information technology in mental and behavioural health Vol. 13; pp. 108 - 115 |
|---|---|
| Main Authors: | , , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Netherlands
Elsevier B.V
01.09.2018
Elsevier |
| Subjects: | |
| ISSN: | 2214-7829, 2214-7829 |
| Online Access: | Get full text |
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| Abstract | Clinical trials have demonstrated the efficacy of internet delivered cognitive behaviour therapy (ICBT) for anxiety and depression. However, relatively little is known about the context, operations, and outcomes of ICBT when administered as part of routine care. This paper describes the setting, relationship to existing health services, procedures for referral, assessment, treatment, patients and outcomes of ICBT clinics in Sweden, Denmark, Norway, Canada and Australia.
All five clinics provide services free or at low cost to patients. All have systems of governance to monitor quality of care, patient safety, therapist performance and data security. All five clinics include initial assessments by clinicians and between 10 and 20 min of therapist support during each week. Published reports of outcomes all demonstrate large clinical improvement, low rates of deterioration, and high levels of patient satisfaction. Services that require a face to face assessment treat smaller numbers of patients and have fewer patients from remote locations.
The paper shows that therapist-guided ICBT can be a valuable part of mental health services for anxiety and depression. Important components of successful ICBT services are rigorous governance to maintain a high standard of clinical care, and the measurement and reporting of outcomes.
•This study describes internet-delivered cognitive behaviour therapy (ICBT) in routine care in five high income countries•Each service uses a comprehensive framework of policies and procedures to ensure patient safety, data safety, and service quality•Each clinic measures outcomes to monitor progress and safety, and demonstrate the effectiveness of ICBT in routine care•The provision of these services within public health systems enables services to be offered free or at low cost•High quality ICBT can be tailored to local contexts and delivered to a large number of patients in routine clinical care |
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| AbstractList | Clinical trials have demonstrated the efficacy of internet delivered cognitive behaviour therapy (ICBT) for anxiety and depression. However, relatively little is known about the context, operations, and outcomes of ICBT when administered as part of routine care. This paper describes the setting, relationship to existing health services, procedures for referral, assessment, treatment, patients and outcomes of ICBT clinics in Sweden, Denmark, Norway, Canada and Australia. All five clinics provide services free or at low cost to patients. All have systems of governance to monitor quality of care, patient safety, therapist performance and data security. All five clinics include initial assessments by clinicians and between 10 and 20 min of therapist support during each week. Published reports of outcomes all demonstrate large clinical improvement, low rates of deterioration, and high levels of patient satisfaction. Services that require a face to face assessment treat smaller numbers of patients and have fewer patients from remote locations. The paper shows that therapist-guided ICBT can be a valuable part of mental health services for anxiety and depression. Important components of successful ICBT services are rigorous governance to maintain a high standard of clinical care, and the measurement and reporting of outcomes. Clinical trials have demonstrated the efficacy of internet delivered cognitive behaviour therapy (ICBT) for anxiety and depression. However, relatively little is known about the context, operations, and outcomes of ICBT when administered as part of routine care. This paper describes the setting, relationship to existing health services, procedures for referral, assessment, treatment, patients and outcomes of ICBT clinics in Sweden, Denmark, Norway, Canada and Australia.All five clinics provide services free or at low cost to patients. All have systems of governance to monitor quality of care, patient safety, therapist performance and data security. All five clinics include initial assessments by clinicians and between 10 and 20 min of therapist support during each week. Published reports of outcomes all demonstrate large clinical improvement, low rates of deterioration, and high levels of patient satisfaction. Services that require a face to face assessment treat smaller numbers of patients and have fewer patients from remote locations.The paper shows that therapist-guided ICBT can be a valuable part of mental health services for anxiety and depression. Important components of successful ICBT services are rigorous governance to maintain a high standard of clinical care, and the measurement and reporting of outcomes. Keywords: Delivery, Description, Implementation, Internet-delivered cognitive behaviour therapy, Psychological treatment, Routine care, Depression, Anxiety, Disorders Clinical trials have demonstrated the efficacy of internet delivered cognitive behaviour therapy (ICBT) for anxiety and depression. However, relatively little is known about the context, operations, and outcomes of ICBT when administered as part of routine care. This paper describes the setting, relationship to existing health services, procedures for referral, assessment, treatment, patients and outcomes of ICBT clinics in Sweden, Denmark, Norway, Canada and Australia. All five clinics provide services free or at low cost to patients. All have systems of governance to monitor quality of care, patient safety, therapist performance and data security. All five clinics include initial assessments by clinicians and between 10 and 20 min of therapist support during each week. Published reports of outcomes all demonstrate large clinical improvement, low rates of deterioration, and high levels of patient satisfaction. Services that require a face to face assessment treat smaller numbers of patients and have fewer patients from remote locations. The paper shows that therapist-guided ICBT can be a valuable part of mental health services for anxiety and depression. Important components of successful ICBT services are rigorous governance to maintain a high standard of clinical care, and the measurement and reporting of outcomes. • This study describes internet-delivered cognitive behaviour therapy (ICBT) in routine care in five high income countries • Each service uses a comprehensive framework of policies and procedures to ensure patient safety, data safety, and service quality • Each clinic measures outcomes to monitor progress and safety, and demonstrate the effectiveness of ICBT in routine care • The provision of these services within public health systems enables services to be offered free or at low cost • High quality ICBT can be tailored to local contexts and delivered to a large number of patients in routine clinical care Clinical trials have demonstrated the efficacy of internet delivered cognitive behaviour therapy (ICBT) for anxiety and depression. However, relatively little is known about the context, operations, and outcomes of ICBT when administered as part of routine care. This paper describes the setting, relationship to existing health services, procedures for referral, assessment, treatment, patients and outcomes of ICBT clinics in Sweden, Denmark, Norway, Canada and Australia. All five clinics provide services free or at low cost to patients. All have systems of governance to monitor quality of care, patient safety, therapist performance and data security. All five clinics include initial assessments by clinicians and between 10 and 20 min of therapist support during each week. Published reports of outcomes all demonstrate large clinical improvement, low rates of deterioration, and high levels of patient satisfaction. Services that require a face to face assessment treat smaller numbers of patients and have fewer patients from remote locations. The paper shows that therapist-guided ICBT can be a valuable part of mental health services for anxiety and depression. Important components of successful ICBT services are rigorous governance to maintain a high standard of clinical care, and the measurement and reporting of outcomes.Clinical trials have demonstrated the efficacy of internet delivered cognitive behaviour therapy (ICBT) for anxiety and depression. However, relatively little is known about the context, operations, and outcomes of ICBT when administered as part of routine care. This paper describes the setting, relationship to existing health services, procedures for referral, assessment, treatment, patients and outcomes of ICBT clinics in Sweden, Denmark, Norway, Canada and Australia. All five clinics provide services free or at low cost to patients. All have systems of governance to monitor quality of care, patient safety, therapist performance and data security. All five clinics include initial assessments by clinicians and between 10 and 20 min of therapist support during each week. Published reports of outcomes all demonstrate large clinical improvement, low rates of deterioration, and high levels of patient satisfaction. Services that require a face to face assessment treat smaller numbers of patients and have fewer patients from remote locations. The paper shows that therapist-guided ICBT can be a valuable part of mental health services for anxiety and depression. Important components of successful ICBT services are rigorous governance to maintain a high standard of clinical care, and the measurement and reporting of outcomes. Clinical trials have demonstrated the efficacy of internet delivered cognitive behaviour therapy (ICBT) for anxiety and depression. However, relatively little is known about the context, operations, and outcomes of ICBT when administered as part of routine care. This paper describes the setting, relationship to existing health services, procedures for referral, assessment, treatment, patients and outcomes of ICBT clinics in Sweden, Denmark, Norway, Canada and Australia. All five clinics provide services free or at low cost to patients. All have systems of governance to monitor quality of care, patient safety, therapist performance and data security. All five clinics include initial assessments by clinicians and between 10 and 20 min of therapist support during each week. Published reports of outcomes all demonstrate large clinical improvement, low rates of deterioration, and high levels of patient satisfaction. Services that require a face to face assessment treat smaller numbers of patients and have fewer patients from remote locations. The paper shows that therapist-guided ICBT can be a valuable part of mental health services for anxiety and depression. Important components of successful ICBT services are rigorous governance to maintain a high standard of clinical care, and the measurement and reporting of outcomes. •This study describes internet-delivered cognitive behaviour therapy (ICBT) in routine care in five high income countries•Each service uses a comprehensive framework of policies and procedures to ensure patient safety, data safety, and service quality•Each clinic measures outcomes to monitor progress and safety, and demonstrate the effectiveness of ICBT in routine care•The provision of these services within public health systems enables services to be offered free or at low cost•High quality ICBT can be tailored to local contexts and delivered to a large number of patients in routine clinical care |
| Author | Mathiasen, Kim Dear, Blake Hadjistavropoulos, Heather Nugent, Marcie Titov, Nickolai Kraepelien, Martin Svanborg, Cecilia Adlam, Kelly Nordgreen, Tine Nielssen, Olav Repål, Arne Bruvik, Kristin Hogstad Lindefors, Nils Kaldo, Viktor Staples, Lauren Hovland, Anders Blom, Kerstin |
| AuthorAffiliation | d Division of Psychiatry, Haukeland University Hospital, Bergen, Norway b MindSpot Clinic, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia j Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Sweden a MindSpot Clinic, Department of Psychology, Macquarie University, Sydney, Australia k Department of Psychology, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden f Department of Clinical Psychology, University of Bergen, Norway i Centre for Telepsychiatry, Mental Health Services of Southern Denmark, Denmark e Solli District Psychiatric Centre, Nesttun, Norway g Vestfold Hospital, Norway c Department of Psychology, University of Regina, Regina, Canada h Department of Psychology, Faculty of Health Sciences, University of Southern Denmark, Denmark |
| AuthorAffiliation_xml | – name: i Centre for Telepsychiatry, Mental Health Services of Southern Denmark, Denmark – name: e Solli District Psychiatric Centre, Nesttun, Norway – name: c Department of Psychology, University of Regina, Regina, Canada – name: j Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Sweden – name: a MindSpot Clinic, Department of Psychology, Macquarie University, Sydney, Australia – name: f Department of Clinical Psychology, University of Bergen, Norway – name: k Department of Psychology, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden – name: g Vestfold Hospital, Norway – name: b MindSpot Clinic, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia – name: d Division of Psychiatry, Haukeland University Hospital, Bergen, Norway – name: h Department of Psychology, Faculty of Health Sciences, University of Southern Denmark, Denmark |
| Author_xml | – sequence: 1 givenname: Nickolai surname: Titov fullname: Titov, Nickolai email: nick.titov@mq.edu.au organization: MindSpot Clinic, Department of Psychology, Macquarie University, Sydney, Australia – sequence: 2 givenname: Blake surname: Dear fullname: Dear, Blake organization: MindSpot Clinic, Department of Psychology, Macquarie University, Sydney, Australia – sequence: 3 givenname: Olav surname: Nielssen fullname: Nielssen, Olav organization: MindSpot Clinic, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia – sequence: 4 givenname: Lauren surname: Staples fullname: Staples, Lauren organization: MindSpot Clinic, Department of Psychology, Macquarie University, Sydney, Australia – sequence: 5 givenname: Heather surname: Hadjistavropoulos fullname: Hadjistavropoulos, Heather organization: Department of Psychology, University of Regina, Regina, Canada – sequence: 6 givenname: Marcie surname: Nugent fullname: Nugent, Marcie organization: Department of Psychology, University of Regina, Regina, Canada – sequence: 7 givenname: Kelly surname: Adlam fullname: Adlam, Kelly organization: Department of Psychology, University of Regina, Regina, Canada – sequence: 8 givenname: Tine surname: Nordgreen fullname: Nordgreen, Tine organization: Division of Psychiatry, Haukeland University Hospital, Bergen, Norway – sequence: 9 givenname: Kristin Hogstad surname: Bruvik fullname: Bruvik, Kristin Hogstad organization: Division of Psychiatry, Haukeland University Hospital, Bergen, Norway – sequence: 10 givenname: Anders surname: Hovland fullname: Hovland, Anders organization: Solli District Psychiatric Centre, Nesttun, Norway – sequence: 11 givenname: Arne surname: Repål fullname: Repål, Arne organization: Vestfold Hospital, Norway – sequence: 12 givenname: Kim orcidid: 0000-0001-6067-8866 surname: Mathiasen fullname: Mathiasen, Kim organization: Department of Psychology, Faculty of Health Sciences, University of Southern Denmark, Denmark – sequence: 13 givenname: Martin orcidid: 0000-0002-5294-4156 surname: Kraepelien fullname: Kraepelien, Martin organization: Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Sweden – sequence: 14 givenname: Kerstin orcidid: 0000-0002-6681-0554 surname: Blom fullname: Blom, Kerstin organization: Division of Psychiatry, Haukeland University Hospital, Bergen, Norway – sequence: 15 givenname: Cecilia surname: Svanborg fullname: Svanborg, Cecilia organization: Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Sweden – sequence: 16 givenname: Nils orcidid: 0000-0002-7369-4969 surname: Lindefors fullname: Lindefors, Nils organization: Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Sweden – sequence: 17 givenname: Viktor surname: Kaldo fullname: Kaldo, Viktor organization: Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Sweden |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30206525$$D View this record in MEDLINE/PubMed https://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-80572$$DView record from Swedish Publication Index (Linnéuniversitetet) |
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| Keywords | Internet-delivered cognitive behaviour therapy Description Disorders Depression Routine care Anxiety Delivery Implementation Psychological treatment |
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40 Klein (10.1016/j.invent.2018.07.006_bb0200) 2011; 13 Kivi (10.1016/j.invent.2018.07.006_bb0195) 2014; 43 Damschroder (10.1016/j.invent.2018.07.006_bb0075) 2009; 4 Erbe (10.1016/j.invent.2018.07.006_bb0110) 2017; 19 Andersson (10.1016/j.invent.2018.07.006_bb0010) 2014; 13 Hedman (10.1016/j.invent.2018.07.006_bb0155) 2012; 12 Wootton (10.1016/j.invent.2018.07.006_bb0395) 2015; 2 Nordmo (10.1016/j.invent.2018.07.006_bb0280) 2015; 2 Andersson (10.1016/j.invent.2018.07.006_bb0020) 2006; 74 Bergstrom (10.1016/j.invent.2018.07.006_bb0040) 2010; 10 Lee (10.1016/j.invent.2018.07.006_bb0205) 2017; 20 Bee (10.1016/j.invent.2018.07.006_bb0035) 2008; 8 Twomey (10.1016/j.invent.2018.07.006_bb0365) 2015; 32 Clark (10.1016/j.invent.2018.07.006_bb0055) 2018; 391 Richards (10.1016/j.invent.2018.07.006_bb0300) 2012; 32 |
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Med. doi: 10.1017/S0033291710000772 – volume: 8 issue: 2 year: 2013 ident: 10.1016/j.invent.2018.07.006_bb0380 article-title: The effectiveness of Internet cognitive behavioural therapy (iCBT) for depression in primary care: a quality assurance study publication-title: PLoS One doi: 10.1371/journal.pone.0057447 – volume: 19 issue: 9 year: 2017 ident: 10.1016/j.invent.2018.07.006_bb0110 article-title: Blending face-to-face and internet-based interventions for the treatment of mental disorders in adults: systematic review publication-title: J. Med. Internet Res. doi: 10.2196/jmir.6588 |
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| SubjectTerms | Anxiety Delivery Depression Description Disorders Health Informatics Hälsoinformatik Implementation Internet-delivered cognitive behaviour therapy Psychological treatment Psychology Psykologi Review Routine care |
| Title | ICBT in routine care: A descriptive analysis of successful clinics in five countries |
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