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Principal Investigator: Dr. Heather Hadjistavropoulos Coordinator: Marcie Nugent

Principal Investigator: Dr. Heather Hadjistavropoulos Coordinator: Marcie Nugent Funded 2010-2013. Why provide Online-CBT? What is involved in Online-CBT? What are our preliminary findings? What’s next?. Reason for Collaboration.

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Principal Investigator: Dr. Heather Hadjistavropoulos Coordinator: Marcie Nugent

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  1. Principal Investigator: Dr. Heather Hadjistavropoulos Coordinator: Marcie Nugent Funded 2010-2013

  2. Why provide Online-CBT? What is involved in Online-CBT? What are our preliminary findings? What’s next?

  3. Reason for Collaboration • 11% of adults will suffer from Major Depressive Disorder (MDD) in their lifetime 1 • 28% will suffer from an anxiety disorder during their lifetime 2 • Over 70% of those with mental health or substance abuse problems receive no treatment for those problems for various reasons, such as3 • Limited access to trained mental health providers • Mobility of patients • Stigma 1. Patten et al., (2006). Canadian Journal of Psychiatry, 51, 84-90. 2. Kessler et al., (2005). Archives of General Psychiatry, 62, 617-27. 3. Statistics Canada (2002). Canadian Community Health survey: Mental Health and Well being.

  4. CLIENT THERAPIST Therapist Assisted Online-CBT • Structured self-help CBT materials presented in a systematic step by step accessible fashion via the Internet using text, video, audio, clip art • Identified therapist who provides support, encouragement, and therapeutic activities via e-mail/Internet • Research evidence supports efficacy, but Online-CBT is not yet being used frequently in practice

  5. Create a website and policies and procedures that allows therapists to provide Online-CBT to residents of Saskatchewan who have difficulties with depression, generalized anxiety, and/or panic. Provide education and training to diverse registered health professionals and students on how to deliver services online. Conduct research on how to best train therapists, and deliver and manage online-CBT in Southern Saskatchewan.

  6. General Intake Process

  7. GAD Online Example

  8. Outcome Measures • At baseline, 6 weeks, 12 weeks during treatment, 3 months, 1 year, and 2 year follow-up, clients complete outcome measures:

  9. Summary of Service Provision

  10. Percentage Excluded 26% 19.8% 15.5% 12.9% 12.9% 11.2%

  11. Client Demographic Profile

  12. 11% 22% 2% 48% 5% 10%

  13. Total= 1247 hrs

  14. Preliminary Analysis of Client OutcomesClients Complete all Measures

  15. Preliminary Analysis of Client Outcomes

  16. Intent to Treat Analysis

  17. Preliminary Intent to Treat Analysis(Completed midpoint or above)

  18. Preliminary Analysis of Treatment Satisfaction and Therapeutic Alliance *Kiropoulos, L. A., Klein, B. Austin, D. W., Gilson, K., Pier, C., Mitchell, J., & Ciechomski, L. (2008) Is internet-based CBT for panic disorder and agoraphobia as effective as face-to-face CBT? Journal of Anxiety Disorders 22(8),1273-1284

  19. Comments from Client Participants “When I was at my lowest the program gave me something to focus on. It made me feel like there was help for me and let me know that I could do something about how I felt” “For me, the best part of the program was learning techniques for coping with anxiety, in particular the breathing and guided imagery exercises” “I was really impressed with the level of communication I had with my therapist and my ability to do the program on my own time”

  20. What Should Online Therapy Look Like in Saskatchewan? • Which clients? • Which problems? • Which therapists? • What organizational framework? • Who funds?

  21. Longer Term Directions • Online Screening • Transdiagnostic modules • Shorten number of modules • Modules for specific populations (e.g., chronic pain) • Other regions in Saskatchewan

  22. New Programs Online-CBT for Older Adults with Generalized Anxiety • 7 modules • Therapist-assisted guidance where clients receive support via e-mail once per week • Eligibility • Aged 60 years and older • Experience at least moderate symptoms of generalized anxiety • Have access to and comfort in using a computer and the Internet • Not receiving other psychological services Online-CBT for Maternal Depression • 7 modules • Therapist-assisted via email and telephone • Eligibility • Be a SK resident • Aged 18 years and older • Experience minor to major depressive symptoms, • Have a child <1 year old

  23. For More Information • Dr. Heather Hadjistavropoulos • 585-5133 (hadjista@uregina.ca) • Marcie Nugent • 337-3331 (marcie.nugent@uregina.ca)

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