JustKiddo/KiddosVault huggingface dataset:
Reduced Contact Cognitive-Behavioral Interventions for Adult Depression: A Review.

Depression is a highly prevalent and debilitating mental health condition. Evidence suggests that there is a widening gap between the demand for and availability of effective treatments. As such, there is a vast need for the development and dissemination of accessible and affordable treatments for depression. In the past decade, there has been a proliferation of reduced client-therapist contact protocols for depression. In this article, the authors review and compare the efficacy of reduced contact cognitive-behavioral interventions for adult depression across two degrees of therapist-client contact (i.e., no therapist-client contact versus minimal therapist-client contact interventions). The authors also discuss the methodological and theoretical limitations of this research base. The present review suggests that a) reduced contact interventions for depression can be effective in remediating the symptoms of depression; b) the effect sizes of some reduced contact protocols may approximate those reported in traditional protocols involving significantly greater client-therapist contact; and c) protocols which employ some form of client-therapist contact, on average, generate higher effect sizes than those that are purely self-help in nature. A discussion of the theoretical and applied implications of such findings, as well as areas in need of further research, is provided.
Sudden gains during psychological treatments of anxiety and depression: a meta-analysis.

The present study quantitatively reviewed the literature on sudden gains in psychological treatments for anxiety and depression. The authors examined the short- and long-term effects of sudden gains on treatment outcome as well as moderators of these effects. The authors conducted a literature search using PubMed, PsycINFO, the Cochrane Library, and manual searches. The meta-analysis was based on 16 studies and included 1,104 participants receiving psychological treatment for major depressive disorder or an anxiety disorder. Effect size estimates suggest that sudden gains had a moderate effect on primary outcome measures at posttreatment (Hedges's g = 0.62) and follow-up (Hedges's g = 0.56). These effect sizes were robust and unrelated to publication year or number of treatment sessions. The effect size of sudden gains in cognitive-behavioral therapy was higher (Hedges's g = 0.75) than in other treatments (Hedges's g = 0.23). These results suggest that sudden gains are associated with short-term and long-term improvements in depression and anxiety, especially in cognitive-behavioral therapy.
The long-term effects of bibliotherapy in depression treatment: Systematic review of randomized clinical trials.

Literature shows bibliotherapy can be helpful for moderate depression treatment. The aim of this systematic review is to verify the long-term effects of bibliotherapy. After bibliographic research, we included RCTs articles about bibliotherapy programme treatment of depression published in English language between 1990 and July 2017. All RCTs were assessed with Cochrane's Risk of Bias tool. Ten articles (reporting 8 studies involving 1347 subjects) out of 306 retrieved results were included. All studies analyze the effects of bibliotherapy after follow-up periods ranging from 3months to 3years and show quiet good quality in methods and analyses. The treatment was compared to standard treatments or no intervention in all studies. After long-term period follow-ups, six studies, including adults, reported a decrease of depressive symptoms, while four studies including young people did not show significant results. Bibliotherapy appears to be effective in the reduction of adults depressive symptoms in the long-term period, providing an affordable prompt treatment that could reduce further medications. The results of the present review suggest that bibliotherapy could play an important role in the treatment of a serious mental health issue. Further studies should be conducted to strengthen the evidence of bibliotherapy's efficacy.
Dropout from individual psychotherapy for major depression: A meta-analysis of randomized clinical trials.

Dropout from mental health treatment poses a substantial problem, but rates vary substantially across studies and diagnoses. Focused reviews are needed to provide more detailed estimates for specific areas of research. Randomized clinical trials involving individual psychotherapy for unipolar depression are ubiquitous and important, but empirical data on average dropout rates from these studies is lacking. We conducted a random-effects meta-analysis of 54 such studies (N=5852) including 80 psychotherapy conditions, and evaluated a number of predictors of treatment- and study-level dropout rates. Our overall weighted dropout estimates were 19.9% at the study level, and 17.5% for psychotherapy conditions specifically. Therapy orientation did not significantly account for variance in dropout estimates, but estimates were significantly higher in psychotherapy conditions with more patients of minority racial status or with comorbid personality disorders. Treatment duration was also positively associated with dropout rates at trend level. Studies with an inactive control comparison had higher dropout rates than those without such a condition. Limitations include the inability to test certain potential predictors (e.g., socioeconomic status) due to infrequent reporting. Overall, our findings suggest the need to consider how specific patient and study characteristics may influence dropout rates in clinical research on individual therapy for depression.
Long-term effects of psychotherapy on moderate depression: a comparative study of narrative therapy and cognitive-behavioral therapy.

In a previous clinical controlled trial (Lopes et al., 2014), narrative therapy (NT) showed promising results in ameliorating depressive symptoms with comparable outcomes to cognitive-behavioral therapy (CBT) when patients completed treatment. This paper aims to assess depressive symptoms and interpersonal problems in this clinical sample at follow-up. Using the Beck Depression Inventory-II and Outcome Questionnaire-45.2 Interpersonal Relations Scale, naturalistic prospective follow-up assessment was conducted at 21 and 31 months after the last treatment session. At follow-up, patients kept improving in terms of depressive symptoms and interpersonal problems. The odds that a patient maintained recovery from depressive symptoms at follow-up were five times higher than the odds that a patient maintained recovery from interpersonal problems. In the same way, the odds of a patient never recovering from interpersonal problems were five times higher than the odds of never recovering from depressive symptoms. The study did not control for the natural course of depression or treatment continuation. For depressed patients with greater interpersonal disabilities, longer treatment plans and alternative continuation treatments should be considered.
I didn't know cognitive therapy was deep: a case study of sudden and lasting gains in cognitive-supportive therapy of depression.

Sudden gains is a robust phenomenon that has been found to occur among a variety of psychotherapies, clinical conditions, settings, patient populations, and differing levels of therapist expertise. Sudden gains predict superior end-of-treatment outcomes and long-term maintenance of gains. While cognitive changes during the critical session appear to account for the sudden gains, the nature of these changes has not been fully explained, and no detailed reports of how therapists and patients explain these changes have been presented. This case involved a 61-year-old woman with depression, fibromyalgia, and severe osteoarthritis who, after being in psychotherapy treatment for nearly a year, achieved sudden gains after one particular psychotherapy session. The authors discuss the nature of the cognitive changes that both the patient and therapist understood to occur during that critical session and that they believed contributed to the remission of major depressive disorder over a 2-year period. This case study also explores the possible synergistic effects of medications and cognitive interventions on sudden gains. The commentary on the case links this discussion of sudden gains to an intervention created by Viederman and Perry in the 1980s called the psychodynamic life narrative, which they found could sometimes alleviate symptoms rapidly and dramatically by reframing a person's self-image during a depressive crisis, especially one related to a feeling of despair triggered by medical illness. An increased understanding of the nature of interventions that produce cognitive changes leading to immediate, dramatic, and lasting improvement could potentially contribute to the development of more effective treatments for depression and other clinical conditions.
Feasibility of a blended group treatment (bGT) for major depression: uncontrolled interventional study in a university setting.

This study investigated the feasibility of a novel blended (face-to-face and computer-based) group intervention for the reduction of depressive symptoms in major depression. Patient-centred uncontrolled interventional study. University setting in a general community sample. A multimodal recruitment strategy (public health centres and public areas) was applied. Based on independent interviews, 26 participants, diagnosed with major depressive disorder (81% female; 23% comorbidity >1 and 23% comorbidity >2), entered treatment. Acceptance and mindfulness based, as well as self-management and resource-oriented psychotherapy principles served as the theoretical basis for the low-threshold intervention. The blended format included face-to-face sessions, complemented with multimedia presentations and a platform featuring videos, online work sheets, an unguided group chat and remote therapist-patient communication. The Center for Epidemiological Studies-Depression scale and the 12-item General Health Questionnaire. Large to very large within group effect sizes were found on self-reported depression (F(2, 46.37)=25.69, p<0.001; d=1.80), general health (F(2,46.73)=11.47, p<0.001; d=1.32), personal resources (F(2,43.36)=21.17, p<0.001; d=0.90) and mindfulness (F(2,46.22)=9.40, p<0.001; d=1.12) after a follow-up period of 3months. Treatment satisfaction was high, and 69% ranked computer and multimedia use as a therapeutic factor. Furthermore, participants described treatment intensification as important advantage of the blended format. Half of the patients (48%) would have preferred more time for personal exchange. The investigated blended group format seems feasible for the reduction of depressive symptoms in major depression. The development of blended interventions can benefit from assuring that highly structured treatments actually meet patients' needs. As a next step, the intervention should be tested in comparative trials in routine care. DRKS00010894; Pre-results.
Analysis of the Components of a Cognitive-Behavioral Intervention for the prevention of Depression Administered via Conference Call to Nonprofessional Caregivers: A Randomized Controlled Trial.

Effective and accessible interventions for indicated prevention of depression are necessary and lacking, especially for informal caregivers. Although telephone-based interventions could increase the accessibility for caregivers, randomized controlled trials are scarce, with no examination of prevention to date. Moreover, the efficacy of specific therapeutic components in preventive cognitive-behavioral programs is unknown. The main objective of this study was to evaluate the efficacy of a telephone-administered psychological preventive intervention in informal caregivers with high depressive symptoms. A total of 219 caregivers were randomized to a cognitive-behavioral conference call intervention (CBCC, n = 69), a behavioral-activation conference call intervention (BACC, n = 70), or a usual care control group (CG, n = 80). Both interventions consisted of five 90-minute group sessions. At the post-intervention, incidence of depression was lower in CBCC and BACC compared to CG (1.5% and 1.4% vs. 8.8%). Relative risk was 0.17 for the CBCC and 0.16 for the BACC, and the number-needed-to-treat was 14 in both groups. Depressive symptoms were significantly lower in BACC and BACC groups compared to CG (d = 1.16 and 1.29), with no significant differences between CBCC and BACC groups. The conference call intervention was effective in preventing depression and the behavioral-activation component (BACC) was comparable to the CBCC intervention.
[Short-Term Psychodynamic Therapy in Depression - An Evidence-Based Unified Protocol].

With a lifetime prevalence of about 17% depression is the most common mental disorder. Psychotherapy is efficacious in the treatment of depression, with no significant differences between different forms of psychotherapies. For psychodynamic therapy (PDT) various models proved to be efficacious in randomized controlled trials (RCTs). As a consequence the evidence for PDT is scattered between different forms or orientations of PDT entailing problems regarding psychotherapy training and the transfer of research into clinical practice. Thus, our aim was to develop a unified protocol for the dynamic treatment of depression that is based on those models of PDT that proved efficacious in randomized controlled trials (RCTs). As a first step we conducted a systematic search of RCTs investigating manualized or manual-based individual psychodynamic therapy for depressive disorders in adults that proved to be efficacious compared to comparison conditions. 11 studies fulfilled our inclusion criteria. In a second step we systematically reviewed the studies with regard to the treatment concepts they had applied. 7 highly consistent treatment components could be identified. We conceptualized them in the form of 7 interrelated treatment modules which constitute the unified psychodynamic protocol for depression. The protocol may enhance the empirical status of PDT and facilitate both psychotherapy training as well as the transfer of research to clinical practice. Through the focused use of techniques that proofed efficacious it is expected to bring more benefit to depressed patients and therefore also have a positive impact on the health care system.
Depression self-management support: a systematic review.

To systematically review empirical evidence regarding the efficacy of depression self-management support (SMS) interventions for improving depression symptomatology and preventing relapse. Pubmed and PsycINFO databases were searched for relevant articles on depression SMS interventions. Scanning of references in the articles and relevant reviews and communications with field experts yielded additional articles. Two independent reviewers analyzed the articles for inclusion and data was extracted from the selected articles. 13 papers met the inclusion criteria and reported the results of six separate studies, including three pilot studies. The results were mostly positive. A majority of the trials assessing depression severity changes found SMS to be superior to care as usual. SMS interventions were found to improve self-management behaviors and self-efficacy. Mixed results were found concerning relapse rates. Promising results were found on assessments of functional status. Based on the findings, cost-effectiveness remains unclear. SMS has been mostly examined through pilot studies with insufficient power. The results are promising, but larger randomized controlled trials are needed. SMS interventions can be administered by non-physician professionals and are well accepted by patients, but more research is needed before we can recommend implementing specific depression SMS approaches in primary care.
Activation therapy for the treatment of inpatients with depression - protocol for a randomised control trial compared to treatment as usual.

Inpatients with depression have a poor long term outcome with high rates of suicide, high levels of morbidity and frequent re-admission. Current treatment often relies on pharmacological intervention and focuses on observation to maintain safety. There is significant neurocognitive deficit which is linked to poor functional outcomes. As a consequence, there is a need for novel psychotherapeutic interventions that seek to address these concerns. We combined cognitive activation and behavioural activation to create activation therapy (AT) for the treatment of inpatient depression and conducted a small open label study which demonstrated acceptability and feasibility. We propose a randomised controlled trial which will compare treatment as usual (TAU) with TAU plus activation therapy for adult inpatients with a major depressive episode. The behavioural activation component involves therapist guided re-engagement with previously or potentially rewarding activities. The cognitive activation aspect utilises computer based exercises which have been shown to improve cognitive function. The proposed randomised controlled trial will examine whether or not the addition of this therapy to TAU will result in a reduced re-hospitalisation rate at 12weeks post discharge. Subjective change in activation and objectively measured change in activity levels will be rated, and the extent of change to neurocognition will be assessed. Unique trial number: U1111-1190-9517. Australian New Zealand Clinical Trials Registry (ANZCTR) number: ACTRN12617000024347p .
The efficacy of behavioural activation treatment for co-occurring depression and substance use disorder (the activate study): a randomized controlled trial.

Epidemiological studies suggest that compared with the general population, mood disorders are up to 4.7 times more prevalent in substance dependent samples. Comorbid substance use disorder (SUD) and depression has been associated with a more severe and protracted illness course and poorer treatment outcomes. Despite this, the development and assessment of behavioural interventions for treating depression among individuals with SUDs have received little empirical attention. Behavioural Activation Treatment for Depression (BATD-R) is an empirically supported treatment for depression that has shown some efficacy among substance users. This paper describes the study protocol of a parallel, single blind, randomised controlled trial to determine the efficacy and feasibility of a modified version of the BATD-R (Activate) in reducing symptoms of depression and substance dependence among individuals in residential rehabilitation (RR) and opioid substitution therapy (OST). A sample of approximately 200 individuals with depressive symptomatology in treatment for SUD will be recruited from RR and OST services in New South Wales, Australia. Dynamic random allocation following minimisation methodology will be used to assign participants to one of two groups. The control group will receive treatment as usual (TAU), which will be the model of care provided in accordance with standard practice at participating RR and OST services. The intervention group will receive Activate, comprising 10 individual 60-min therapy sessions with a psychologist employed on the research team, in addition to TAU. Data collection will occur at baseline (pre-intervention), and 3-months and 12-months post baseline. The association between depression and substance dependence has been well documented, yet practical and effective treatments are scarce. The findings of the present study will contribute significantly to understanding the types of programs that are effective in treating this comorbidity. This trial is registered with the Australian and New Zealand Clinical Trials registry, ACTRN12613000876796 . Registered on 7 August, 2013.
Sudden gains and treatment outcomes among depressed individuals in a partial hospitalization programme.

Sudden gains commonly occur among patients receiving psychotherapy for depression and have been found to consistently predict better treatment outcomes. However, the majority of prior research has examined sudden gains primarily in weekly or biweekly treatment settings. Individuals were divided into two groups: those who experienced at least one sudden gain and those who did not. Rates of sudden gain occurrence, pretreatment factors and posttreatment outcomes were examined between the two groups. Over 60% of this sample experienced at least one sudden gain, the majority of which occurred during the first 3days of treatment. Sudden gains were associated with significantly lower baseline depression and anxiety severity. Patients who experienced sudden gains reported significantly greater improvement in depressive and anxiety symptoms, coping skills, functioning, positive mental health and well-being at treatment termination. This study was conducted in a single location with a relatively homogeneous sample. Due to a lack of follow-up data, we were unable to determine if treatment outcomes were sustained after treatment termination. The assessment timeline of the depressive symptoms differs between baseline and daily scales, which may have affected the number of observed sudden gains after the initial treatment day. The proportion of sudden gains in this study is higher than those found in outpatient settings, demonstrating that this phenomenon may commonly occur among depressed patients in acute treatment. These results suggest that the mechanisms by which sudden gains occur may be reinforced by daily, intensive treatment.
EFFECTS OF RELIGIOUS VERSUS STANDARD COGNITIVE-BEHAVIORAL THERAPY ON OPTIMISM IN PERSONS WITH MAJOR DEPRESSION AND CHRONIC MEDICAL ILLNESS.

We compared the effectiveness of religiously integrated cognitive behavioral therapy (RCBT) versus standard CBT (SCBT) on increasing optimism in persons with major depressive disorder (MDD) and chronic medical illness. Participants aged 18-85 were randomized to either RCBT (n = 65) or SCBT (n = 67) to receive ten 50-min sessions remotely (94% by telephone) over 12 weeks. Optimism was assessed at baseline, 12 and 24 weeks by the Life Orientation Test-Revised. Religiosity was assessed at baseline using a 29-item scale composed of religious importance, individual religious practices, intrinsic religiosity, and daily spiritual experiences. Mixed effects growth curve models were used to compare the effects of treatment group on trajectory of change in optimism. In the intention-to-treat analysis, both RCBT and SCBT increased optimism over time, although there was no significant difference between treatment groups (B = -0.75, SE = 0.57, t = -1.33, P = .185). Analyses in the highly religious and in the per protocol analysis indicated similar results. Higher baseline religiosity predicted an increase in optimism over time (B = 0.07, SE = 0.02, t = 4.12, P < .0001), and higher baseline optimism predicted a faster decline in depressive symptoms over time (B = -0.61, SE = 0.10, t = -6.30, P < .0001), both independent of treatment group. RCBT and SCBT are equally effective in increasing optimism in persons with MDD and chronic medical illness. While baseline religiosity does not moderate this effect, religiosity predicts increases in optimism over time independent of treatment group.