Attitudes of Professionals and the General Public in Israel Regarding ICBT
Condition: Panic Disorder; Depression
MeSH terms: Depression; Panic Disorder
Study type: Interventional

Summary: 
      This study examines uptake and attrition for internet based treatments for panic disorder and
      depression in Israel The primary benefits of this work will be a) in providing better
      understanding of ICBT for panic disorder and depression outcomes. Both panic and depression
      are heavy public health burdens, associated with a significant market potential for both
      therapeutic and diagnostic uses. b) In providing compatible scale to measure the working
      alliance during internet-based treatment.
    

Detailed description: 
      The current study examines ICBT for panic and depression in Israel. Compelling evidence
      regarding the efficacy of ICBT has been reported for the treatment of depression and various
      anxiety disorders (Mayo-Wilson & Montgomery; 2013). This the first study to examine ICBT for
      panic and depression in Israel. The primary focus will be on treatment outcomes (symptom
      reduction and improved functioning), attrition, and acceptability and comparing outcomes to
      previous studies of face to face and internet treatments, including on the main proposed
      mechanism of change; interpretation of bodily sensations via the BBSIQ. The efficacy of ICBT
      has been established in many studies, but is insufficient for implementation without
      adaptation to local cultural needs and language. We will also examine changes in healthcare
      utilization and costs according to the results.

      For the full programs of the current study see: https://www.iterapi.se/sites/icbt_israel and
      https://www.iterapi.se/sites/depression_israel/

      The limited role of the therapist in ICBT is mainly to allow greater scaling. a second goal
      of the current study is to fill this gap by examining different aspects of the alliance with
      treatment outcomes and attrition using a newly developed self-report measure, the Internet
      Patient Experiences and Attunement Responsiveness (I-PEAR). We propose that the I-PEAR and
      its subscales (I-PEAR program; hereafter I-PEARp, I-PEAR therapist; hereafter I-PEARt; and
      Therapist-rated I-PEAR; hereafter thI-PEAR) will explain more variance of the outcome and
      dropouts than traditional scales (i.e., WAI-6, WAI-T). In the current study we examined the
      relationship between the alliance measures to treatment outcomes and attrition. Alll
      secondary measures will be examined in terms of change and how their change is related to
      change in symptoms (PDSS, ASI, MI in panic, PHQ, HAM-D in depression). These analyses include
      changes in attachment, insight, and emotions. Research is limited about the role of insight
      in panic disorder, therefore another secondary aim of this study is to examine the role of
      clinical (i.e., SAIQ and SAI) and cognitive insight (i.e., BCIS and BABS) in panic disorder,
      if they change and their relationship to symptom severity (i.e., PDSS, ASI, MI), symptom
      change, and correlates (e.g., cognitive flexibility, metacognition, jumping to conclusions,
      and implicit theories). Secondary studies will examine changes in self-criticism, emotion
      preferences and goals, sexual functioning, and curiosity and their relationship to outcomes.
    

Intervention name(s): ICBT for panic and depression
Intervention type(s): Behavioral
Intervention description(s): The most known type of CBT for treating PD consists of two major strategies: cognitive restructuring, and interoceptive and structured exposure to bodily sensations that have become associated with panic attacks. As for depression, the most known type of CBT for treating depression consists of two major strategies: cognitive restructuring, the relationship between thoughts and feelings, behavioural activation, sleep hygiene and relaxation. Each ICBT program includes six modules, containing psychoeducation, cognitive restructuring exposures, acceptance, and consolidation of gains and relapse prevention. The online modules include reading passages, worksheets, videos, and homework assignments. After completing each module participants practice related skills and complete homework assignments. The treatment is up to 16 weeks long; participants are encouraged to complete the treatment within this time period, and reminders are sent to monitor their progress
Other intervention name(s): Internet Cognitive behavioral therapy for panic and depressive disorder.
Intervention model: Single Group Assignment
Intervention model description: All eligible people are enrolled to internet-based CBT for panic disorder or depression
Masking: None (Open Label)
Primary purpose: Treatment