Browsing by Subject "kognitiivis-behavioraalinen terapia"
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(2024)Tavoitteet: Ahdistushäiriöt ovat yleisimpiä lasten ja nuorten mielenterveyden häiriöitä, ja häiriötasoisesta ahdistuksesta kärsivistä vain noin 20–40 % saa riittävää hoitoa. Hoitamaton ja/tai pitkittynyt ahdistus aiheuttaa Suomessa useiden satojen miljoonien eurojen kustannuksia vuosittain, jonka lisäksi kyseessä on aina riski yksilön elämänlaadun pitkäaikaiselle heikkenemiselle. Varhaisia ja vaikuttavia interventioita tarvitaan siis enemmän ja niiden saatavuutta on parannettava. Kirjallisuuskatsauksen tarkoituksena oli tarkastella lasten ja nuorten ahdistuneisuuden hoidon vaikuttavuutta aikarajoitetuilla, kognitiivis-behavioraalisen terapian (KBT) viitekehykseen perustuvilla interventioilla, kuten Terapiat etulinjaan-hankkeessa kehitetyllä Lasten ja nuorten ahdistuksen kognitiivinen lyhytinterventiolla (ALI). Menetelmät: Kirjallisuuskatsaus toteutettiin etsimällä julkaisuja PubMed-, Scopus- ja Web of Science -tietokannoista yhdistelemällä hakusanoja ”brief”, “time limited”, ”cognitive behavioral therapy”, ”anxiety”, ”youth”, “children”, “adolescent”, “Scandinavia”, ja “parent” sekä artikkeleiden lähdeluetteloita tarkastelemalla. Lisäksi lähdemateriaalina hyödynnettiin mm. Käypä hoito -suosituksia. Tulokset ja johtopäätökset: Tutkimuskirjallisuuden perusteella, aikarajoitettu KBT on lasten ja nuorten ahdistuksen hoidossa vaikuttava hoitomuoto, joskin efektikoot ovat keskimäärin pienempiä kuin pidemmissä KBT-hoidoissa. ALI:n sisältö vastaa määritelmiä kognitiivis-behavioraalista lyhytterapiasta, joilla saavutettavissa oleva oireiden lieveneminen voi vähentää lasten ja nuorten päivittäistä kärsimystä ja arjen haittaa, myös Pohjoismaissa. Vanhempien osallistaminen hoitoon voi olla yhteydessä lasten ja nuorten hoidon tulosten parempaan pysyvyyteen, suurempaan yleisen toimintakyvyn paranemiseen sekä sekundääristen oireiden, kuten masennuksen lievenemiseen. Tulevassa tutkimuksessa voidaan tarkastella ALI:n vaikuttavuuden seurannan tuloksia suomalaisten palveluiden arjessa ja vertailla niitä kansainvälisesti toteutettuihin tutkimuksiin.
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(2019)The treatment of social anxiety disorder with internet delivered cognitive-behavior therapy has been studied for the past two decades, but still reviews of studies on the subject could not been found in the databases used in this study. The goal of this review was to examine the efficacy of iCBT in treating social anxiety disorder and to review the treatment protocols used in the efficacy studies. A systematic literature search was conducted in the databases available through EBSCOhost (ia. CINAHL, MEDLINE, eBook Collection (EBSCOhost) & eBook Academic Collection (EBSCOhost)) with the search term ”((((internet OR web) AND (cognitive behav* therapy)) OR iCBT) AND (social phobia OR social anxiety disorder)))”. Studies which examined the efficacy of iCBT in treating social anxiety disorder with an RCT trial comparing it to waiting list or treatment as usual conditions were included in the review. The search revealed 11 studies filling these requirements, in which three separately developed treatment protocols were studied. Guided iCBT significantly reduces the symptoms of social anxiety disorder and it was significantly more efficacious in reducing symptoms than waiting list, also clinically significant improvement was considerably more common in people receiving the treatment. Only a few studies comparing iCBT to live therapies were found, and even though they had promising results, conclusions could not be made based on two studies. The treatment protocols were similar to each other and there were no substantial differences noted in the efficacies of the different treatments. Treatment satisfaction was high which supports the role of iCBT as an acceptable treatment option. There was variation between the studies in the time therapists used per patient, but even the longest average time therapists used indicated that the therapists used their time more efficiently compared to live treatments. There was a lot of variation between the studies in adherence and completion rates, and the maintenance of adherence should be attended to also in future treatment protocols.
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(2021)Aims. Health anxiety is defined as persistent preoccupation or fear about the possibility of having one or more serious illnesses. According to cognitive-behavioral model the critical mechanisms for the maintenance of health anxiety are cognitive, affective, physiological and behavioral. Understanding the cognitive-behavioral model, treatment efficacy and mediators of treatment effect is likely to facilitate the development of better treatments. The aim of the present review is to investigate clinical efficacy of cognitive behavior therapy for health anxiety and to investigate mediators of treatment effect. Methods. Literature search was conducted in PubMed and Web of Science -databases. In addition Google scholar was used. When the clinical efficacy of cognitive behavior therapy was investigated the search terms included "hypochondriasis" OR "health anxiety" OR "illness anxiety" AND "treatment”. The search was limited to include only meta-analyses and systematic reviews. When the mediators of treatment effect were investigated the search terms included "hypochondriasis" OR "health anxiety" OR "illness anxiety" AND "mediators" AND "treatment”. Results and conclusions. According to meta-analyses cognitive behavior therapy is efficacious treatment for health anxiety. The preliminary findings suggest that improvement in cognitive behavior therapy for health anxiety is at least partially mediated by change in the maintenance mechanisms proposed by the cognitive behavioral model. Mediators of treatment effect may be reduced perceived risk of disease, less attention to bodily symptoms, and increased tolerance of uncertainty. According to one study non-reactivity to inner experiences, health anxiety behaviours, perceived competence in managing health anxiety and somatosensory amplification may be better viewed as secondary outcomes of the treatment than as mediators. The preliminary findings are promising but further investigations are needed.
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