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    Predicting outcomes and sudden gains from initial in-session interactions during remote cognitive behavioral thearpy for severe health anxiety

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    Author
    Malins, Samuel
    Morriss, Richard K.
    Schroder, Thomas
    Brown, Paula
    Boycott, Naomi
    Keyword
    Cognitive behavioural therapy
    Anxiety
    Telemedicine
    COVID-19
    Psychotherapy
    SARS-CoV-2
    Date
    2020
    
    Metadata
    Show full item record
    DOI
    10.1002/cpp.2543
    Publisher's URL
    https://onlinelibrary.wiley.com/doi/10.1002/cpp.2543
    Abstract
    There has been a dramatic increase in remote psychotherapy since the onset of the COVID-19 crisis. There is also expected to be an increase in mental health problems in the wake of the COVID-19 pandemic. An increase in severe health anxiety (SHA) is particularly anticipated, for which Cognitive-Behavioural Therapy (CBT) is a frontline treatment. However, it is unclear what interaction-types are associated with outcome-improvement in remote-CBT (rCBT) for SHA. This study aimed to identify interaction-types that predict outcomes and sudden gains in rCBT for SHA using initial therapy session content. Forty-eight participants in rCBT for SHA had interactions at their first sessions categorized and rated in terms of patient activation: An individual's confidence and ability to manage their health. Multilevel modelling assessed whether early interaction-types predicted session-by-session wellbeing. For participants experiencing sudden gains (n = 12) interactions at the session directly prior to the gain were similarly categorised and rated. The scores were then compared to ratings for the preceding session. A smaller proportion of early sessions was taken up with problem descriptions amongst those with greater outcome-improvements. There was also a significant reduction in the proportion of the session spent describing problems in the session directly prior to a sudden gain, as compared to the previous session. Conversely, clients with better outcomes made more positive evaluations of themselves and therapy, noticed more positive changes, and made more contributions to structuring interactions at initial sessions. Conclusion. Specific early interaction-types predict session-by-session outcomes and precede sudden gains in rCBT for SHA.
    Citation
    Malins, S., Moghaddam, N., Morriss, R., Schröder, T., Brown, P. & Boycott, N. (2020). Predicting outcomes and sudden gains from initial in-session interactions during remote cognitive behavioral thearpy for severe health anxiety. Clinical Psychology and Psychotherapy, 28(4), pp. 891-906.
    Type
    Article
    URI
    http://hdl.handle.net/20.500.12904/14197
    Collections
    Anxiety

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