internet based intervention

There is a notable lack of empirical validation regarding the use of internet-based emotion-focused cognitive behavioral therapy (IECBT) for counseling pregnant women.

This study examines the feasibility, acceptability, and effectiveness of IECBT in counseling women with suspected fetal anomalies.

In a quasi-experimental study, 130 pregnant women diagnosed with anxiety disorders were randomly assigned to either IECBT with spousal participation (65 participants) or IECBT alone (65 participants). All participants completed three pregnancy-specific stress questionnaires—the NuPDQ, Spielberger State Anxiety Inventory, and Edinburgh Depression Scale—both before and immediately after the intervention.

Within-group analyses indicated that both counseling methods, with and without spousal involvement, led to significant reductions in pregnancy-specific stress, depression, and anxiety symptoms by the end of the intervention (P < 0.001). Between-group comparisons revealed that IECBT with spousal participation significantly reduced pregnancy-specific stress (effect size = 0.055, P = 0.007) and depressive symptoms (effect size = 0.480, P < 0.001) compared to IECBT without spousal involvement. However, neither intervention produced a significant reduction in anxiety symptoms (effect size = 0.001, P = 0.787).

Both IECBT approaches (with and without spousal participation) are feasible, reliable, and effective methods for alleviating depression and stress symptoms in pregnant women with suspected fetal anomalies.

Despite the high prevalence of depressive and anxiety disorders among women with threatened abortion (TA), there is scant evidence regarding the efficacy of psychotherapies for this group.

This research aimed to assess the effectiveness, acceptability, and feasibility of specific internet-based cognitive behavioral therapy (iCBT-Specific) and unified protocol (iUP) for women with a TA.

In this semi-experimental study (from April to October 2023), after the treatment content was prepared, a total of 80 pregnant women with TA, over 18 years of age, having a gestational age of 5 - 12 weeks, from a hospital and two private clinics, who were diagnosed with depressive and anxiety disorders based on the short structured diagnostic interview (Mini-International Neuropsychiatric Interview), were selected. The participants were divided into two groups, undergoing iUP or iCBT-specific psychotherapies. All participants completed the Brief Symptom Inventory (BSI-18) to measure the levels of depressive and anxiety symptoms. Following eight weeks of internet-based therapy, consisting of eight 50-minute sessions, they completed the BSI-18 again, along with the Client Satisfaction Questionnaire (CSQ-8) and the System Usability Scale (SUS). Statistical analysis was performed using SPSS version 22 software, and t -test, paired t -test, and ANCOVA tests were used.

Both the iUP and iCBT-Specific models demonstrated high acceptability, and the average feasibility of treatment was above average for both models. In terms of acceptability and feasibility of treatment for women with TA, neither model proved to be superior (all P > 0.05). Both iUP and iCBT-Specific models were effective in reducing depression and anxiety in these women (effect size for within groups were respectively Eta = 0.370, Eta = 0.536). Also, in terms of improving depression and anxiety, there was no significant difference in the effectiveness of iUP and iCBT-Specific treatments (respectively P = 0.146, Eta = 0.027 and P = 0.221, Eta = 0.019)

The iUP treatment can be recognized as a reliable alternative to the iCBT-Specific method for alleviating depressive and anxiety symptoms in women with TA. Also, our results help gynecologists to use iUP as an alternative treatment when there is no definitive diagnosis of the type of disorder.

Postpartum weight retention (PPWR) has many health risks. Digital self-monitoring of weight can potentially make postpartum weight management easier. We aim to test to what extent the self-monitoring of weight, steps and mental health through an mHealth application increases postpartum weight loss and reduces the odds of substantial PPWR (≥5 kg).

Participants were mothers in the intervention arm of the INTER-ACT multicenter randomized controlled trial (RCT), an inter-pregnancy lifestyle intervention among mothers with excessive gestational weight gain. Participants (n=288) had access to an mHealth application to log their weight, steps and mental health between 6 weeks and 6 months postpartum. A linear multiple regression model and a logistic regression model were run to test to what extent self-monitoring via the app increases postpartum weight loss and reduces the risk of substantial PPWR.

Women who logged their weight more often lost more weight (B=0.03, β=0.26, CIB =[0.01,0 .05], P<0.01), and had reduced odds of substantive PPWR (OR=0.99, CIOR =[0.98, 0.999], P<.05). Mental health logging reduced the odds of substantive PPWR (OR=0.98, CIOR =[0.97, 1.00], P<0.05), but was unrelated to the amount of weight loss. Steps logging was unrelated to either weight loss or substantive PPWR.

Mothers with excessive gestational weight gain can benefit from app-based lifestyle interventions to reduce PPWR by self-monitoring their weight. More attention to mental health in PPWR interventions is needed.

Type 1 diabetes mellitus (T1DM) is one of the most common chronic diseases in childhood and adolescence, which is associated with various psychological problems. This study aims to compare the effect of group internet-delivered self-management training (iSMT) and “patient child” play (PCP) on externalizing and internalizing problems in children with T1DM in Isfahan City, Iran.

This randomized clinical trial was conducted from January 2020 to October 2021. From all children aged 8 to 11 years with T1DM diagnosed by endocrinologists, 75 children were selected based on inclusion and exclusion criteria and were randomly assigned into three groups, iSMT, PCP, and control (each group was 25). Their parents filled out the child behavior checklist (CBCL) for them in the pre and post-treatment stages. The iSMT group received 10 sessions of education via Skyroom and the playgroup performed PCP for 10 sessions. The control group did not receive any psychological intervention. All participants received routine diabetes medication. Data were analyzed using SPSS software, version 23 and analysis of variance (ANOVA) for 59 children in 3 groups (iSMT=19, PCP=20, and control=20).

The results showed that the PCP group had more improvement in SP compared to the iSMT group as well as a significant improvement in rule-breaking behaviors (RB) compared to the control group.

PCP is effective in improving SP and RB of children with T1DM and can be used as a complementary treatment for them.

In late 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19). The SARS-COV-2 pandemic is causing psychological impacts such as stress, anxiety, and depression. Concerning this situation, improvement in internet-based mental health services is necessary. Therefore, this study aimed to compare the effectiveness of Internet-based Mindfulness-based Stress Reduction (IMBSR) with the Online Counseling Guidelines of the Ministry of Health (OCGMH) in the reduction of depression, anxiety, and stress during the SARS-COV-2 pandemic.

 A quasi-experimental study with a two-group randomized controlled, pretest-posttest questioner was designed. Based on inclusion and exclusion criteria, 84 participants were enrolled in the study that had contact with Ferdowsi University of Mashhad's Psychology and Counseling Clinic through online networks to complain about anxiety and distress caused by the coronavirus. Data analysis was performed using Independent sample t-test. both internet-based interventions (i.e., IMBSR and OCGMH) were executed by clinical psychologists.

The mean scores for stress, anxiety, and depression were significantly improved after both internet interventions (i.e., IMBSR and OCGMH). Further analysis showed that stress and anxiety significantly decreased in the IMBSR group compared to the OCGMH group (P<0.05). however, participants in the OCGMH group had a lower score of the depression index than that of the IMBSR group (P<0.05).

To summarize, IMBSR intervention improved the stress and anxiety during the quarantine of SARS-COV-2. Together these results provide important insights into internet-based interventions during pandemic situations. As a suggestion, advances in internet-based mental health services are necessary during the quarantine of diseases.

Coronavirus disease-19 (COVID-19) is a widespread disease all over the world that has causedmany psychological complications such as health anxiety (HA) and low quality of life (QOL). Mindfulnessbasedapproaches could improve these complications. Therefore, this study aimed to investigate the effect ofInternet-delivered mindfulness stress reduction combined with acceptance and commitment therapy (IMSRACT)on QOL and HA of caregivers of patients infected by COVID-19.

In this randomized clinical trial, 72 people from Golpayegan city, Iran, who had a patient with COVID-19 in their family were selected from March to June 2020. A caregiver with a score above 27 on the Health Anxietyinventory (HAI-18) was selected using simple random sampling. Participants were assigned in the interventionor control group by permuted block random allocation. The intervention group was trained by MSR and ACTtechniques for 9 weeks accomplished via WhatsApp. All participants completed the QOLQuestionnaire-12 (SF-12) items and HAI-18 before and after completing IMSR-ACT sessions. The data were analyzed through SPSS-23 software, using Chi square, independent and paired t-test, and analysis of covariance, and P-value<0.05 wasconsidered as significant.

The results showed that the intervention group compared to the control group had a significantdecrease in all subscales of HAI after the intervention including worry about consequences (5.78±2.66 vs.7.37±1.34, P=0.004) and awareness of bodily sensation or changes (8.90±2.77 vs. 11.75±2.30, P=0.001), worryabout health (10.94±2.38 vs. 13.09±1.92, P=0.001), and total score of HAI (25.62±4.93 vs. 32.25±3.93, P=0.001).Also, the intervention group compared to the control group had better QOL after the intervention in generalhealth perceptions (3.03±0.96 vs. 2.43±0.95, P=0.01), mental health (7.12±2.25 vs. 6.34±1.85 and P=0.01) andmental component summary) 16.78±3.75 vs. 15.43±3.05, P=0.01), physical component summary (16.06±2.66 vs.15.19±2.25, P=0.01), and total score of SF-12 (32.84±5.39 vs. 30.62±4.34, P=0.004).

Internet-delivered MSR combined with ACT could improve the HA and QOL of caregivers withpatients infected by COVID-19. Thus, it can used in other similar situations for now and future. Also, it seemsto be a useful approach for caregivers of the other illnesses.Trial Registration Number: IRCT20180909040974N5

Misophonia is a disorder in which people show negative emotions such as anger, disgust, and anxiety about certain sounds, such as mouth and nose sounds, as well as some repetitive sounds. This disorder has a high prevalence and causes many problems for patients.

This study aimed to examine and compare the effectiveness of two therapies, including online group-mindfulness and acceptance‐based therapy (OG-MACT) and online group-cognitive-behavioral therapy (OG-CBT) in patients with misophonia.

This study was a two-group random assignment pretest-posttest design. Thirty-eight participants were recruited using convenience sampling and randomly assigned to OG-CBT (n = 19) and OG-MACT (n = 19) groups. The statistical population included patients with misophonia (a score higher than seven on the Misophonia Questionnaire) referred to the Tehran Institute of Psychiatry from October to December 2019. They were asked to respond to online self-report questionnaires evaluating misophonia, distress tolerance, quality of life, depression, anxiety, and stress scale in three stages, including before treatment sessions, one week after the end of sessions, and during a three-month follow-up.

The difference in the mean scores of the scales at different times did not differ according to the type of treatment group (OG-CBT versus OG-MACT). The results showed that the effect of time was significant on misophonia scores. Over time, this finding also applies to depression, anxiety, and stress subscales in the distress tolerance questionnaire. However, there was no significant difference in the quality of life over time. The changes in misophonia were clinically significant in 53% of OG-MACT members and 69% of OG-CBT members.

According to the findings, the two online group therapies of CBT and MACT effectively reduced the symptoms of misophonia.

 The obesity crisis is one of the major public health issues in the 21st century, and depression, anxiety, and stress are the psychological factors that mediate obesity.

 This research was conducted to evaluate the effectiveness of Internet-based cognitive-behavioral therapy (ICBT) in reducing body mass index (BMI), stress, anxiety, and depression in overweight women via a virtual group.

 This randomized controlled trial study was conducted on three groups of the experiment, the waiting list, and the treatment-as-usual. It was done as single-phase, single-center, and double-blinded. The statistical population included all women with BMI ≥ 25 in Neyshabur city in 2019 - 2020. The research sample included 90 subjects randomly assigned to the groups. The therapeutic intervention was applied in the form of 42 ICBT sessions using a virtual WhatsApp group. The participants completed the Depression Anxiety Stress Scale (DASS), and their BMI was also calculated before and after the sessions.

 The analysis of covariance indicated the significant effect of ICBT on the reduction of BMI compared to the usual treatment group and waiting list group [F (72, 2) = 15.54, P < 0.0005; Partialη2 = 0.30]. However, it was not significant on the reduction of stress [F (72, 2) = 0.47, P = 0.63; Partialη2 = 0.01], anxiety [F (72, 2) = 0.49, P = 0.61; Partialη2 = 0.01], and depression [F (72, 2) = 0.06, P = 0.93; Partialη2 = 0.002].

 The present study showed the direct effect of ICBT on the reduction of BMI like the treatment-as-usual for obesity. However, these sessions could not reduce the participants’ stress, anxiety, and depression.

In the late 2019, an acute respiratory syndrome [severe acute respiratory syndrome coro-navirus 2 (SARS-CoV-2)] resulted in a pandemic coronavirus disease (COVID-19). This study was designed to com-pare the efficacy of internet-based cognitive behavioral therapy for insomnia (ICBT-I) with online relaxation training for management of insomnia during SARS-CoV-2 pandemic.

This controlled trial was conducted on adults (18-65 years) with the complaint of insomnia who called psychology call centers in Mashhad, Iran, from March to June 2020. Participants with insomnia symptoms starting after SARS-CoV-2 pandemic who had Insomnia Severity Index (ISI) scores of ≥ 15 were included in the study. Five weekly sessions of ICBT-I as the intervention were compared with 5 weekly online relaxation training sessions in the control group. ISI before and after 5 weeks of follow-up was compared in both groups.

From a total cohort of 144 subjects included in the study, 98 were excluded and the remainder were allocated to 23 cases and 23 control subjects. During follow-up period, 5 individuals (21.7%) dropped out in each group. The mean ISI scores improved after therapy (20.6 to 8.5 and 21.8 to 13.0 for intervention and control groups, respectively).

ICBT-I significantly improved insomnia severity during home quarantine of SARS-CoV-2 pandemic. We suggest that ICBT-I could be an effective and feasible alternative in pandemic of an infectious disease. Clients accepted ICBT-I with a minor drop-out in our study.

During coronavirus (COVID-19) pandemic, frontline medical staff were exposed to numerous psychological problems due to unpredictable conditions. A psychological intervention for medical staff is the provision of a group where emotions and feelings are shared.

The purpose of this study was to evaluate the experiences of front-line medical staff about virtual Balint group.

Eight sessions of virtual Balint group were held through Skype. Participants were the frontline medical staff involved in the treatment of COVID-19 patients. The group leader was a psychiatrist and an analytical psychotherapist. The group had two coleaders, a clinical psychologist and a psychiatrist. They were both experienced conductors who had a background of participation in Balint groups. Finally, eight in-depth semi-structured interviews were performed. Interpretative phenomenological analysis (IPA) was carried out to analyze the obtained data.

Three themes were extracted, including the effects of Balint group, Balint group structure, and virtuality of Balint group. Each theme included several categories, and each category had some codes.

Leaders in the Balint group were active and had a supportive role. Some participants did not share their faces, and this made others feel insecure. Body language is an important issue in empathy and understanding of others that is overlooked in virtual Balint groups.