The Efficacy and Effectiveness of Online CBT - Jeroen Ruwaard
The Efficacy and Effectiveness of Online CBT - Jeroen Ruwaard The Efficacy and Effectiveness of Online CBT - Jeroen Ruwaard
114 Chapter 6. Online CBT in Routine Clinical PracticeTable 6.2: Means and standard deviations of measures of specific and general psychopathology,per measurement occasion.Measurement occasionsTreatment Pretest Posttest 6Wk. FU 1Yr. FUmeasure a n b M SD n M SD n M SD n M SDDepressionSpecific PsychopathologyBDI 405 24.2 8.0 301 8.4 7.7 249 8.7 7.7 131 9.0 7.6DASS Depression 22.0 9.1 6.8 8.1 7.5 7.8 7.7 8.1PanicPDSS-SR 136 11.5 5.8 109 4.5 4.2 80 4.8 4.2 44 3.1 4.3PosttraumaticStressIES Intrusion 477 24.6 7.3 384 13.0 9.3 336 11.7 9.6cIES Avoidance 23.4 8.5 12.0 8.9 11.2 10.0BurnoutOLBI Exhaustion 470 2.7 0.6 396 2.3 0.6 341 2.3 0.6 184 2.2 0.7OLBI Disengagment 3.0 0.4 2.3 0.5 2.3 0.5 2.2 0.6DASS Stress 19.7 8.8 7.8 7.1 7.9 7.1 7.3 7.9General Psychopathology (DASS global score)Pretest Posttest 6Wk. FU 1Yr. FUn M SD n M SD n M SD n M SDDepression 413 53.6 21.1 301 20.0 19.6 249 21.1 19.5 131 20.4 18.7Panic Disorder 136 47.3 24.6 108 20.2 22.5 80 20.0 20.6 44 15.2 17.2PosttraumaticStress476 43.5 25.7 381 24.2 24.9 334 23.6 27.1Burnout 470 44.2 22.6 399 15.8 16.5 342 16.1 16.0 185 14.8 17.2a BDI: Beck Depression Inventory, version IA (range: 0-63; cut-off: 10); DASS: Depression Anxiety Stress Scales (DASS-42;range: 0-126; cut-off: 30, DASS-Stress: cut-off: 14). PDSS-SR: Panic Disorder Severity Scale - Self report (range: 0-28; cut-off:8); IES: Impact of Event Scale (Intrusion subscale: range: 0-35; Avoidance Subscale: range 0-40; sumscore cut-off: 24 ); OLBI:Oldenburg Burnout Inventory (OLBI: range 1-4; cut-off: 2.18).b Pretest data were missing for 8 patients in the depression sample, 3 patients in the panic sample, and 1 patient in the PTSsample.c The assessment protocol of the treatment manual for posttraumatic stress did not include a one-year follow-up.
6.2. Results 115Table 6.3: Regression analysis and effect sizes of changes in specific and generalpsychopathology.Treatment Pre vs. Post, 6Wk. FU Pre vs. 1Yr. FUmeasure a b SE t c d d b SE t dDepressionSpecific PsychopathologyBDI -15.3 0.46 33.4 1.9±0.1 -14.2 0.82 17.2 1.8±0.2DASS Depression -14.8 0.52 28.4 1.6±0.1 -13.9 0.74 18.8 1.5±0.2PanicPDSS-SR -6.6 0.45 14.6 1.2±0.2 -7.5 0.68 11.1 1.3±0.3PosttraumaticStressIES Intrusion -12.0 0.42 28.3 1.6±0.1eIES Avoidance -11.4 0.58 19.6 1.3±0.1BurnoutOLBI Exhaustion -0.4 0.03 12.7 0.7±0.1 -0.5 0.05 9.5 0.8±0.2OLBI Disengagment -0.7 0.03 23.6 1.6±0.1 -0.8 0.04 18.5 1.8±0.2DASS Stress -11.9 0.42 28.1 1.3±0.1 -12.1 0.62 19.4 1.4±0.1General Psychopathology (DASS global score)Pre vs. Post, 6Wk. FUPre vs. 1Yr. FUb SE t c d d b SE t dDepression -32.9 1.23 26.8 1.6±0.1 -31.6 1.70 18.2 1.5±0.1Panic Disorder -26.1 2.20 11.9 1.3±0.2 -29.7 3.10 9.7 1.2±0.1PosttraumaticStress-18.1 1.20 15.5 0.7±0.1Burnout -28.2 1.05 27.4 1.2±0.1 -28.7 1.47 19.6 1.3±0.1a BDI: Beck Depression Inventory, version IA; PDSS-SR: Panic Disorder Severity Scale - Self report; IES: Impact of Event Scale;OLBI: Oldenburg Burnout Inventory (OLBI); DASS: Depression Anxiety Stress Scales (DASS-42).b b (SE): regression estimate and standard error of raw change score; Negative values of b represent symptom reductions.c t: test statistic. N: depression: n = 413; panic disorder: n = 139; posttraumatic stress: n = 478; burnout: n = 470. Degreesof freedom of the t-test were conservatively set to the number of therapists in each sample (depression: n = 74; panic disorder:n = 24; posttraumatic stress: n = 65; burnout: n = 51). All regression parameters are significant at P < .001 after Bonferronicorrections for multiple testing.d d: Cohen’s d effect size (95% confidence interval).e The assessment protocol of the treatment manual for posttraumatic stress did not include a one-year follow-up.
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114 Chapter 6. <strong>Online</strong> <strong>CBT</strong> in Routine Clinical PracticeTable 6.2: Means <strong>and</strong> st<strong>and</strong>ard deviations <strong>of</strong> measures <strong>of</strong> specific <strong>and</strong> general psychopathology,per measurement occasion.Measurement occasionsTreatment Pretest Posttest 6Wk. FU 1Yr. FUmeasure a n b M SD n M SD n M SD n M SDDepressionSpecific PsychopathologyBDI 405 24.2 8.0 301 8.4 7.7 249 8.7 7.7 131 9.0 7.6DASS Depression 22.0 9.1 6.8 8.1 7.5 7.8 7.7 8.1PanicPDSS-SR 136 11.5 5.8 109 4.5 4.2 80 4.8 4.2 44 3.1 4.3PosttraumaticStressIES Intrusion 477 24.6 7.3 384 13.0 9.3 336 11.7 9.6cIES Avoidance 23.4 8.5 12.0 8.9 11.2 10.0BurnoutOLBI Exhaustion 470 2.7 0.6 396 2.3 0.6 341 2.3 0.6 184 2.2 0.7OLBI Disengagment 3.0 0.4 2.3 0.5 2.3 0.5 2.2 0.6DASS Stress 19.7 8.8 7.8 7.1 7.9 7.1 7.3 7.9General Psychopathology (DASS global score)Pretest Posttest 6Wk. FU 1Yr. FUn M SD n M SD n M SD n M SDDepression 413 53.6 21.1 301 20.0 19.6 249 21.1 19.5 131 20.4 18.7Panic Disorder 136 47.3 24.6 108 20.2 22.5 80 20.0 20.6 44 15.2 17.2PosttraumaticStress476 43.5 25.7 381 24.2 24.9 334 23.6 27.1Burnout 470 44.2 22.6 399 15.8 16.5 342 16.1 16.0 185 14.8 17.2a BDI: Beck Depression Inventory, version IA (range: 0-63; cut-<strong>of</strong>f: 10); DASS: Depression Anxiety Stress Scales (DASS-42;range: 0-126; cut-<strong>of</strong>f: 30, DASS-Stress: cut-<strong>of</strong>f: 14). PDSS-SR: Panic Disorder Severity Scale - Self report (range: 0-28; cut-<strong>of</strong>f:8); IES: Impact <strong>of</strong> Event Scale (Intrusion subscale: range: 0-35; Avoidance Subscale: range 0-40; sumscore cut-<strong>of</strong>f: 24 ); OLBI:Oldenburg Burnout Inventory (OLBI: range 1-4; cut-<strong>of</strong>f: 2.18).b Pretest data were missing for 8 patients in the depression sample, 3 patients in the panic sample, <strong>and</strong> 1 patient in the PTSsample.c <strong>The</strong> assessment protocol <strong>of</strong> the treatment manual for posttraumatic stress did not include a one-year follow-up.
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