A guided Internet-delivered intervention for adjustment disorders: A randomized controlled trial

I. Rachyla, S. Mor, P. Cuijpers, C. Botella, D. Castilla, S. Quero

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Abstract

Evidence of self-help interventions for adjustment disorder (AjD) is limited. This study aims at testing in a randomized controlled trial (RCT) the effectiveness of a disorder-specific, Internet-delivered cognitive–behavioural therapy (ICBT) intervention for AjD. Participants were randomly allocated to either an ICBT with brief weekly telephone support (n = 34) or a waiting list group (n = 34). Beck's inventories for depression and anxiety were used as primary outcomes. The secondary outcomes were AjD symptoms, post-traumatic growth, positive and negative affect, and quality of life. In all, 76.5% of the participants completed the intervention. Compared with the control group, participants in the intervention condition showed significantly greater improvement in all outcomes (Cohen's d ranged from 0.54 to 1.21) except in anxiety symptoms measured by Beck Anxiety Inventory (d = 0.27). Only ICBT group showed a significant improvement in post-traumatic growth, positive and negative affect, and quality of life. The number of cases that achieved clinically meaningful change in all outcome measures was also higher in the ICBT group. All therapeutic gains were maintained at 3-, 6- and 12-month follow-ups. The current study provides evidence on the effectiveness of ICBT interventions to reduce the impact of AjD. Results suggest that brief self-help intervention with minimal therapist support is more effective than the mere passage of time in reducing the distress symptoms associated to the disorder and also can confer additional benefits.
Original languageEnglish
Pages (from-to)313-324
Number of pages12
JournalClinical Psychology and Psychotherapy
Volume28
Issue number2
Early online date21 Sept 2020
DOIs
Publication statusPublished - Mar 2021

Funding

The authors wish to thank the following institutions for the funding support that they provided to conduct this project: Ministerio de Economía y Competitividad (Spain; Plan Nacional I + D + I, PSI2013‐41783‐R); Plan 2018 de Promoción de la Investigación de la Universitat Jaume I (UJI‐2018‐57); Generalitat Valenciana pre‐PhD grant program (VALi+d: ACIF/2015/181) and CIBERObn, an initiative of the Instituto de Salud Carlos III (ISCIII) (ISC III CB06 03/0052). The aforementioned institutions had no role in the design or execution of the study, analyses and interpretation of the data, or decision to submit results.

FundersFunder number
Ministerio de Economía y CompetitividadPSI2013‐41783‐R
Generalitat ValencianaACIF/2015/181
Instituto de Salud Carlos IIIISC III CB06 03/0052
Universitat Jaume IUJI‐2018‐57
Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición

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