Can between-session homework be delivered digitally? A pilot randomized clinical trial of CBT for adjustment disorders

Soledad Quero; Iryna Rachyla; Mar Molés; Sonia Mor; Cintia Tur; Pim Cuijpers; Alba López-Montoyo; Cristina Botella

doi:10.3390/ijerph16203842

Can between-session homework be delivered digitally? A pilot randomized clinical trial of CBT for adjustment disorders

Soledad Quero^*, Iryna Rachyla, Mar Molés, Sonia Mor, Cintia Tur, Pim Cuijpers, Alba López-Montoyo, Cristina Botella

^*Corresponding author for this work

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Adjustment disorder (AjD) is one of the most common disorders in clinical practice, and its symptoms are severe enough to cause great distress and functional impairment. The AjD CBT protocol specifically developed for this disorder has shown positive results when delivered face to face and through virtual reality. Despite existing evidence supporting the benefits of therapeutic homework as part of a psychological intervention, little is known about how to increase homework engagement in psychotherapy. This study examines the feasibility (doability, initial efficacy and acceptability) of a digital support system to deliver homework via the Internet in the treatment of AjD. Participants were randomly assigned to a traditional homework condition or a digital support system condition. Both interventions resulted in statistically significant improvements, with large effect sizes, in all the outcome measures at post-treatment, with no significant differences between groups. At 12-month follow-up, these therapeutic gains were maintained, and an improvement was even observed in both conditions, with no significant differences between groups. Additionally, treatment satisfaction predicted efficacy in both groups separately and when the whole group was considered. This is the first study to explore the feasibility an initial efficacy of delivering a therapeutic homework component for AjD through the Internet.

Original language	English
Article number	3842
Pages (from-to)	1-19
Number of pages	19
Journal	International Journal of Environmental Research and Public Health
Volume	16
Issue number	20
DOIs	https://doi.org/10.3390/ijerph16203842
Publication status	Published - 11 Oct 2019

Funding

Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, 12006 Castellón, Spain; [email protected] (I.R.); [email protected] (M.M.); [email protected] (S.M.); [email protected] (C.T.); [email protected] (A.L.-M.); [email protected] (C.B.) CIBER Fisiopatología de la Obesidad y Nutrición (CIBERON), Instituto Salud Carlos III, 28029 Madrid, Spain Department of Clinical, Neuro, and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081BT Amsterdam, The Netherlands; [email protected] Correspondence: [email protected]; Tel.: +34-964387641 Funding: This research was funded by Plan 2011 de Promoción de la Investigación UJI–Proyectos BANCAIXA (P11B2011 – 20), 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), and CIBER. CIBER Fisiopatología de la Obesidad y Nutrición is an initiative of ISCIII.

Funders	Funder number
Plan Nacional I+D+I	PSI2013-41783-R
Center for International Business Education and Research, University of Illinois at Urbana-Champaign
Ministerio de Economía y Competitividad
Instituto de Salud Carlos III
Universitat Jaume I	UJI-2018-57

Keywords

Adjustment disorders
Between-session homework
CBT
Efficacy
Feasibility
Internet-delivered therapy
Virtual reality

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10.3390/ijerph16203842

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title = "Can between-session homework be delivered digitally? A pilot randomized clinical trial of CBT for adjustment disorders",

abstract = "Adjustment disorder (AjD) is one of the most common disorders in clinical practice, and its symptoms are severe enough to cause great distress and functional impairment. The AjD CBT protocol specifically developed for this disorder has shown positive results when delivered face to face and through virtual reality. Despite existing evidence supporting the benefits of therapeutic homework as part of a psychological intervention, little is known about how to increase homework engagement in psychotherapy. This study examines the feasibility (doability, initial efficacy and acceptability) of a digital support system to deliver homework via the Internet in the treatment of AjD. Participants were randomly assigned to a traditional homework condition or a digital support system condition. Both interventions resulted in statistically significant improvements, with large effect sizes, in all the outcome measures at post-treatment, with no significant differences between groups. At 12-month follow-up, these therapeutic gains were maintained, and an improvement was even observed in both conditions, with no significant differences between groups. Additionally, treatment satisfaction predicted efficacy in both groups separately and when the whole group was considered. This is the first study to explore the feasibility an initial efficacy of delivering a therapeutic homework component for AjD through the Internet.",

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AU - Tur, Cintia

AU - Cuijpers, Pim

AU - López-Montoyo, Alba

AU - Botella, Cristina

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Can between-session homework be delivered digitally? A pilot randomized clinical trial of CBT for adjustment disorders

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