Efficacy of a between-session homework component delivered digitally for the treatment of adjustment disorders: Results from a pilot randomized clinical trial

Background: Adjustment Disorder (AjD) is one of the most frequently diagnosed mental disorders worldwide. However, there is still no treatment of choice for this problem. One of the first treatment programs specifically designed for AjD is the one presented in this study, a CBT protocol that uses Vi...

Full description

Bibliographic Details
Main Authors: Soledad Quero, Amanda Díaz-García, Sara Fernández-Buendía, Mar Molés, Cintia Tur, Diana Castilla, Pim Cuijpers, Cristina Botella
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-12-01
Series:Frontiers in Virtual Reality
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/frvir.2022.937606/full
_version_ 1811178531724460032
author Soledad Quero
Soledad Quero
Amanda Díaz-García
Sara Fernández-Buendía
Mar Molés
Cintia Tur
Diana Castilla
Pim Cuijpers
Cristina Botella
Cristina Botella
author_facet Soledad Quero
Soledad Quero
Amanda Díaz-García
Sara Fernández-Buendía
Mar Molés
Cintia Tur
Diana Castilla
Pim Cuijpers
Cristina Botella
Cristina Botella
author_sort Soledad Quero
collection DOAJ
description Background: Adjustment Disorder (AjD) is one of the most frequently diagnosed mental disorders worldwide. However, there is still no treatment of choice for this problem. One of the first treatment programs specifically designed for AjD is the one presented in this study, a CBT protocol that uses Virtual Reality (VR) to improve patients’ adherence. Another key aspect to improve treatment outcomes is the use of between-sessions homework. However, little is known about how to increase patient engagement with these tasks. The use of Information and Communication Technologies (ICTs) can help patients to see homework as less demanding and provides greater flexibility. A previous study tested the feasibility of TEO (Online Emotional Therapy), a program to implement online homework during treatment. The aim of this study is to present session-to-session efficacy data from the homework assignment component and the patients’ preferences and opinions about this component in both formats (Traditional vs. TEO).Methods: A two-arm pilot randomised clinical trial (RCT) was conducted with 57 patients with AjD. The two groups received the same CBT intervention with VR support, but one group completed homework in the traditional way and the other using TEO. Mood, self-efficacy and positive and negative emotions were measured to test the effect of the homework component in each treatment session. Preferences about the homework format were also assessed before and after treatment.Results: Both types of administration produced significant improvements in mood, self-efficacy and emotional variables after completion of the homework component and before and after each homework session. Effect sizes ranged from small to large, with no differences between groups. Regarding the acceptability of the program, most participants preferred the TEO condition both before starting the treatment and after completing the homework assignment. Overall, participants were satisfied with all homework sessions and found them useful. Again, no significant differences were found between groups.Conclusion: This is the first time that the effect of an online homework program during AjD treatment has been tested. It is proposed that this way of implementing homework could be as effective as the traditional format, but would be preferred by patients.Clinical Trial Registration:clinicaltrials.gov, identifier NCT02452411
first_indexed 2024-04-11T06:19:58Z
format Article
id doaj.art-b28f70879495414498dc8a852002b397
institution Directory Open Access Journal
issn 2673-4192
language English
last_indexed 2024-04-11T06:19:58Z
publishDate 2022-12-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Virtual Reality
spelling doaj.art-b28f70879495414498dc8a852002b3972022-12-22T04:40:49ZengFrontiers Media S.A.Frontiers in Virtual Reality2673-41922022-12-01310.3389/frvir.2022.937606937606Efficacy of a between-session homework component delivered digitally for the treatment of adjustment disorders: Results from a pilot randomized clinical trialSoledad Quero0Soledad Quero1Amanda Díaz-García2Sara Fernández-Buendía3Mar Molés4Cintia Tur5Diana Castilla6Pim Cuijpers7Cristina Botella8Cristina Botella9Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón, SpainCIBER of Physiopathology of Obesity and Nutrition (CIBERObn), Madrid, SpainDepartment of Psychology and Sociology, Universidad de Zaragoza, Teruel, SpainDepartment of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón, SpainDepartment of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón, SpainDepartment of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón, SpainDepartment of Personality, Evaluation and Psychological Treatment, Universitat de València, Valencia, SpainDepartment of Clinical, Neuro, and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, NetherlandsDepartment of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón, SpainCIBER of Physiopathology of Obesity and Nutrition (CIBERObn), Madrid, SpainBackground: Adjustment Disorder (AjD) is one of the most frequently diagnosed mental disorders worldwide. However, there is still no treatment of choice for this problem. One of the first treatment programs specifically designed for AjD is the one presented in this study, a CBT protocol that uses Virtual Reality (VR) to improve patients’ adherence. Another key aspect to improve treatment outcomes is the use of between-sessions homework. However, little is known about how to increase patient engagement with these tasks. The use of Information and Communication Technologies (ICTs) can help patients to see homework as less demanding and provides greater flexibility. A previous study tested the feasibility of TEO (Online Emotional Therapy), a program to implement online homework during treatment. The aim of this study is to present session-to-session efficacy data from the homework assignment component and the patients’ preferences and opinions about this component in both formats (Traditional vs. TEO).Methods: A two-arm pilot randomised clinical trial (RCT) was conducted with 57 patients with AjD. The two groups received the same CBT intervention with VR support, but one group completed homework in the traditional way and the other using TEO. Mood, self-efficacy and positive and negative emotions were measured to test the effect of the homework component in each treatment session. Preferences about the homework format were also assessed before and after treatment.Results: Both types of administration produced significant improvements in mood, self-efficacy and emotional variables after completion of the homework component and before and after each homework session. Effect sizes ranged from small to large, with no differences between groups. Regarding the acceptability of the program, most participants preferred the TEO condition both before starting the treatment and after completing the homework assignment. Overall, participants were satisfied with all homework sessions and found them useful. Again, no significant differences were found between groups.Conclusion: This is the first time that the effect of an online homework program during AjD treatment has been tested. It is proposed that this way of implementing homework could be as effective as the traditional format, but would be preferred by patients.Clinical Trial Registration:clinicaltrials.gov, identifier NCT02452411https://www.frontiersin.org/articles/10.3389/frvir.2022.937606/fulladjustment disorderbetween-session homeworkinternet-based therapyCBTvirtual realityefficacy
spellingShingle Soledad Quero
Soledad Quero
Amanda Díaz-García
Sara Fernández-Buendía
Mar Molés
Cintia Tur
Diana Castilla
Pim Cuijpers
Cristina Botella
Cristina Botella
Efficacy of a between-session homework component delivered digitally for the treatment of adjustment disorders: Results from a pilot randomized clinical trial
Frontiers in Virtual Reality
adjustment disorder
between-session homework
internet-based therapy
CBT
virtual reality
efficacy
title Efficacy of a between-session homework component delivered digitally for the treatment of adjustment disorders: Results from a pilot randomized clinical trial
title_full Efficacy of a between-session homework component delivered digitally for the treatment of adjustment disorders: Results from a pilot randomized clinical trial
title_fullStr Efficacy of a between-session homework component delivered digitally for the treatment of adjustment disorders: Results from a pilot randomized clinical trial
title_full_unstemmed Efficacy of a between-session homework component delivered digitally for the treatment of adjustment disorders: Results from a pilot randomized clinical trial
title_short Efficacy of a between-session homework component delivered digitally for the treatment of adjustment disorders: Results from a pilot randomized clinical trial
title_sort efficacy of a between session homework component delivered digitally for the treatment of adjustment disorders results from a pilot randomized clinical trial
topic adjustment disorder
between-session homework
internet-based therapy
CBT
virtual reality
efficacy
url https://www.frontiersin.org/articles/10.3389/frvir.2022.937606/full
work_keys_str_mv AT soledadquero efficacyofabetweensessionhomeworkcomponentdelivereddigitallyforthetreatmentofadjustmentdisordersresultsfromapilotrandomizedclinicaltrial
AT soledadquero efficacyofabetweensessionhomeworkcomponentdelivereddigitallyforthetreatmentofadjustmentdisordersresultsfromapilotrandomizedclinicaltrial
AT amandadiazgarcia efficacyofabetweensessionhomeworkcomponentdelivereddigitallyforthetreatmentofadjustmentdisordersresultsfromapilotrandomizedclinicaltrial
AT sarafernandezbuendia efficacyofabetweensessionhomeworkcomponentdelivereddigitallyforthetreatmentofadjustmentdisordersresultsfromapilotrandomizedclinicaltrial
AT marmoles efficacyofabetweensessionhomeworkcomponentdelivereddigitallyforthetreatmentofadjustmentdisordersresultsfromapilotrandomizedclinicaltrial
AT cintiatur efficacyofabetweensessionhomeworkcomponentdelivereddigitallyforthetreatmentofadjustmentdisordersresultsfromapilotrandomizedclinicaltrial
AT dianacastilla efficacyofabetweensessionhomeworkcomponentdelivereddigitallyforthetreatmentofadjustmentdisordersresultsfromapilotrandomizedclinicaltrial
AT pimcuijpers efficacyofabetweensessionhomeworkcomponentdelivereddigitallyforthetreatmentofadjustmentdisordersresultsfromapilotrandomizedclinicaltrial
AT cristinabotella efficacyofabetweensessionhomeworkcomponentdelivereddigitallyforthetreatmentofadjustmentdisordersresultsfromapilotrandomizedclinicaltrial
AT cristinabotella efficacyofabetweensessionhomeworkcomponentdelivereddigitallyforthetreatmentofadjustmentdisordersresultsfromapilotrandomizedclinicaltrial