Internet-based acceptance and commitment therapy (iACT) primarily targets the process of psychological flexibility. Its accessibility and low-intensity delivery are applicable across different treatment and prevention scenarios. This transdiagnostic meta-analysis reviews the effectiveness of iACT on anxiety, depression, quality of life, and psychological flexibility across individuals with different psychological and somatic conditions/complaints, or undiagnosed complaints. Seven databases were searched for randomized controlled trials that reported on anxiety, depression, quality of life, and psychological flexibility outcomes from iACT in any adult population. Engagement with iACT was summarized and methodological and population-related variables were investigated as potential moderators of effectiveness. Across 25 studies, small pooled effects were found for all outcomes at post-assessment and maintained at follow-up time-points. Interventions with therapist guidance demonstrated greater effectiveness in improving depression and psychological flexibility outcomes compared to nonguided iACT, and populations defined by a psychological condition or symptoms (e.g., depressed samples) demonstrated greater improvements in anxiety compared to nonclinical or somatic populations (e.g., chronic pain samples or students). Participants completed on average 75.77% of iACT treatments. While we found iACT to be effective in improving and maintaining mental health outcomes across diverse populations, there was limited evidence of reliable, clinically significant effects. PROSPERO registration number: CRD42020140086. 相似文献
Despite the vastly increased dissemination of the low-intensity (LI) version of cognitive behavior therapy (CBT) for the treatment of anxiety and depression, no valid and reliable indices of the LI-CBT clinical competencies currently exist. This research therefore sought to develop and evaluate two measures: the low-intensity assessment competency scale (LIAC) and the low-intensity treatment competency scale (LITC). Inductive and deductive methods were used to construct the competency scales and detailed rating manuals were prepared. Two studies were then completed. The first study used a quantitative, fully-crossed design and the second a multi-center, quantitative longitudinal design. In study one, novice, qualified, and expert LI-CBT practitioners rated an LI-CBT assessment session (using the LIAC) and an LI-CBT treatment session (using the LITC). Study two used the LIAC and LITC across four training sites to analyze the competencies of LI-CBT practitioners over time, across raters, and in relation to the actor/patients’ feedback concerning helpfulness, the alliance, and willingness to return. Both the LIAC and LITC were found to be single factor scales with good internal, test-retest reliability and reasonable inter-rater reliability. Both measures were sensitive to measuring change in clinical competence. The LIAC had good concurrent, criterion, discriminant, and predictive validity, while the LITC had good concurrent, criterion, and predictive validity, but limited discriminant validity. A score of 18 accurately delineated a minimum level of competence in LI-CBT assessment and treatment practice, with incompetent practice associated with patient disengagement. These observational ratings scales can contribute to the clinical governance of the burgeoning use of LI-CBT interventions for anxiety and depression in routine services and also in the methods of controlled studies. 相似文献
By mid-March 2020, most countries had implemented nationwide lockdown policies aimed at decelerating the spread of SARS-CoV-2. At that time, nobody knew how long these policies would have to remain in force and whether they would have to be extended, intensified or made more flexible. The present study aimed to illuminate how the general public in Germany reacted to the prospect of increasing the length, the intensity and/or the flexibility of distancing rules implied by different lockdown scenarios. Endorsement of and compliance with five specific lockdown scenarios were assessed in a large (N = 14,433) German sample. Results showed that lockdown length affected respondents' reactions much more strongly than intensity or flexibility. Additional analyses (i.e., mixture distribution modelling) showed that half of the respondents rejected any further extensions or intensifications, while 20% would endorse long-term strategies if necessary. We argue that policy-makers and political communicators should take the public's endorsement of and compliance with such scenarios into account, as should simulations predicting the effects of different lockdown scenarios. 相似文献
Journal of Religion and Health - The aim of this study is to explore experiences and perceived effects of the Rosary on issues around health and well-being, as well as on spirituality and... 相似文献
Almost all participants in the debate about the ethics of accidents with self-driving cars have so far assumed moral universalism. However, universalism may be philosophically more controversial than is commonly thought, and may lead to undesirable results in terms of non-moral consequences and feasibility. There thus seems to be a need to also start considering what I refer to as the “relativistic car” — a car that is programmed under the assumption that what is morally right, wrong, good, bad, etc. is determined by the moral beliefs of one’s society or culture. My investigation of this idea involves six steps. First, I explain why and how the moral universalism/relativism debate is relevant to the issue of self-driving cars. Second, I argue that there are good reasons to consider accident algorithms that assume relativism. Third, I outline how a relativistic car would be programmed to behave. Fourth, I address what advantages such a car would have, both in terms of its non-moral consequences and feasibility. Fifth, I address the relativistic car’s disadvantages. Finally, I qualify and conclude my considerations.
Clinicians working in the field of acquired brain injury (ABI, an injury to the brain sustained after birth) are challenged to develop suitable care pathways for an individual client’s needs. Being able to predict psychosocial outcomes after ABI would enable clinicians and service providers to make advance decisions and better tailor care plans. Machine learning (ML, a predictive method from the field of artificial intelligence) is increasingly used for predicting ABI outcomes. This review aimed to examine the efficacy of using ML to make psychosocial predictions in ABI, evaluate the methodological quality of studies, and understand researchers’ rationale for their choice of ML algorithms. Nine studies were reviewed from five databases, predicting a range of psychosocial outcomes from stroke, traumatic brain injury, and concussion. Eleven types of ML were employed with a total of 75 ML models. Every model was evaluated as having high risk of bias, unable to provide adequate evidence for predictive performance due to poor methodological quality. Overall, there was limited rationale for the choice of ML algorithms and poor evaluation of the methodological limitations by study authors. Considerations for overcoming methodological shortcomings are discussed, along with suggestions for assessing the suitability of data and suitability of ML algorithms for different ABI research questions. 相似文献
Client agency is considered a crucial contributor to good treatment outcome. Recent studies, however, differ strongly in how they conceptualise and investigate agency. The current study explores the nature of client agency in ten clients’ pre-treatment interviews. Applying Consensual Qualitative Research, we constructed three overarching categories, subdivided into 14 sub-categories capturing both between- and within-person differences in agency before therapy. We found that all participants oscillated between the experience of a lack of grip on problems on the one hand and noticing their involvement in the problem and taking action on the other. These results present a dynamic conceptualisation of client agency. This allows us to ask pertinent questions for both future research and clinical practice. 相似文献