Improving access to psychological services through therapist-assisted, Internet-delivered cognitive behaviour therapy.
Bibliographic record
Abstract
Depression and anxiety are prevalent yet undertreated conditions. Therapist-assisted Internet-delivered cognitive behaviour therapy (ICBT) is efficacious for these conditions and can serve to overcome barriers to accessing mental health care (e.g., distance, time). In therapist-assisted ICBT, patients review cognitive behavioural treatment materials over the Internet. In addition, providers offer support and direction most commonly through weekly emails or phone calls. Despite the evidence for and advantages of therapist-assisted ICBT, very few patients have access to this treatment in Canada. In this paper, we describe the Online Therapy Unit for Service, Education and Research that was developed at the University of Regina to improve patient access to ICBT in Saskatchewan. With the support of national and provincial funding, this unit created an ICBT web application for the treatment of depression and anxiety, established policies and procedures for delivery of ICBT, trained therapists to deliver the service, and has been coordinating the delivery of ICBT across multiple diverse settings in Saskatchewan. The current paper describes how the Unit is organized and collaborates with community mental health clinics, thus serving to improve access to ICBT. We provide information on the web application, and the process of ICBT from both the patient and provider perspective. We further describe patient and provider utilization of and feedback about ICBT along with recent and future directions for the Unit. Thus far, the Unit has had a positive impact expanding access to psychological services in Saskatchewan and has the potential to inform similar initiatives in other provinces.Keywords: Internet, therapist-assisted, cognitive behaviour therapy, depression, anxietyResumeLa depression et l'anxiete sont des troubles courants, mais les gens qui en souffrent restent souvent sans traitement. La therapie cognitivo-comportementale offerte en ligne (TCCL) par des therapeutes s'est revelee efficace pour ces conditions et peut aider a aplanir les obstacles a l'obtention de soins de sante mentale (par ex., en raison de la distance ou du manque de temps). Dans le cadre de ce type de therapie, les patients obtiennent en ligne des docu- ments sur la therapie comportementale. De plus, les therapeutes leur offrent un soutien et une orientation, le plus souvent au moyen de courriels ou par telephone une fois par semaine. En depit des preuves et des avantages en faveur de la TCCL, tres peu de patients au Canada y ont acces. Dans cet article, nous decrivons la Online Therapy Unit for Service, Education and Research qui a ete etablie a l'Universite de Regina dans le but d'ameliorer l'acces a la TCCL. Grâce a des fonds provenant de sources nationales et provinciales, l'unite a cree une application Web pour les services de TCCL pour le traitement de la depression et de l'anxiete, a etabli des politiques et des procedures pour la prestation du traitement, et a forme des therapeutes a cette fin. Elle coordonne la prestation de ces services au sein de divers environnements en Saskatchewan. L'article decrit l'organisation de l'unite ainsi que sa facon de travailler en collaboration avec des cliniques communautaires de sante mentale afin d'ameliorer l'acces a la TCCL. Il decrit aussi l'application Web et le procede therapeutique, a la fois du point de vue du patient et du therapeute. Il precise l'utilisation des services par le patient et le fournisseur, et presente les commentaires obtenus sur la TCCL et les prochaines etapes pour l'unite. A ce jour, l'unite a eu des repercussions positives en elargissant l'acces a des services psychologiques en Saskatchewan et elle a le poten- tiel de contribuer, a titre de source d'information, a des initiatives dans d'autres provinces.Mots-cles : en ligne, therapeute, therapie cognitivo-comportementale, anxiete.Depression and anxiety are highly prevalent in Canada (Pearson, Janz, & Ali, 2013), but many Canadians report that these condi- tions go untreated (Sunderland & Findlay, 2013). …
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.003 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".