Related to [[Article - Internet-Based Self-Help for Psychosis - Findings from a Randomized Controlled Trial]] # 202108310949 Study Protocol - Internet based intervention for people with psychosis study EviBas Rüegg et al. BMC Psychiatry (2018) 18:102 https://doi.org/10.1186/s12888-018-1644-8 Nina Rüegg1* , Steffen Moritz2, Thomas Berger1, Thies Lüdtke2,3 and Stefan Westermann1 ![[An internet-based intervention for people with psychosis (EviBaS)- study protocol for a randomized controlled trial.pdf]] An internet-based intervention for people with psychosis (EviBaS): study protocol for a randomized controlled trial ---- [[HOPES Project Index]] #CBT **STUDY PROTOCOL** This project wants to reach people who do not receive psychological treatment but are looking for support .Internet-based interventions might even be able to reach a group of patients that discontinued a previous face-to-face therapy. No Result yet. [[202108311016 What are the different therapies for people with Schizophrenia]] - About 65% of individuals with a first episode relapse during the subsequent three years [16], resulting in inpatient costs about two to five times higher compared to non-relapsed patients [17]. - CBTp targets psychological mechanisms of symptom formation and maintenance that were primarily identified or corroborated using experimental psychopathology research [25–27] CBT helps in giving alternate belief and reducing distress of experiencing hallucinations - For example, the distress (consequence) related to hearing voices (situation) is assumed to be determined not by hearing voices per se, but predominantly by automatic thoughts and the according belief system. Consequently, alternative help- ful beliefs about voices established with the help of cog- nitive techniques are supposed to result in less distress [28]. Similarly, ACT focus on helping patients to notice their thoughts and feelings though cognitive distancing. - Acceptance and Commitment Therapy (ACT) focuses on noticing rather than changing thoughts and feelings [32]. ACT seems to be effective in treating mental health problems [33]. In schizophrenia, ACT helps people to cope with psychotic experiences using strategies such as cognitive distancing, which is characterized by learning to see one’s belief as a hypothetical statement rather than a fact. Instead of trying to change, modify, or con- trol odd cognitions or disturbing sensory states, patients are encouraged to instead simply be aware of these experiences [34]. A meta-analysis showed a medium- sized effect of ACT on symptoms of psychosis [35]. Metacognitive Training ( MCT) is also another method to help people critically evaluate cognitive biases. Metacognitive Train- ing for psychosis (MCT), developed specifically for people with schizophrenia [36, 37]. MCT invites participants to critically evaluate cognitive biases such as jumping to con- clusions and overconfidence in their thinking (metacogni- tion). These biases might increase the likelihood of psychotic symptoms [38]. Studies show that MCT is efficacious in reducing psychotic symptoms [39, 40]. Internet-based cognitive behavioral therapy (iCBT) can help to overcome treatment gaps in many mental disorders [45] While patients work their way through a structured self- help program that is typically based on CBT manuals, therapists or coaches assist and support them via a secured e-mail system. Meta-analyses on internet-based treatments show a superiority of guided interventions in comparison to unguided, automated programs in terms of efficacy, adherence to treatment, and drop-out rates [47–49]. Advantageous of Internet-based treatments Main advantages of guided internet-based treatments include: (1) low-threshold accessibility, (2) flexible usage independent of time and place at a self- determined pace, (3) high levels of anonymity and privacy (which is an attractive feature for many persons with a mental disorder due to their fear of stigmatization) and (4) low costs of delivery to large populations [50]. The intervention called EviBaS (for Evidence-Based Self- help intervention) consists of an online program based on CBT principles, while also including components of ACT and MCT treatments. A smartphone app provides the possibility of exercising the modules in everyday life. ![[Screenshot 2021-08-31 at 10.04.27 AM.png]] There are 11 text-based modules in the online program, addressing a variety of topics (see Table 1). Each module includes texts and a worksheet. The worksheets can also be accessed via the optional app. The only mandatory module is the introductory one. After completion, the par- ticipants can choose from the remaining ten modules freely. Relapse prevention is recommended as the last module. Study participants are asked to work on approxi- mately one to two modules per week. The time required to finish one module may vary, but will usually not exceed 60 min. The intervention is self-paced, so that participants are able to work on topics they prioritize, such as emo- tional issues rather than positive symptomatology [73]. While working with the program, participants will be in contact with a personal moderator if they want to. The moderator will guide the participants through the pro- gram with at least one message per week. The main goal of this steady contact is to help participants structure their usage of the program and to encourage regular participa- tion [47]. If necessary (in case of a participant not using the intervention for seven days), the moderator reminds the participant to interact with the program. Participants’ questions are answered within three workdays by modera- tors. There is a biweekly supervision of all the moderators in the study team led by a licenced psychotherapist with extensive experience in CBTp. The different outcome measures used in the study are 1. Positive and Negative Syndrome Scale (PANSS) 2. MINI International Neuropsychiatric Interview (MINI) 3. Paranoia Checklist 4. Launay–Slade Hallucination Scale (LSHS-R) 5. Delusion and Voices Self-Assessment (DV-SA) 6. Incongruence questionnaire (K-INK) 7. World Health Organization Quality of Life Assessment (WHO-QoL-BREF) 8. Rosenberg Self-Esteem Scale (RSES) 9. Insomnia Severity Index (ISI) 10. Penn State Worry Questionnaire - Abbreviated (PSWQ-A) 11. Patient Health Questionnaire (PHQ-9) 12. Box Task 13. Mindful Attention Awareness Scale (MAAS) 14. Interpersonal Competence Questionnaire (ICQ) 15. Internalized Stigma of Mental Illness (ISMI) – Short version 16. Medication Adherence Rating Scale (MARS-D) 17. Attitudes towards Psychological Online Interventions (APOI) 18. Credibility/Expectancy Questionnaire (CEQ) 19. University of Rhode Island Change Assessment (URICA) 20. Client Satisfaction Questionnaire (CSQ) 21. Questionnaire about Side Effects Psychosis and Internet (QueSPI) 22. Working Alliance Inventory – Short Revised (WAI-SR)