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ViewAttendees 8

Symposia

Treatment - CBT

Session: Sharing and Leveraging the Lessons of CBT: Understanding How CBT Works and Using that Understanding to Inform Interventions

1 - (SYM 111) A Randomized Controlled Trial of Stepped Care Cognitive-behavioral Therapy for Internalizing Symptoms and Emotion Regulation in Adults in Indiana

Saturday, November 18, 2023
4:30 PM – 6:00 PM PST
Location: Snohomish (605), Level 6

Introduction:  Transdiagnostic self-help cognitive-behavioral therapy (CBT) approaches may help ease the burden of untreated symptoms of internalizing distress in predominantly rural states. The World Health Organization created a free bibliotherapy program called “Doing What Matters in Times of Stress,” which is based on the principles of Acceptance Commitment Therapy (ACT). 

Methods:  We conducted a 6-week randomized controlled trial (N = `238) across the state of Indiana where all participants were given immediate access to a CBT-based single session intervention (SSI) following by randomization to either guided or unguided “Doing What Matters” bibliotherapy. We used mixed models to model change over time as a piecewise function. 

Results:  The sample was in their early 30s (M=32.50, SD = 10.77), mostly female (85.71%) and, consistent with the demographics of the state mostly White (80.67%). Only a fraction of participants accessed the SSI (n = 86). There was no evidence that completing the SSI was associated with improved outcomes. All participants reported large improvements in internalizing distress, well-being, cognitive reappraisal, and expressive suppression. Participants randomized to the guided (vs. unguided) condition experienced greater overall improvements in internalizing distress (SMD: -0.30, 95% CI: -0.51, -0.08) and cognitive reappraisal (SMD: 0.21, 95% CI: 0.03, 0.39) but the differences in well-being (SMD = 0.11, 95% CI: -0.14, 0.36) and expressive suppression were small and not statistically significant (SMD = -0.10, 95% CI: -0.30, 0.08). 

Discussion:  Self-help approaches are scalable and guided self-help is more effective than unguided self-help. More work should focus on engaging men in self-help research. Doing What Matters activates traditional CBT mechanisms more so than hypothesized ACT ones like expressive suppression.