In March 2020, the Dutch government began implementing measures to prevent the spread of the COVID-19 virus, and to reduce the burden to the national healthcare system. Historically, Dutch mental...Show moreIn March 2020, the Dutch government began implementing measures to prevent the spread of the COVID-19 virus, and to reduce the burden to the national healthcare system. Historically, Dutch mental healthcare has been slow to implement and utilise digital interventions, however, the new public health policies regarding social distancing presented an acute and emergent need to do so. Despite therapists’ concerns regarding its efficacy and potential technical challenges, countless mental healthcare professionals turned to videoconference therapy to conduct generalistic Basic Mental Healthcare outpatient treatments. This paradigm shift presented a rare opportunity to examine whether videoconferencing therapy yields comparable results to in-person interventions for common mental health disorders. Arkin, a large mental healthcare facility and research institute in central Amsterdam, collects routine outcome monitoring data for patients under its care, to support shared decision-making. For the purposes of this study, basic mental healthcare patients (N = 1392) were divided into three cohorts: Treatments performed prior to, treatments performed partially during, and treatments performed entirely during the COVID-19 lockdown; and pre- and post-test data were used to compare outcomes. Across the three cohort conditions, there were no differences in the treatment outcomes for videoconferencing therapy conducted during lockdowns, as compared to in-person interventions done prior to the COVID-19 pandemic, or blended treatments that had commenced as in-person treatment before the pandemic and then transitioned to videoconferencing during the lockdown. This observational study seems to indicate that videoconferencing and in-person therapies can produce similar clinical results in Basic Mental Healthcare patients with common mental health disorders, bolstering the findings of other meta-analyses and randomized controlled studies investigating this topic.Show less
The corona crisis offered a natural experiment to compare videoconferencing treatment with in person treatment. The COVID-19 epidemic requiring social distancing through its lockdown measures...Show moreThe corona crisis offered a natural experiment to compare videoconferencing treatment with in person treatment. The COVID-19 epidemic requiring social distancing through its lockdown measures forced a sudden and total transition from in person to videoconferencing mode of treatment provision, irrespective of the preference of the therapist or client. Routine Outcome Monitoring (ROM) data allowed the comparison of three groups of treatment delivery: (1) treatments that were largely or completely performed in person, (2) treatments that started in person but suddenly switched to treatment via videoconferencing due to the corona measures, and (3) treatments that were performed entirely with video conferencing. The research question in this study is: How does treatment conducted (partially) through videoconferencing compare to in person therapy in effectiveness? It was hypothesized that full in person treatment would be more effective than (partial) videoconferencing treatment. The participants in this research were patients receiving treatment at Sinai Center, a Mental Healthcare Clinic in The Netherlands, specialized in the treatment of PTSD. The patients who were included in this study were predominantly diagnosed with PTSD and had completed their treatment in the years 2018 till 2021. ROM data were used to analyse the pre- and post-test scores of the three cohorts with repeated measures ANOVA in a two (time) by three (conditions) factorial design. Also, the proportions of recovered, improved, unchanged, and deteriorated patients were compared among the three cohorts with a chi-square test. Contrary to what was hypothesized, the results showed that there was no significant difference between the three treatment groups in outcome of therapy. Some limitations of the study may have influenced the results; incomplete background information of the patients to account for in the analyses, lack of a disorder specific questionnaire to measure outcome, the effects of the pandemic and lockdown on the patients.Show less
The growth and development of psychology and mental healthcare is accompanied by a rapid increase in the number of assessment instruments that are utilizer. The downside of presented variety and...Show moreThe growth and development of psychology and mental healthcare is accompanied by a rapid increase in the number of assessment instruments that are utilizer. The downside of presented variety and availability is an abundance, which hinders interpretation of test results, comparison of outcomes, and communication among colleagues and with patients about their test results. This may lead to diminished patient involvement and treatment progress. A common metric is lacking, linking test scores to a common metric, such as the T-score metric based on the Item Response Theory (IRT), may provide a solution to the Babel tower dilemma. The current study investigates the feasibility of an approach to develop a common metric and applies this to three anxiety-related questionnaires: Agoraphobic Cognitions Questionnaire (ACQ), Bodily Sensations Questionnaire (BSQ), and Mobility Inventory (MI) based on the data collected from 210 patients and 430 normal participants. IRT was applied to attain T-scores, form non-linear transformation formulas to estimate T-scores based on raw test scores and theory-based T-scores. The distributions and correspondence of the two Tscores were inspected. The theory-based T-scores and T-scores based on transformation formulas correspond sufficiently for ACQ and BSQ, but for the MI the proposed approach failed to produce useable T-scores. The reasons, pros and cons of IRT are discussed, as well as practical applications, focusing the attention on Routine Outcome Monitoring (ROM). The use of a common metric will allow ease comparison of scores from various instruments and aids communication, while characteristics of IRT allow the use of variable questionnaires and adaptive tailored testing assisting the utilization of ROM in treatment.Show less
