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New Study Reveals Internet-Based Cognitive Behavioural Therapy Can Improve Depression and Insomnia

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Significant improvements in depression and insomnia symptoms over time can be achieved using internet-based cognitive behavioural therapy (ICBT), according to a new study by Hebrew University of Jerusalem researchers.

The new study in Psychotherapy Research led by Dr Dina Zalaznik from the Hebrew University Department of Psychology, highlights the critical role of interpersonal factors in ICBT. These findings advance the understanding of depression treatment through internet interventions and therapy’s broader benefits.

The study focused on two crucial aspects: the therapeutic alliance and attachment styles. Study participants, consisting of 39 mostly female participants (59%) with an average age of 38 years, were recruited through ads for a free trial and underwent screening, including online surveys and a phone interview. The internet-based cognitive behavioural therapy program consisted of six modules covering psychoeducation, cognitive work, behavioural activation, challenging thoughts, optional cognitive behavioural therapy for insomnia, and relapse prevention. Treatment was delivered by supervised doctoral students, with weekly guidance and homework assignments. Dropout rates and treatment adherence were also examined.

One of the key findings was the importance of the alliance between the therapist and the patient, as well as the alliance with the programme, in predicting adherence and dropout rates. While both alliances played a role in treatment outcomes, only the therapist alliance was significantly related to symptom improvement.

The results also showed that avoidant attachment style scores improved significantly during ICBT, whereas anxious attachment did not show significant improvement. This finding suggests that although the focus of ICBT is not on interpersonal relationships and the therapist’s involvement is limited, the emotional and cognitive components of attachment can still be positively impacted.

The researchers note that clinicians should consider using a weekly questionnaire to track these relationships and make necessary improvements, and that future studies should explore factors influencing these relationships further.

The research paper titled “Interpersonal factors in internet-based cognitive behavioural therapy for depression: Attachment style and alliance with the programme and with the therapist” is now available here.

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