|
1
|
Nyamathi AM, Salem BE, Gelberg L, Garfin DR, Wolitsky-Taylor K, Shin SS, Yu Z, Hudson A, Yadav K, Clarke R, Alikhani M, van Cise E, Lee D. Pilot randomized controlled trial of biofeedback on reducing psychological and physiological stress among persons experiencing homelessness. Stress Health 2023. [PMID: 38146789 DOI: 10.1002/smi.3366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 12/27/2023]
Abstract
People experiencing homelessness report increased exposure to traumatic life events and higher rates of depression, anxiety, and post-traumatic stress disorder as compared with the general population. Heart rate variability-biofeedback (HRV-BF) has been shown to decrease symptoms of stress, anxiety, depression, and PTSD. However, HRV-BF has not been tested with the most vulnerable of populations, homeless adults. The purpose of this randomized controlled trial was to compare the effectiveness of an HRV-BF intervention versus a Health Promotion (HP) active control intervention focused on improving mental health symptoms among homeless adults. Guided by a community advisory board, homeless adults residing in Skid Row, Los Angeles (n = 40) were randomized to either the HRV-BF or an active HP control group and received eight weekly, 30-min sessions over two months, delivered by a nurse-led community health worker team. Dependent variables of HRV, mental health, anxiety, depression, and PTSD were measured at baseline, the 8-week session, and/or 2-month follow-up. All intervention sessions were completed by 90% (36/40) of participants. Both the HRV-BF and HP interventions showed significant increases in HRV from baseline to 2-month follow-up, with no significant difference between the intervention groups. The HRV-BF programme revealed a somewhat greater, although non-significant, improvement in anxiety, depression, and PTSD symptoms than the HP programme. The usefulness of both interventions, focused on emotional and physical health, warrants future studies to examine the value of a combined HRV-BF and HP intervention.
Collapse
Affiliation(s)
- Adeline M Nyamathi
- Sue & Bill Gross School of Nursing, University of California, Irvine, California, USA
| | - Benissa E Salem
- School of Nursing, University of California, Los Angeles, California, USA
| | - Lillian Gelberg
- David Geffen School of Medicine at UCLA, University of California Los Angeles Fielding School of Public Health, Los Angeles, California, USA
| | - Dana Rose Garfin
- Community Health Sciences/Fielding School of Public Health, Los Angeles, California, USA
| | - Kate Wolitsky-Taylor
- Department of Psychiatry, University of California, Los Angeles, California, USA
| | - Sanghyuk S Shin
- Sue & Bill Gross School of Nursing, University of California, Irvine, California, USA
| | - Zhaoxia Yu
- Department of Statistics, School of Information and Computer Sciences, University of California, Irvine, California, USA
| | | | - Kartik Yadav
- Sue & Bill Gross School of Nursing, University of California, Irvine, California, USA
| | - Richard Clarke
- Office of Research, University of California, Irvine, California, USA
| | - Mitra Alikhani
- School of Nursing, University of California, Los Angeles, California, USA
| | | | - Darlene Lee
- Susan Samueli Integrative Health Institute, University of California, Irvine, California, USA
| |
Collapse
|
|
2
|
Kobak KA, Craske MG, Rose RD, Wolitsky-Taylor K. Web-based therapist training on cognitive behavior therapy for anxiety disorders: a pilot study. ACTA ACUST UNITED AC 2013; 50:235-47. [PMID: 23398031 DOI: 10.1037/a0030568] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The need for clinicians to use evidence-based practices (such as cognitive behavior therapy [CBT]) is now well recognized. However, a gap exists between the need for empirically based treatments and their availability. This is due, in part, to a shortage of clinicians formally trained on CBT. To address this problem, we developed a Web-based therapist CBT training program, to increase accessibility to this training. The program uses a two-step approach: an interactive multimedia online tutorial for didactic training on CBT concepts, followed by live remote observation through a videoconference of trainees conducting CBT, with immediate feedback in real time during critical moments to enhance learning through iterative guidance and practice. Thirty-nine clinicians from around the county completed the online didactic training and 22 completed the live remote training. Results found a significant increase in knowledge of CBT concepts and a significant increase in clinical skills, as judged by a blind rater. User satisfaction was high for both the online tutorial and the videoconference training. Utilization of CBT by trainees increased after training. Results support the acceptability and effectiveness of this Web-based approach to training.
Collapse
|