Breakout E – October 13, 2011 (MC: Maria Monroe-DeVita)
1. Self-Guided, Computer-Based Stress Management and Resilience Training
Presenter: Raphael Rose, PhD
Authors: Raphael D. Rose, Michelle G. Craske, University of California, Los Angeles, Jay C. Buckey, Jr., Dartmouth Medical School, and James A. Cartreine, Brigham and Women’s Hospital
Abstract: As part of a NASA-funded project, we developed an evidenced-based, self-directed, interactive multimedia program to train users how to manage stress and build resilience. The program is called SMART-OP (Stress Management and Resilience Training for Optimal Performance). The 6-session program includes education about stress, and training and exercises focused on three parts of a stress response (thoughts, feelings and actions), and is based on cognitive-behavioral therapy. The program’s content can be modified to be applicable to various different populations. SMART-OP has potential for widespread dissemination via computer or internet, thereby addressing important implementation issues. We are about to complete a randomized controlled efficacy trial with a sample of healthy but stressed business and law students at UCLA. Outcome is assessed by performance on a standardized laboratory social stress test (Trier). Measurements include psychophysiology data (i.e., heart rate variability, respiration, blood pressure, skin conductance), biomarkers for stress (i.e., cortisol and salivary alpha amylase), and performance on a speech, arithmetic problems, memory and non-verbal motor tasks, and self-report measures. Preliminary data on usefulness indicates high user satisfaction.
We will demonstrate SMART-OP, present preliminary outcome data from our efficacy trial, and discuss how evidenced-based self-guided behavioral health programs can address implementation issues.
Presenter: Linda A. Dimeff, PhD
Authors: Linda A. Dimeff, Ignacio Contreras, BTECH Research, Inc., Shireen L. Rizvi, Rutgers, David Carroll, Parsons, The New School for Design, and Marsha M. Linehan, University of Washington
Abstract: Borderline Personality Disorder (BPD) is a severe psychological disorder, affecting up to 6% of the population, often co-occurring with substance abuse disorders, depression, suicidal and non-suicidal self-injurious behaviors. Dialectical Behavior Therapy (DBT) is one of only a few efficacious treatments for BPD. Behavioral skills taught as part of DBT are critical for BPD clients to avoid problem behaviors (e.g. cutting or substance abuse), especially between therapy sessions when therapists are not present to intervene.
Given the ubiquitous nature of mobile phones and their considerable potential for behavior change, especially for multimedia-rich ‘smart’ phones, we developed and tested the DBT Coach prototype. This user-friendly mobile phone application was designed to help individuals with BPD apply DBT skills to fidelity outside of the therapeutic environment. Utilizing an iterative process of development with extensive end-user feedback, the DBT Coach provides step-by-step coaching on the skill of Opposite Action.
Following successful development, we conducted a quasi-experimental study with 22 BPD patients enrolled in DBT treatment. Participants were provided a smart phone with the Coach installed for a two-week period. Results indicate that both emotion intensity and urges to use substances significantly decreased during the study (t(255)=12.41, p<.001 and t(275)=7.05, p<.001 respectively). Furthermore, participants reported a decrease in depression, as measured by the BDI (t(21) = 2.69, p=.014) and general distress as measured by the BSI (t(21) = 2.49, p=.021). Strengths and limitations of this research approach will be discussed, as well as qualitative findings and potential impact of the DBT Coach as therapy adjunct.
Presenter: Linda A. Dimeff, PhD
Authors: Linda A. Dimeff, Melinda Welch, Jake Zavertnik, BTECH Research, Inc., Sam Hubley, and Sona Dimidjian, University of Colorado
Abstract: Despite the availability of evidence-based treatments for depression such as behavioral activation (BA), large gaps exist between empirical research and clinical practice. This presentation reports on our efforts to facilitate the widespread dissemination of BA via computer-assisted therapy (CAT). BA-CAT is designed for clinicians and clients to use together in-session by providing structured, step-by-step guidance through each BA session with text, video demonstrations, and a variety of interactive tools. Results from BA-CAT pilot-testing demonstrated that clinicians are interested in learning about BA via computer training and that clinicians who participated in BA computer training reported high satisfaction with the program. The presentation concludes with images of our most recent iteration of BA-CAT to illustrate for the audience the “look” and “feel” of the program.