In March 2020, New York City became the epicenter of the COVID-19 pandemic. Waves of illness, uncertainty, isolation, disruption, and loss led to increased rates of emotional distress. To extend access to evidence-based mental health services, we initiated an open trial of emotion regulation therapy in the context of the pandemic (ERT-P), delivered via telehealth and “blended” with an internet and mobile intervention (IMI) to augment treatment (e.g., video modules, between-session exercises, mindful regulation practices). ERT-P is a brief, 9-session psychotherapy program that integrates principles from traditional and contemporary cognitive behavioral therapies and mindfulness-based interventions to well-sui motivational and regulatory mechanisms associated with distress.
The current study sought to evaluate the efficacy of ERT-P, investigate the impact of COVID-19 severity on treatment response, and explore whether sociodemographic, clinical, and contextual patient characteristics predict differential patterns of treatment response. Patients (N =134) were distressed, treatment-seeking adults in New York State. At pre- and posttreatment, as well as 3-month and 9-month follow-ups, patients completed assessments of perseverative negative thinking (PNT; worry, rumination), symptoms of emotional distress, and indices of quality of life. Patients exhibited statistically significant, large-magnitude reductions in all outcomes of interest at posttreatment (ds 1.53 – 2.74), which were maintained during the follow-up period (ds 0.75 – 1.33).
Those who enrolled in treatment when the pandemic was most severe (i.e., highest seven-day averages of cases, hospitalizations, and deaths) demonstrated greater improvement in PNT at posttreatment compared to those who enrolled earlier and later, irrespective of vaccine availability. Longer-term trajectories of improvement were not impacted by enrollment date and COVID-19 severity. Exploring predictors of reliable improvement identified a mix of sociodemographic, clinical, and contextual characteristics associated with acute treatment response. Notably, parenthood was consistently associated with a decreased likelihood of reliable improvement in worry, rumination, and distress.
Despite the study’s open trial design, which precludes causal attributions, ERT-P demonstrated preliminary efficacy. Further, ERT-P was found to be feasible and acceptable, evidenced by high patient satisfaction ratings, perceived usability of the IMI platform, and low attrition rates (10.5%). The current trial succeeded in its clinical objective to rapidly mobilize and extend access to evidence-based mental health services to a diverse group of distressed adults amidst the evolving landscape of the COVID-19 pandemic.
| Identifer | oai:union.ndltd.org:columbia.edu/oai:academiccommons.columbia.edu:10.7916/3nxm-jf74 |
| Date | January 2024 |
| Creators | Spaeth, Phillip |
| Source Sets | Columbia University |
| Language | English |
| Detected Language | English |
| Type | Theses |
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