Title: Outcomes and Experiences of Delivering Internet-based Cognitive Behavioral Therapy in the US during the COVID-19 pandemic. Abstract: Objectives Internet-based cognitive behavioral therapy (ICBT) for tinnitus is an evidence-based intervention, but not available in the US. Thus, ICBT was adapted for use in the US and evaluated. This talk describes experiences of delivering ICBT in this population during the COVID-19 pandemic. Design Two RCTs were undertaken. The first trial included 158 participants using a delayed treatment design, whereas the second trial was a dismantling study used a parallel design for 136 participants. The primary outcome was a change in tinnitus distress as measured by the Tinnitus Functional Index (TFI). Secondary outcome measures included measures of anxiety, depression, insomnia, tinnitus cognitions, hearing-related difficulties, and health-related quality of life. Treatment engagement variables included monitoring engagement regarding the number of logins, number of modules opened and number of messages sent. Results Both trials indicated that undertaking the ICBT led to large improvements of tinnitus severity which were maintained at follow up. There was furthermore a greater reduction for most secondary effects. Results are suggestive that the applied relaxation components may be sufficient to achieve reductions of tinnitus distress. Tinnitus distress decreased the most at post-intervention for those with significant depression at baseline. The trials were undertaken during the first wave of the COVID-19 pandemic, possibly contributing to engagement and compliance being lower than that of trials undertaken in Europe. Conclusions Although results are comparable to results found using ICBT in Europe, participant engagement was much lower. For some participants, the pandemic or having COVID-19 impacted on their ability to focus on the trial. When dismantling the treatment components, the active ingredient could be applied relaxation. There does not appear to be any differential effects depending on subgroups. Ways of improving intervention compliance and engagement are required as well as evaluating the long-term effects are required. Best wishes, Eldré -- Please click here to view our e-mail disclaimer http://www.aru.ac.uk/email-disclaimer
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