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Background: Emotional activation is regarded as central in psychotherapy. We have developed a method called VideoTalk, in which patients video themselves at home according to the therapist's instructions, and the videos are watched together in the therapy session. The aim of the study was to find out whether watching and listening to a video in psychotherapy readily activates the patient's emotions. Methods: The video material was analysed by theory‐based content analysis using the interacting cognitive subsystems (ICS) theory. The ICS theory suggests a link between sensory information and emotions and describes two levels of meaning: propositional and implicational. The implicational level gains information from the propositional level and directly from perceptions and is central to the activation of emotions. Five patients participated in our schema therapy‐based intervention. Our material included videos of 10 therapy sessions, in which the patient and the therapist watched a video made by the patient at home in a state of helplessness. Watching the video in the session was performed in parts, and between watching periods, there were observation phases consisting of discussion about what the patient had seen and heard on the video and how it affected them. Our data included 38 observation phases, and in 35 of these, the patient verbalised an emotion after watching the video. The implicational level was involved in almost all observation phases in which the patient verbalised emotions. Results: Our findings are in line with the hypothesis that added multisensory information via video enhances input to the implicational level and therefore emotional activation in psychotherapy. This is a possible mechanism by which the use of VideoTalk could facilitate the psychotherapy process. [ABSTRACT FROM AUTHOR]

Background: Studies have shown a high prevalence of depression during pregnancy, and there is also evidence that cognitive behavioral therapy (CBT) is one of the most effective psychosocial interventions. Emerging evidence from randomized controlled trials (RCTs) has shown that technology has been successfully harnessed to provide CBT interventions for other populations. However, very few studies have focused on their use during pregnancy. This approach has become increasingly important in many clinical areas due to the COVID-19 pandemic, and our study aimed to expand the knowledge in this particular clinical area.Objective: Our systematic review aimed to bring together the available research-based evidence on digitalized CBT interventions for depression symptoms during pregnancy.Methods: A systematic review of the Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, MEDLINE, Embase, PsycINFO, Scopus, ClinicalTrials.gov, and EBSCO Open Dissertations databases was carried out from the earliest available evidence to October 27, 2021. Only RCT studies published in English were considered. The PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-analyses) guidelines were followed, and the protocol was registered on the Prospective Register of Systematic Reviews. The risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials.Results: The review identified 7 studies from 5 countries (the United States, China, Australia, Norway, and Sweden) published from 2015 to 2021. The sample sizes ranged from 25 to 1342 participants. The interventions used various technological elements, including text, images, videos, games, interactive features, and peer group discussions. They comprised 2 guided and 5 unguided approaches. Using digitalized CBT interventions for depression during pregnancy showed promising efficacy, with guided intervention showing higher effect sizes (Hedges g=1.21) than the unguided interventions (Hedges g=0.14-0.99). The acceptability of the digitalized CBT interventions was highly encouraging, based on user feedback. Attrition rates were low for the guided intervention (4.5%) but high for the unguided interventions (22.1%-46.5%). A high overall risk of bias was present for 6 of the 7 studies.Conclusions: Our search only identified a small number of digitalized CBT interventions for pregnant women, despite the potential of this approach. These showed promising evidence when it came to efficacy and positive outcomes for depression symptoms, and user feedback was positive. However, the overall risk of bias suggests that the efficacy of the interventions needs to be interpreted with caution. Future studies need to consider how to mitigate these sources of biases. Digitalized CBT interventions can provide prompt, effective, evidence-based interventions for pregnant women. This review increases our understanding of the importance of digitalized interventions during pregnancy, including during the COVID-19 pandemic.Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42020216159; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=216159. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess the changes after a short training course in the practice orientation of general practitioners (GPs) in diagnosing and treating patients with depression. A controlled intervention study design was used, with pre- and post-intervention measurements. The intervention was conducted in four health care centers in Finland. One health care center functioned as the control. The intervention was a 3-day training course, targeted at all the staff of the intervention health care centers. It included lectures on depression and practice in small groups, focusing especially on patient-caregiver relationships and interaction. Both in the intervention and in the control health care centers all patients were screened for depression during 1 week before and 4 months after the training. The agreement on the patients' depressive status was measured by comparing the patients' Beck Depression Inventory (BDI) scores with the GPs' assessments. Practice orientation was evaluated from descriptions given by the treating GPs. In the intervention health care centers 18% (210 of 1154) of the patients in the pretest phase and 17% (132 of 799) in the posttest phase were indicated as depressed by the BDI. Contrary to expectations, the GPs' originally low sensitivity (in comparison with the BDI) in detecting depression decreased even somewhat more after the training course (17.1%/11.4%). However, the practice changed slightly from being symptom-oriented toward being patient- or even family-oriented in the intervention health care centers. [ABSTRACT FROM AUTHOR]