Implementing computer-based psychotherapy among veterans in outpatient treatment for substance use disorders
Open accessAbstract
Objective: Computer-based psychotherapy interventions (CBPIs) are increasingly offered as first-level access to evidence-based mental health treatment. However, their implementation has not been evaluated in public-sector outpatient settings. Methods: An evidence-based CBPI for insomnia was implemented with provider and patient education sessions, on-site Internet access, and clinician telephone support. Persons receiving care at a Veterans Health Administration substance abuse treatment clinic were screened for chronic insomnia and offered CBPI access. The feasibility of this strategy was evaluated in a pre-post design, which assessed engagement and completion rates, participant-reported acceptability, and clinical outcomes. Results: Of 100 veterans referred, 51 enrolled in the program, of whom 22 (43%) completed all sessions, 13 (26%) partially completed the program, and 16 (31%) did not engage. There were no statistically significant differences between these three groups in baseline characteristics. In the total sample, Insomnia Severity Index (ISI) scores decreased (improved) by 32% (mean6SD of 6.366.2 points, t=6.82, df=44, p,.001). Veterans who completed all six sessions displayed clinically and statistically significant improvements on the ISI compared with those who did not engage, as shown in a regression analysis that controlled for baseline insomnia severity, time between assessments, and sedative-hypnotic medication use (F=3.87, df=4 and 40, p<.004). Among all participants, 67% agreed that they would engage in another CBPI in the future. When questioned about potential barriers, 36% of the full sample endorsed a preference for face-to-face therapy. Conclusions: A strategy of brief provider and patient education, on-site Internet access, and telephone support was feasible and effective for implementing CBPIs in outpatient substance abuse treatment settings for veterans.
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Cites
Statistics
Claims the paper makes
6 of 21 cited sources checked · 1 supported · 0 flagged · accuracy not yet measured
- Premisecitation
The Restore program, a six-session Internet-based self-administered therapy for insomnia, has demonstrated efficacy in a controlled trial of 118 people with chronic insomnia.
“The program has shown efficacy in a controlled trial involving 118 persons with chronic insomnia (20).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [20] source
- Premisecitation
Trials of clinician-assisted computerized interventions for depression have reported dropout rates of 30% to 50%.
“For example, trials of clinician-assisted computerized interventions for depression have reported dropout rates of between 30% and 50% (31).”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [31] source
Treatment Attendance reports a 32% mean dropout rate from a review of computerized CBT for depression, but does not specify that those reviewed treatments were clinician-assisted. Treatment Attendance and Follow-up Participation reports that 47% of participants in this paper’s clinician-assisted computer condition completed all 10 sessions—53% did not. Thus the paper supports substantial dropout, but not the stated 30%–50% range specifically for clinician-assisted trials. (LLM, conf=0.86)
Experimental — accuracy not yet measured
- Premisecitation
Studies of sedative-hypnotic medication treatment for insomnia have shown strong placebo effects.
“Studies of sedative-hypnotic medication treatment for insomnia have shown strong placebo effects (38).”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [38] source
The Discussion (Meaning of the study; page unavailable) says the placebo response accounted for about half of the response to Z drugs. But it also calls that response small and of questionable clinical importance. The Introduction says the FDA trials lacked untreated controls, so this study could not directly assess the placebo effect itself; the claim’s description of strong placebo effects overstates what it established. (LLM, conf=0.86)
Experimental — accuracy not yet measured
- Interpretationcitation
Reduced engagement and completion in public mental health treatment settings may be the rule rather than an exception.
“Reduced engagement and completion in such treatment settings may be the rule rather than an exception (30).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [30] source
In “The Law of Attrition (Or: Why Do eHealth Users Discontinue Usage?),” the paper describes stopping use or being lost to follow-up as a fundamental characteristic of eHealth applications, citing low completion of online panic-disorder and depression programs. This supports the claim's general point about reduced engagement and completion, but the paper does not establish that it is typical across public mental health treatment settings more broadly. (LLM, conf=0.85)
Experimental — accuracy not yet measured
- Findingown data
Of 51 veterans who enrolled, 22 (43%) finished the computer-based psychotherapy for insomnia.
“| | Total sample (N=51) | Completers (N=22, 43%) a | completers (N=13, 26%) a | engage (N=16, 31%) a |”
Quote in the paperNot a substantial claim
- Findingown data
There were no statistically significant baseline differences among completers, partial completers, and nonengagers.
“There were no statistically significant differences between groups of completers, partial completers, and nonengagers for baseline characteristics (Table 1).”
- Also stated in: § Abstract · plain
“There were no statistically significant differences between these three groups in baseline characteristics.”
Quote in the paperNot a substantial claim - Also stated in: § Abstract · plain
- Findingown data
In the total sample, ISI scores decreased by a mean of 6.3 points (32% decrease) from baseline to follow-up (t=6.82, df=44, p<.001).
“In the total sample, total ISI scores decreased by a mean of 6.3 points (32% decrease) from baseline to follow-up (t=6.82,df=44, p,.001).”
- Also stated in: § Abstract · plain
“In the total sample, Insomnia Severity Index (ISI) scores decreased (improved) by 32% (mean6SD of 6.366.2 points, t=6.82, df=44, p,.001).”
Quote in the paperSubstantial claim - Also stated in: § Abstract · plain
- Findingown data
In adjusted linear regression, statistically significant differences were observed in mean follow-up ISI scores between engagement and completion groups (F=3.87, df=4 and 40, p≤.004).
“In adjusted linear regression analysis, statistically significant differences were observed in mean follow-up ISI scores between engagement and completion groups (F=3.87,df=4 and 40, p#.004).”
- Also stated in: § Abstract · plain
“Veterans who completed all six sessions displayed clinically and statistically significant improvements on the ISI compared with those who did not engage, as shown in a regression analysis that controlled for baseline insomnia severity, time between assessments, and sedative-hypnotic medication use (F=3.87,df=4 and 40, p#.004).”
Quote in the paperSubstantial claim - Also stated in: § Abstract · plain
- Findingown data
Of 45 participants with follow-up acceptability data, 30 (67%) agreed or strongly agreed that they would try another computer-based therapy for a different mental health, physical, or other problem.
“| Strongly agree, agree | 30 | 67 | 15 | 50 | 9 | 30 | 6 | 20 | | |”
Quote in the paperSubstantial claim - Findingown data
Sixteen participants (36%) agreed they would have preferred meeting in person.
“When asked if they would have preferred meeting in person, only 16 participants (36%) agreed (Table 2).”
Quote in the paperNot a substantial claim - Findingown data
This study showed large effect sizes on the ISI among both completers and partial completers compared with those who did not engage.
“This study showed large effect sizes on the ISI among both completers and partial completers compared with those who did not engage.”
Quote in the paperSubstantial claim - Findingown data
Results showed only small changes in sedative-hypnotic medication use.
“Results showed only small changes in such use.”
Quote in the paperSubstantial claim - Findingown data
Those who did not engage showed only a nonsignificant 3% decrease in ISI.
“Those who did not engage showed only a nonsignificant decrease of 3%, from 19.9 to 14.6.”
Quote in the paperNot a substantial claim - Findingown data
Of 51 veterans who enrolled, 16 (31%) never engaged with the program.
“| | Total sample (N=51) | Completers (N=22, 43%) a | completers (N=13, 26%) a | engage (N=16, 31%) a |”
Quote in the paperNot a substantial claim - Findingown data
Partial completers had a statistically significant 27% decrease in ISI score, from 19.9 to 14.6 (t=2.64, df=12, p=.022).
“Partial completers also experienced a statistically significant decrease in the ISI score of 27%, from 19.9 to 14.6 (t=2.64,df=12, p=.022).”
Quote in the paperSubstantial claim - Findingown data
There were no statistically significant differences in the number of new sedative-hypnotic starts or stops between engagement and completion groups.
“Likewise, there were no statistically significant differences in the number of new sedative-hypnotic starts or stops between engagement and completion groups.”
Quote in the paperNot a substantial claim - Findingown data
Evaluation of baseline characteristics and engagement and completion status did not reveal any factors that may have accounted for differences.
“However, the evaluation of baseline characteristics and engagement and completion status did not reveal any factors that may have accounted for these differences.”
Quote in the paperSubstantial claim - Findingown data
The mean baseline insomnia level was moderate to severe, with an ISI score of 20 out of 28.
“The mean insomnia level for the sample represented moderate to severe insomnia (ISI score=20 out of 28, with higher scores indicating more severe insomnia)”
Quote in the paperNot a substantial claim - Findingown data
A majority (N=410, 91%) of contacts were phone messages or short motivational conversations.
“A majority (N=410, 91%) were either phone messages or short conversations of a motivational nature.”
Quote in the paperNot a substantial claim - Premisecitation
Self-help computer-based psychotherapy interventions for insomnia have shown efficacy.
“Such CBPIs for insomnia have shown efficacy (19).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [19] source
- Interpretationown data
A strategy combining education for providers and patients, Internet access at the clinic, and telephone support makes computer-based psychotherapy for insomnia workable in VHA outpatient mental health and substance use treatment settings.
“Results suggest that the implementation of a CBPI for insomnia using a strategy consisting of provider and patient education sessions, clinic-based Internet access, and telephone-based support is feasible in VHA outpatient mental health and substance abuse treatment settings.”
Quote in the paperSubstantial claim - Interpretationcitation
The finding that no baseline factors predicted engagement and completion is similar to other studies showing few such predictors.
“Moreover, our finding that no baseline factors predicted engagement and completion is similar to that of other studies showing few such predictors (36,37).”
Quote in the paperNot a substantial claim0 of 2 sources checked - Interpretationown data
Implementing Restore with provider education, optional on-site Internet access, patient education, and weekly telephone support is feasible.
“Results suggest that implementation of the Restore program using this strategy is feasible, which is supported by evidence in three areas: reasonable engagement and completion rates in comparison with those found in other studies of CBPIs, positive selfreport of satisfaction, and a dose-response type of association between engagement in the program and insomnia improvement, independent of sedative”
- Also stated in: § Abstract · plain
“A strategy of brief provider and patient education, on-site Internet access, and telephone support was feasible and effective for implementing CBPIs in outpatient substance abuse treatment settings for veterans.”
Quote in the paperSubstantial claim - Also stated in: § Abstract · plain
- Premisecitation
Before this study, no strategy had been created or pilot-tested for delivering such programs in large public health systems that serve many patients with multiple chronic conditions.
“a strategy for their implementation in large public health care systems treating numerous patients facing multiple chronic conditions had not been devised or piloted”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [40] source
- Interpretationown data
In future CBPI implementation efforts, support can be provided easily by clinicians or potentially by support personnel within a practice setting.
“Moreover, an exploration of the amount and content of support provided indicates that in future CBPI implementation efforts, support can be easily provided by clinicians or potentially support personnel within a practice setting.”
Quote in the paperSubstantial claim - Study design and conductown data
The study lacks systematic data on how providers responded to the program.
“we do not have systematic data on provider response to the program”
Quote in the paperNot a substantial claim - Study design and conductnone given
The acceptability assessments used in the study have not had their validity evaluated.
“the validity of these assessments has not been evaluated”
Quote in the paperNot a substantial claim - Premisecitation
A recent study of VHA implementation of face-to-face CBT for insomnia reported that only 52% of veterans who engaged completed six sessions.
“Similarly, a recent study of the implementation within the VHA of face-to-face CBT for insomnia reported that only 52% of veterans who engaged completed six sessions (32).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [32] source
- Interpretationreasoning
These findings underscore the difficulty that patients with insomnia face in stopping dependence-inducing medications.
“These findings underscore the difficulty that patients with insomnia face in stopping such dependence-inducing medications.”
Quote in the paperSubstantial claim - Interpretationown data
The program was associated with clinically and statistically significant changes in insomnia severity among individuals who engaged in or completed the program.
“The program was associated with clinically and statistically significant changes in insomnia severity among individuals who engaged in or completed the program.”
Quote in the paperSubstantial claim - Study design and conductnone given
The validity of the acceptability assessments has not been evaluated.
“Finally, although we collected information from participants on acceptability of treatment, the validity of these assessments has not been evaluated”
Quote in the paperNot a substantial claim - Premisecitation
Three prior studies of CBPIs for insomnia have found similarly small changes in sedative-hypnotic use.
“Three prior studies of CBPIs for insomnia have found similarly small changes in sedative-hypnotic use (26)(27)(28).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites (26)(27)(28)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Interpretationown data
Participant self-report data suggest that both CBPIs in general and Restore specifically were acceptable to between one-half and two-thirds of veterans in outpatient substance abuse treatment.
“Participant self-report data from this study suggest that both CBPIs in general and Restore specifically were acceptable to between one-half to two-thirds of veterans in outpatient substance abuse treatment.”
Quote in the paperSubstantial claim
- May combine two claims. 40
- The quote only partly states this claim. 7
- Classified as probably not a substantial claim. 14
May combine two claims.
PremisecitationFace-to-face cognitive-behavioral therapy for insomnia requires extensive provider training and in-person client attendance.
“This therapy is being actively disseminated throughout the Veterans Health Administration (VHA) but requires extensive provider training and in-person client attendance (18).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [18] Manber R, 2012, Journal of Clinical Sleep Medicine source
The paper describes active VHA dissemination and a CBTI provider-training program with a workshop and ongoing expert consultation (Abstract, page not specified). It also outlines patient treatment sessions, but does not say clients must attend in person; that requirement is not supported by our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measured
May combine two claims.
PremisecitationSedative-hypnotics are the current mainstay of insomnia treatment, and many have abuse potential and side effects.
“Sedative-hypnotics, many of which are associated with abuse potential and a host of side effects, are the current mainstay of treatment (14,15).”
Quote in the paperSubstantial claim1 of 2 sources checked- cites [14] source
The Introduction identifies benzodiazepines as traditional insomnia treatments and Z-drugs as approved insomnia treatments; the Effects on Psychomotor Performance section documents adverse effects of hypnotics. The paper does not establish that sedative-hypnotics are the current mainstay of treatment or address their abuse potential. (LLM, conf=0.84)
Experimental — accuracy not yet measured - cites [15] source
May combine two claims. The quote only partly states this claim.
Findingown dataOf 34 engaged participants, 16 (49%) agreed or strongly agreed that the Restore homework was easy to complete; 17 (52%) were neutral or somewhat agreed/disagreed; none disagreed.
“| Strongly agree, agree | 16 | 49 | 11 | 69 | 5 | 31 | | |”
- Also stated in: § CONCLUSIONS · plain
“| The homework prescribed by the | | | | | | | .35 | .554 |”
Quote in the paperNot a substantial claim- Also stated in: § CONCLUSIONS · plain
May combine two claims.
Findingown dataDifferences corresponded to an effect size of 1.2 for completers and .7 for partial completers compared with nonengagers.
“Differences corresponded to an effect size of 1.2 for completers and .7 for partial completers, compared with nonengagers.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataIn this study, 69% of veterans engaged in the intervention and 43% completed it.
“In this study, 69% of veterans engaged in the intervention and 43% completed it”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataSixty-seven percent of enrolled veterans agreed they would participate in another CBPI, while 11% disagreed.
“When asked about the acceptability of CBPI, 67% of enrolled veterans agreed that they would participate in another CBPI, whereas only 11% disagreed (Table 2).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataAmong completers, ISI scores decreased from 20.1 to 10.2 (49% decrease; t=8.14, df=20, p<.001) and further to 9.9 (51%) at three-month follow-up (t=7.40, df=20, p<.001).
“Among completers, ISI scores decreased from 20.1 to 10.2 (49% decrease; t=8.14, df=20, p,.001) and further, to 9.9 (51%) at three-month follow-up (t=7.40,df=20, p,.001).”
Quote in the paperSubstantial claimMay combine two claims.
FindingcitationThe completion rate in this study (43%) was lower than the 68% completion in a university-based controlled trial of Restore and rates of 57% to 95% in trials of other CBPIs for insomnia.
“In this study, 69% of veterans engaged in the intervention and 43% completed it, compared with 68% who completed Restore in a universitybased controlled trial and rates of between 57% and 95% in trials of other CBPIs for insomnia (20,(26)(27)(28)(29).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites (20,(26)(27)(28)(29)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
May combine two claims.
Findingown dataThere were no statistically significant changes in the number of sedative-hypnotic doses ingested per week for the entire sample or in any engagement or completion group.
“There were no statistically significant changes in the number of sedative-hypnotic doses ingested per week for the entire sample or in any of the engagement and completion groups.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown dataOf 23 noncompleters, 2 (9%) agreed or strongly agreed that the homework was too difficult; 10 (44%) were neutral or somewhat agreed/disagreed; 11 (48%) disagreed or strongly disagreed.
“| Strongly agree, agree | 2 | 9 | 1 | 50 | 1 | 50 | | |”
- Also stated in: § CONCLUSIONS · plain
“| | | | | | | 5.76 .056 | |”
Quote in the paperNot a substantial claim- Also stated in: § CONCLUSIONS · plain
May combine two claims.
Findingown dataFor the statement that access to a computer was too difficult, 35% of the total sample agreed, and 63% of those who agreed were nonengagers.
“Specifically, for the statement, “Access to a computer . . .was too difficult,” only 35% of the total sample agreed, 63% of whom were nonengagers.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataNo clinically meaningful or statistically significant differences were observed in either the physical or mental health component of the SF-12.
“No clinically meaningful or statistically significant differences were observed in either component (physical or mental health) of the SF-12.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataThe enrolled sample was largely male (88%) and older (mean age 52.2±10.4 years).
“The population enrolled was largely male (88%) and older (mean age of 52.2610.4years)”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataOf 23 noncompleters, 4 (17%) agreed or strongly agreed that working with the online content was too difficult; 10 (44%) were neutral or somewhat agreed/disagreed; 9 (39%) disagreed or strongly disagreed.
“| Strongly agree, agree | 4 | 17 | 2 | 50 | 2 | 50 | | |”
- Also stated in: § CONCLUSIONS · plain
“| | | | | | | .12 .941 | |”
Quote in the paperNot a substantial claim- Also stated in: § CONCLUSIONS · plain
May combine two claims.
Findingown dataOf 23 noncompleters, 5 (22%) agreed or strongly agreed that they did not feel they had enough support from their VA treatment team; 12 (52%) were neutral or somewhat agreed/disagreed; 6 (26%) disagreed or strongly disagreed.
“| Strongly agree, agree | 5 | 22 | 3 | 60 | 2 | 40 | | |”
- Also stated in: § CONCLUSIONS · plain
“| | | | | | | .48 .785 | |”
Quote in the paperNot a substantial claim- Also stated in: § CONCLUSIONS · plain
May combine two claims. The quote only partly states this claim.
Findingown dataOf 34 engaged participants, 23 (68%) agreed or strongly agreed that the Restore program helped reduce insomnia or improve sleep; 11 (32%) were neutral or somewhat agreed/disagreed; none disagreed; p=.035.
“| Strongly agree, agree | 23 | 68 | 17 | 74 | 6 | 26 | | |”
- Also stated in: § CONCLUSIONS · plain
“| The Restore program was useful for | | | | | | | 4.44 | .035 |”
Quote in the paperSubstantial claim- Also stated in: § CONCLUSIONS · plain
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataThirty-nine participants (77%) reported regular use of at least one sedative-hypnotic.
“and 39 (77%) veterans reported using at least one sedative-hypnotic regularly.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataCompleters and partial completers had 9.0±4.5 and 9.6±4.2 clinical support contacts, respectively, while nonengagers had 7.8±4.6.
“In analysis of follow-up clinical support contacts, completers and partial completers had 9.064.5 and 9.664.2contacts, respectively, whereas those who did not engage had 7.864.6contacts.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataOf 51 veterans who enrolled, 13 (26%) completed only part of the program.
“| | Total sample (N=51) | Completers (N=22, 43%) a | completers (N=13, 26%) a | engage (N=16, 31%) a |”
Quote in the paperNot a substantial claimMay combine two claims. The quote only partly states this claim.
Findingown dataOf 34 engaged participants, 19 (56%) agreed or strongly agreed that the Restore program content, excluding homework, was easy to understand; 15 (44%) were neutral or somewhat agreed/disagreed; none disagreed.
“| Strongly agree, agree | 19 | 56 | 13 | 68 | 6 | 32 | | |”
- Also stated in: § CONCLUSIONS · plain
“| The content of the Restore program | | | | | | | .81 | .369 |”
Quote in the paperSubstantial claim- Also stated in: § CONCLUSIONS · plain
May combine two claims.
Findingown dataOf 23 noncompleters, 1 (4%) agreed or strongly agreed that they did not expect further benefit; 11 (48%) were neutral or somewhat agreed/disagreed; 11 (48%) disagreed or strongly disagreed.
“| Strongly agree, agree | 1 | 4 | 1 | 100 | 0 | - | | |”
- Also stated in: § CONCLUSIONS · plain
“| | | | | | | .80 .669 | |”
Quote in the paperNot a substantial claim- Also stated in: § CONCLUSIONS · plain
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown dataOne hundred individuals were screened and 51 were enrolled.
“One hundred individuals were screened, and 51 were enrolled.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataAmong the 51 enrollees, 43% completed all six sessions, 26% partially completed, and 31% did not engage.
“Of enrollees, 43% completed the program, 26% completed part of the program, and 31% did not engage (Table 1).”
- Also stated in: § Abstract · plain
“Of 100 veterans referred, 51 enrolled in the program, of whom 22 (43%) completed all sessions, 13 (26%) partially completed the program, and 16 (31%) did not engage.”
Quote in the paperSubstantial claim- Also stated in: § Abstract · plain
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataForty-nine percent reported current problematic alcohol or drug use.
“whereas 49% reported current problematic alcohol or drug use”
Quote in the paperNot a substantial claimMay combine two claims. The quote only partly states this claim.
Findingown dataOf 45 participants, 11 (24%) agreed or strongly agreed that more clinician support would make them more likely to use computer-based or online therapy; 21 (47%) were neutral or somewhat agreed/disagreed; 13 (29%) disagreed or strongly disagreed; the chi-square p value was .036.
“| Strongly agree, agree | 11 | 24 | 8 | 73 | 2 | 18 | 1 | 9 | | |”
Quote in the paperNot a substantial claimMay combine two claims. The quote only partly states this claim.
Findingown dataOf 23 noncompleters, 1 (4%) agreed or strongly agreed that understanding the online content was difficult; 8 (35%) were neutral or somewhat agreed/disagreed; 14 (61%) disagreed or strongly disagreed.
“| Strongly agree, agree | 1 | 4 | 0 | - | 1 100 | | |”
- Also stated in: § CONCLUSIONS · plain
“| | | | | | | 1.43 .492 | |”
Quote in the paperNot a substantial claim- Also stated in: § CONCLUSIONS · plain
May combine two claims. The quote only partly states this claim.
Findingown dataOf 45 participants, 16 (36%) agreed or strongly agreed that they preferred in-person meetings over computer-based or online therapy; 23 (51%) were neutral or somewhat agreed/disagreed; 6 (13%) disagreed or strongly disagreed.
“| Strongly agree, agree | 16 | 36 | 3 | 19 | 9 | 56 | 4 | 25 | | |”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataNinety-eight percent of enrolled participants reported a history of an alcohol or drug use disorder or a combination.
“with 98% reporting a history of an alcohol or a drug use disorder or combination”
Quote in the paperNot a substantial claimMay combine two claims. The quote only partly states this claim.
Findingown dataOf 23 noncompleters, 8 (35%) agreed or strongly agreed that getting access to a computer with an Internet connection was too difficult; 4 (17%) were neutral or somewhat agreed/disagreed; 11 (48%) disagreed or strongly disagreed.
“| Strongly agree, agree | 8 | 35 | 3 | 38 | 5 | 63 | | |”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataAmong support contacts, 36 (8%) dealt with computer or Internet questions, and 6 (1%) dealt with program content or clinical questions.
“Among these contacts, 36 (8%) dealt with computer-and Internet-related questions such as username and password loss, and only six (1%) were related to program content or clinical questions.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataSixty-eight percent agreed that Restore was helpful in reducing insomnia; a higher but not statistically significant proportion of completers (74%) agreed compared with partial completers (26%).
“For Restore-specific questions, 68% agreed that the program was helpful in reducing insomnia, with a higher, but not statistically significant, proportion of completers (74%) agreeing compared with partial completers (26%) (Table 3).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataNeither engagement or completion status nor the number of clinical support contacts varied significantly by location of computer use.
“Neither engagement and completion status nor the number of clinical support contacts varied significantly by location of computer use.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataForty-six participants (90%) reported a psychiatric diagnosis.
“and 46 (90%) reported a psychiatric diagnosis.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataTwenty participants (39%) accessed the program from the clinic, and 31 (61%) used a computer elsewhere.
“In the sample, 20 individuals (39%) accessed the program from the clinic, and 31 (61%) used a computer in a different location.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataAgreement with any presented reason for nonengagement or noncompletion was not strong (less than 50% agreeing or strongly agreeing), and differences between partial completers and nonengagers were not statistically significant.
“On questions regarding nonengagement and noncompletion, agreement with any of the presented reasons was not strong (.50% agreeing or strongly agreeing), and differences between partial completers and nonengagers were not statistically significant (Table 4).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataOf 23 noncompleters, 3 (13%) agreed or strongly agreed that they lacked enough time to finish the homework; 11 (48%) were neutral or somewhat agreed/disagreed; 9 (39%) disagreed or strongly disagreed.
“| Strongly agree, agree | 3 | 13 | 0 | - | 3 100 | | |”
- Also stated in: § CONCLUSIONS · plain
“| | | | | | | 5.57 .062 | |”
Quote in the paperNot a substantial claim- Also stated in: § CONCLUSIONS · plain
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationInsomnia is among the most common complaints of veterans from recent conflicts and is strongly associated with trauma, problematic alcohol use, reduced quality of life, and greater use of health services.
“Insomnia is one of the most common complaints of veterans from recent conflicts and is strongly associated with trauma, problematic alcohol use, decreased quality of life, and use of significantly more health services (8)(9)(10)(11)(12)(13).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites (8)(9)(10)(11)(12)(13)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
May combine two claims.
PremisecitationFace-to-face cognitive-behavioral therapy for insomnia is superior to placebo and active pharmacologic agents and is recommended as a first-line treatment.
“Face-to-face CBT has been shown in multiple studies, including meta-analyses, to be superior to both placebo and active pharmacologic agents for the treatment of insomnia, prompting the American Academy of Sleep Medicine to recommend its use as a first-line treatment (16,17).”
Quote in the paperSubstantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe authors state they have no financial relationships with commercial interests.
“The authors report no financial relationships with commercial interests.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
InterpretationcitationAn alternative explanation is that a placebo effect of trying the program was responsible for improved sleep.
“An alternative explanation would be that a placebo effect of trying the program was responsible for improved sleep.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationComputer-based psychotherapy interventions can reduce transportation barriers, reduce stigma-related barriers, accommodate shortages of trained therapists, and promote self-efficacy.
“They can reduce transportation barriers, reduce barriers associated with the stigma of seeking mental health care, accommodate deficiencies in the number of trained therapists, and promote self-efficacy (2)(3)(4).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites (2)(3)(4)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Classified as probably not a substantial claim.
Study design and conductown dataThe analysis of follow-up Insomnia Severity Index scores adjusted for baseline insomnia severity, days between assessments, and sedative-hypnotic doses at baseline and follow-up.
“This analysis was by completion or engagement status, with adjustment for baseline ISI score, days between baseline and follow-up measurement (in order to adjust for spontaneous improvement), as well as the number of sedative-hypnotic doses used in the week before assessment at baseline and follow-up.”
Quote in the paperSubstantial claimMay combine two claims.
Study design and conductreasoningThree-month follow-up measures were accomplished only by completers, which limited statistical power and made results susceptible to type II error.
“Also, three-month follow-up measures were accomplished only by those who competed the program, which limited statistical power, making results susceptible to type II statistical error.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
PremisecitationSeveral earlier studies have described the creation and evaluation of computer-based psychotherapy programs for mental health conditions.
“Whereas multiple past studies have documented the development and testing of CBPI programs for mental health problems”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [40] source
May combine two claims.
PremisecitationComputer-based psychotherapy interventions may increase clinic productivity and reduce costs.
“CBPIs may also increase clinic productivity and reduce costs (5)(6)(7).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites (5)(6)(7)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe funding sources did not influence the study design, analysis, interpretation, report preparation, or publication decision.
“The funding sources had no role in the design, analysis, or interpretation of data or in the preparation of the report or decision to publish.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductreasoningThis was an open pilot trial with a self-selected, non-randomized untreated comparison group, so causal inferences are not conclusive.
“This was an open pilot trial to evaluate initial feasibility of the program and implementation strategy.The untreated comparison group was self-selected and not identified by random assignment; thus causal inferences are not conclusive.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationA small survey at the same clinic suggested that over 50% of patients suffer from clinically significant sleep problems, signifying that only 10% of potentially eligible patients were referred.
“However, a small survey for a different project at the same clinic suggested that over 50% of patients suffer from clinically significant sleep problems (39), signifying that only 10% of potentially eligible patients were referred.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [39] source
May combine two claims.
Study design and conductreasoningThe clinical site does not screen for insomnia among patients, and penetration of the program's use among potential insomnia sufferers is unknown.
“Moreover, the clinical site for this study, like most outpatient mental health clinics, does not screen for the presence of insomnia among patients, and the penetration of this program's use among potential insomnia sufferers is unknown.”
Quote in the paperNot a substantial claim- Rests on an assumption: The clinical site does not screen for insomnia among patients.
May combine two claims.
InterpretationreasoningAdditional explanations for the limited impact on sedative-hypnotic use include the brief study duration and the education component not explicitly discussing decreasing sedative-hypnotic use.
“Additional explanations for this limited impact include the brief duration of the study and the fact that the education component of the strategy did not include an explicit discussion of decreasing sedative-hypnotic use during the program.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningThe sample size of 51 participants was relatively small, especially given the number who did not engage.
“Similarly, the sample size of 51 participants was relatively small, especially given the number of individuals who did not engage.”
Quote in the paperNot a substantial claim
The paper relies on this without support.
Implementation of computer-based psychotherapy interventions has not been evaluated in public-sector outpatient settings.
“However, their implementation has not been evaluated in public-sector outpatient settings.”
The paper relies on this without support.
Strategies for implementing self-help CBPIs in outpatient treatment settings with extensive comorbidity and provider referral and support have not been developed or evaluated.
“Strategies for implementing self-help CBPIs in outpatient treatment settings serving populations with extensive comorbidity and that include provider referral and support have not been developed or evaluated.”
The paper relies on this without support.
The clinical site does not screen for insomnia among patients.
“the clinical site for this study, like most outpatient mental health clinics, does not screen for the presence of insomnia among patients”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Acceptability percentages use the wrong denominators for each group
MinorThe table's 74% and 26% describe how the 23 favorable responses are divided between groups. Within each group, 17 of 21 completers (81%) and 6 of 13 partial completers (46%) agreed.
Reported 74 · recomputed 80.952381
“a higher, but not statistically significant, proportion of completers (74%) agreeing compared with partial completers (26%)”
Overall baseline insomnia mean is below every group mean
MinorTable 1 gives an overall baseline ISI mean of 20.0, although its three exhaustive groups have means of 20.6, 20.7, and 20.6. An overall mean cannot be lower than every group mean.
“| Insomnia Severity Index | 20.064.0”
“20.663.9 | | 20.763.2 | | 20.664.9”
Cites
WARE, J. E., KOSINSKI, M., & KELLER, S. D. (1996) · Medical Care · doi:10.1097/00005650-199603000-00003 · Cited by 17,392 · see citing works
Validation of the Insomnia Severity Index as an outcome measure for insomnia research
Bastien, C. (2001) · Sleep Medicine · doi:10.1016/s1389-9457(00)00065-4 · Cited by 8,067 · see citing works
Morin, C. M., Belleville, G., Bélanger, L., & Ivers, H. (2011) · Sleep · doi:10.1093/sleep/34.5.601 · Cited by 4,620 · see citing works
Eysenbach, G. (2005) · Journal of Medical Internet Research · doi:10.2196/jmir.7.1.e11 · Cited by 2,524 · see citing works
Edinger, J. D., Bonnet, M. H., Bootzin, R. R., Doghramji, K., Dorsey, C. M., Espie, C. A., Jamieson, A. O., McCall, W. V., Morin, C. M., & Stepanski, E. J. (2004) · Sleep · doi:10.1093/sleep/27.8.1567 · Cited by 1,039 · see citing works
Comparative Meta-Analysis of Pharmacotherapy and Behavior Therapy for Persistent Insomnia
Smith, M. T., Perlis, M. L., Park, A., Smith, M. S., Pennington, J., Giles, D. E., & Buysse, D. J. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.1.5 · Cited by 863 · see citing works
An American Academy of Sleep Medicine Report, Morgenthaler, T., Kramer, M., Alessi, C., Friedman, L., Boehlecke, B., Brown, T., Coleman, J., Kapur, V., Lee-Chiong, T., et al. (2006) · Sleep · doi:10.1093/sleep/29.11.1415 · Cited by 835 · see citing works
Espie, C. A., Kyle, S. D., Williams, C., Ong, J. C., Douglas, N. J., Hames, P., & Brown, J. S. L. (2012) · Sleep · doi:10.5665/sleep.1872 · Cited by 550 · see citing works
Internet use and stigmatized illness
Berger, M., Wagner, T. H., & Baker, L. C. (2005) · Social Science & Medicine · doi:10.1016/j.socscimed.2005.03.025 · Cited by 547 · see citing works
Efficacy of an Internet-based behavioral intervention for adults with insomnia
Ritterband, L. M., Thorndike, F. P., Gonder-Frederick, L. A., Magee, J. C., Bailey, E. T., Saylor, D. K., & Morin, C. M. (2009) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2009.66 · Cited by 482 · see citing works
Neylan, T. C., Marmar, C. R., Metzler, T. J., Weiss, D. S., Zatzick, D., Delucchi, K., Wu, R. M., & Schoenfeld, F. B. (1998) · American Journal of Psychiatry · doi:10.1176/ajp.155.7.929 · Cited by 455 · see citing works
The Direct and Indirect Costs of Untreated Insomnia in Adults in the United States
Ozminkowski, R. J., Wang, S. S., & Walsh, J. K. (2007) · SLEEP · doi:10.1093/sleep/30.3.263 · Cited by 403 · see citing works
SF-36: evaluation of quality of life in severe and mild insomniacs compared with good sleepers
Léger, D., Scheuermaier, K., Philip, P., Paillard, M., & Guilleminault, C. (2001) · Psychosomatic Medicine · doi:10.1097/00006842-200101000-00006 · Cited by 377 · see citing works
McCrone, P., Knapp, M., Proudfoot, J., Ryden, C., Cavanagh, K., Shapiro, D. A., Ilson, S., Gray, J. A., Goldberg, D., Mann, A., et al. (2004) · British Journal of Psychiatry · doi:10.1192/bjp.185.1.55 · Cited by 371 · see citing works
Huedo-Medina, T. B., Kirsch, I., Middlemass, J., Klonizakis, M., & Siriwardena, A. N. (2012) · BMJ · doi:10.1136/bmj.e8343 · Cited by 313 · see citing works
Internet-Based Treatment for Insomnia: A Controlled Evaluation.
Ström, L., Pettersson, R., & Andersson, G. (2004) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.72.1.113 · Cited by 311 · see citing works
Kaltenthaler, E., Sutcliffe, P., Parry, G., Beverley, C., Rees, A., & Ferriter, M. (2008) · Psychological Medicine · doi:10.1017/s0033291707002607 · Cited by 267 · see citing works
Computerised Cognitive Behavioural Therapy for Insomnia: A Systematic Review and Meta-Analysis
Cheng, S. K., & Dizon, J. (2012) · Psychotherapy and Psychosomatics · doi:10.1159/000335379 · Cited by 241 · see citing works
McLay, R. N., Klam, W. P., & Volkert, S. (2010) · Military Medicine · doi:10.7205/milmed-d-10-00193 · Cited by 226 · see citing works
Logging on for Better Sleep: RCT of the Effectiveness of Online Treatment for Insomnia
Vincent, N., & Lewycky, S. (2009) · Sleep · doi:10.1093/sleep/32.6.807 · Cited by 206 · see citing works
Hands-on Help: computer-aided Psychotherapy
Marks, I. M., Cavanagh, K., & Gega, L. (2007) · doi:10.25405/ncl.34083078 · Cited by 182 · see citing works
Dissemination of CBTI to the Non-Sleep Specialist: Protocol Development and Training Issues
Manber, R., Carney, C., Edinger, J., Epstein, D., Friedman, L., Haynes, P. L., Karlin, B. E., Pigeon, W., Siebern, A. T., & Trockel, M. (2012) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.1786 · Cited by 178 · see citing works
In the Zzz Zone: The Effects of Z-Drugs on Human Performance and Driving
Gunja, N. (2013) · Journal of Medical Toxicology · doi:10.1007/s13181-013-0294-y · Cited by 177 · see citing works
The relationship between chronically disrupted sleep and healthcare use
(2002) · Sleep · doi:10.1093/sleep/25.3.289 · Cited by 169 · see citing works
Marks, I. M., Cavanagh, K., & Gega, L. (2007) · Psychology Press eBooks · doi:10.4324/9780203962152 · Cited by 167 · see citing works
Farrer, L., Christensen, H., Griffiths, K. M., & Mackinnon, A. (2011) · PLoS ONE · doi:10.1371/journal.pone.0028099 · Cited by 140 · see citing works
Karlin, B. E., Trockel, M., Taylor, C. B., Gimeno, J., & Manber, R. (2013) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0032554 · Cited by 131 · see citing works
Hedman, E., Andersson, E., Lindefors, N., Andersson, G., Rück, C., & Ljótsson, B. (2013) · Psychological Medicine · doi:10.1017/s0033291712001079 · Cited by 98 · see citing works
Chronic Hypnotic-Drug Use: Ineffectiveness, Drug-Withdrawal Insomnia, and Dependence
Kales, A. (1974) · JAMA · doi:10.1001/jama.1974.03230180011004 · Cited by 88 · see citing works
Suzuki, E., Tsuchiya, M., Hirokawa, K., Taniguchi, T., Mitsuhashi, T., & Kawakami, N. (2008) · Journal of Occupational Health · doi:10.1539/joh.l7154 · Cited by 74 · see citing works
Kay-Lambkin, F., Baker, A., Lewin, T., & Carr, V. (2011) · Journal of Medical Internet Research · doi:10.2196/jmir.1522 · Cited by 63 · see citing works
Morgan, K., Thompson, J., Dixon, S., Tomeny, M., & Mathers, N. (2003) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(02)00569-x · Cited by 62 · see citing works
Comparative meta-analysis of pharmacotherapy and behavior therapy for persistent insomnia.
Smith, M. T., Perlis, M. L., Park, A., Smith, M. S., Pennington, J., & Giles, D. E. (2002) · PsycEXTRA Dataset · doi:10.1037/e323162004-002 · Cited by 60 · see citing works
Research on Multiple Chronic Conditions: Where We Are and Where We Need to Go
Tinetti, M. E., & Basu, J. (2014) · Medical Care · doi:10.1097/mlr.0000000000000093 · Cited by 45 · see citing works
Feedback from recently returned veterans on an anonymous web-based brief alcohol intervention
Lapham, G. T., Hawkins, E. J., Chavez, L. J., Achtmeyer, C. E., Williams, E. C., Thomas, R. M., Ludman, E. J., Kypri, K., Hunt, S. C., & Bradley, K. A. (2012) · Addiction Science & Clinical Practice · doi:10.1186/1940-0640-7-17 · Cited by 33 · see citing works
Pilot of a novel intervention for postconcussive symptoms in active duty, veterans, and civilians.
King, E. G., Kretzmer, T. S., Vanderploeg, R. D., Asmussen, S. B., Clement, V. L., & Belanger, H. G. (2013) · Rehabilitation Psychology · doi:10.1037/a0033116 · Cited by 29 · see citing works
How Internet Technology Can Improve the Quality of Care for Substance Use Disorders
Cucciare, M. A., Weingardt, K. R., & Humphreys, K. N. (2009) · Current Drug Abuse Reviews · doi:10.2174/1874473710902030256 · Cited by 27 · see citing works
Vincent, N., Walsh, K., & Lewycky, S. (2013) · Behavioral Sleep Medicine · doi:10.1080/15402002.2012.700662 · Cited by 18 · see citing works
Troublesome Triad: Trauma, Insomnia, and Alcohol
Lande, R. G. (2012) · Journal of Addictive Diseases · doi:10.1080/10550887.2012.735569 · Cited by 17 · see citing works
Kok, R. N., van Straten, A., Beekman, A., Bosmans, J., de Neef, M., & Cuijpers, P. (2012) · BMC Psychiatry · doi:10.1186/1471-244x-12-131 · Cited by 12 · see citing works
Hermes, E. D. A., Tsai, J., & Rosenheck, R. (2015) · Telemedicine and e-Health · doi:10.1089/tmj.2014.0215 · Cited by 8 · see citing works
Self-citationAttitudes and Awareness of Web-Based Self-Care Resources in the Military: A Preliminary Survey Study
Luxton, D. D., Armstrong, C. M., Fantelli, E., & Thomas, E. K. (2011) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2011.0006 · Cited by 6 · see citing works
Cheng, S. K., & Dizon, J. M. R. (2012) · Figshare · doi:10.6084/m9.figshare.5123158
Flagged first, then by citations
Research works printed but not linked: 1
- Kapur VK, 2002, Sleep, 25, 289
Cited by
Sorted by citations
Koffel, E., Bramoweth, A. D., & Ulmer, C. S. (2018) · Journal of General Internal Medicine · doi:10.1007/s11606-018-4390-1 · Cited by 391 · see citing works
Digital Cognitive Behavioral Therapy (dCBT) for Insomnia: a State-of-the-Science Review
Luik, A. I., Kyle, S. D., & Espie, C. A. (2017) · Current Sleep Medicine Reports · doi:10.1007/s40675-017-0065-4 · Cited by 156 · see citing works
“In addition, feasibility research suggests that dCBT might be an effective treatment in patients with substance use disorder [46] and that a supportive app can successfully be used in patients with posttraumatic stress disorder [10].”
BackgroundUser‐centered design for technology‐enabled services for eating disorders
Graham, A. K., Wildes, J. E., Reddy, M. C., Munson, S. A., Taylor, C. B., & Mohr, D. C. (2019) · International Journal of Eating Disorders · doi:10.1002/eat.23130 · Cited by 103 · see citing works
“…reason for limited reach and suboptimal engagement— problems that are not unique to eating disorders (e.g., Arean et al., 2016; Gilbody et al., 2015; Hermes & Rosenheck, 2016; Localytics, 2017; Owen et al., 2015; Quanbeck et al., 2018; Shaw et al., 2016)—is that technology-enabled services are not…”
BackgroundComputer-based self-help therapy: A qualitative analysis of attrition
Hermes, E. D. A., Merrel, J. D., Clayton, A. R., Morris, C., & Rowe, M. (2016) · Health Informatics Journal · doi:10.1177/1460458216683536 · Cited by 25 · see citing works
Self-citationSpeed, T. J., Hanks, L., Turner, G., Gurule, E., Kearson, A., Buenaver, L. F., Smith, M. T., & Antoine, D. G. (2022) · Trials · doi:10.1186/s13063-022-06885-7 · Cited by 19 · see citing works
Koffel, E., Branson, M., Amundson, E. C., & Wisdom, J. P. (2020) · Behavioral Sleep Medicine · doi:10.1080/15402002.2020.1828085 · Cited by 19 · see citing works
“More work is needed to determine best practices for providing education about behavioral sleep interventions to providers in hospital settings (Hermes & Rosenheck, 2016; Parsons et al., 2017).”
BackgroundNazem, S., Barnes, S. M., Forster, J. E., Hostetter, T. A., Monteith, L. L., Kramer, E. B., Gaeddert, L. A., & Brenner, L. A. (2023) · JMIR Mental Health · doi:10.2196/50516 · Cited by 15 · see citing works
“…in an uncontrolled pre-post intervention study of a 6-session self-administered iCBT-I, veterans seeking care in a Department of Veterans Affairs (VA) substance use disorder outpatient clinic achieved clinically significant improvements in insomnia severity following the iCBT-I intervention [32].”
InfluentialCoteur, K., Nuland, M. V., Vanmeerbeek, M., Henrard, G., Anthierens, S., den Broeck, K. V., Sutter, A. D., Creupelandt, H., Devroey, D., Overmeire, R. V., et al. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-033688 · Cited by 7 · see citing works
Hermes, E. D. A., Rosenheck, R. A., Burrone, L., Dante, G., Lukens, C. L., & Martino, S. (2021) · Implementation Research and Practice · doi:10.1177/26334895211053659 · Cited by 8 · see citing works
Self-citationCan Digital Therapeutics Open a New Era of Sleep Medicine?
Park, K., Lee, S., & Lee, E. M. (2021) · Chronobiology in Medicine · doi:10.33069/cim.2021.0028 · Cited by 8 · see citing works
“Effectiveness of dCBTi has been reported for depression, anxiety disorder, and substance use disorder [33,34].”
BackgroundGupta, N., Bhalla, I. P., & Rosenheck, R. A. (2019) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-018-00920-z · Cited by 7 · see citing works
Self-citationContemporary Social Work Practice with Veterans: An Introduction to the Special Issue
Bloeser, K. J., & Ray, K. (2018) · Clinical Social Work Journal · doi:10.1007/s10615-018-0659-4 · Cited by 3 · see citing works
“2017), are less likely to fill psychotropic medication prescriptions for serious mental illness (Hermes and Rosenheck 2015), and are more likely to use the emergency department for health care (Gundlapalli et al.”
Background
- Authors
- Hermes, E. D. A., & Rosenheck, R. A.
- Affiliations
- Yale University (US)
- Venue
- Psychiatric Services
- Published
- 2016-02-01
- Volume
- 67
- Issue
- 2
- Pages
- 176-183
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- OpenAlex
- W2184751741
- Semantic Scholar
- 1e40a2d6811d4a5f70c6b38d53cd5cabf68cbda7
- Cited by
- 12
- References
- 42
- Citations by year
- 2023: 1 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 2 · 2018: 2 · 2017: 1 · 2016: 1
- FWCI
- 1.07
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- veterans, substance use disorders, insomnia, insomnia severity, implementation feasibility, outpatient care, clinician education, patient education
- MeSH terms
- Adult, Ambulatory Care, Feasibility Studies, Female, Humans, Sleep Initiation and Maintenance Disorders, Male
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-09-28.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.
Cited sources are checked by gpt-6-sol.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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