Ingrid Titzler

Ingrid Titzler
Friedrich-Alexander-University of Erlangen-Nürnberg | FAU · Clinical Psychology and Psychotherapy

MSc

About

43
Publications
4,586
Reads
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183
Citations
Introduction
Ingrid Titzler works at the chair of Clinical Psychology and Psychotherapy, Friedrich-Alexander-University of Erlangen-Nürnberg. Ingrid is engaged in research in e-Mental Health, Health Psychology and Clinical Psychology and Psychotherapy. She worked for the projects E-COMPARED and ImpleMentAll, PsychOnlineTherapy, 'With us in balance'. Her research interest: blendend psychotherapy, guided IMIs and telebased coaching. She works also as therapist with CBT license.
Education
October 2010 - October 2012

Publications

Publications (43)
Article
Introduction Farmers, forest workers and gardeners have a higher risk of developing depression compared to other occupational populations. As part of the German pilot project “With us in balance”, the potential of six guided internet- and mobile-based interventions (IMIs) to prevent depression among their insurants is examined. The IMI program is t...
Preprint
BACKGROUND Internet-based Cognitive Behaviour Therapy (iCBT) services for common mental health disorders have been found to be effective. There is a need for effective strategies to improve implementation in routine practice. One-size-fits-all strategies are likely to be ineffective and tailored implementation is considered as a promising approach....
Article
Full-text available
Introduction Farmers have a high risk for depression (MDD). Preventive measures targeting this often remotely living population might reduce depression burden. The study aimed to evaluate the effectiveness of personalized telephone coaching in reducing depressive symptom severity and preventing MDD in farmers compared to enhanced treatment as usual...
Article
Background: Internet-based interventions (IBIs) are effective for prevention and treatment of various mental disorders and thus, pose a valuable addition to improve routine care. Yet, uptake of and adherence to IBIs is often limited. To increase the actual use of IBIs, it is important to identify factors for engaging and adhering to IBIs. Objective...
Article
Full-text available
Background Although major depressive disorder (MDD) is characterized by a pervasive negative mood, research indicates that the mood of depressed patients is rarely entirely stagnant. It is often dynamic, distinguished by highs and lows, and it is highly responsive to external and internal regulatory processes. Mood dynamics can be defined as a comb...
Article
Full-text available
Background Behavioral activation (BA), either as a stand-alone treatment or as part of cognitive behavioral therapy, has been shown to be effective for treating depression. The theoretical underpinnings of BA derive from Lewinsohn et al’s theory of depression. The central premise of BA is that having patients engage in more pleasant activities lead...
Article
Full-text available
Objective Evidence of long-term stability for positive mental health effects of internet-based interventions (IBIs) for depression prevention is still scarce. We evaluate long-term effectiveness of a depression prevention program in green professions (i.e. agriculture, horticulture, forestry). Methods This pragmatic RCT (n = 360) compares a tailor...
Preprint
BACKGROUND Behavioral activation (BA), either as a stand-alone treatment or as part of cognitive behavioral therapy, has been shown to be effective for treating depression. The theoretical underpinnings of BA derive from Lewinsohn et al’s theory of depression. The central premise of BA is that having patients engage in more pleasant activities lead...
Article
Background: Sleep disturbance symptoms are common in major depressive disorder (MDD) and have been found to hamper the treatment effect of conventional face-to-face psychological treatments such as cognitive behavioral therapy. To increase the dissemination of evidence-based treatment, blended cognitive behavioral therapy (bCBT) consisting of web-...
Article
Full-text available
Introduction: Internet- and mobile-based interventions (IMIs) and their integration into routine psychotherapy (i.e., blended therapy) can offer a means of complementing psychotherapy in a flexible and resource optimized way. Objective: The present study will evaluate the non-inferiority, cost-effectiveness, and safety of two versions of integrated...
Presentation
Background. Depressive disorder has a major impact on public health. Thus, prevention of depression is becoming increasingly important. Farmers are a vulnerable population for developing depression or other mental health disorders due to a variety of risk factors in their work context. The German social insurance company for farmers, forest owners...
Article
Background: Major Depressive Disorder (MDD) has a major impact on public health. Reduction of depression burden in general population is of greatest importance and might be achieved by implementation of depression prevention measures into routine care. We evaluate an online prevention measure as part of a national project aiming to reduce depressio...
Article
Full-text available
Introduction: Chronic pain is highly prevalent, associated with substantial personal and economic burdens, and increased risk for mental disorders. Individuals in green professions (agriculturists, horticulturists, foresters) show increased prevalence of chronic pain and other risk factors for mental disorders. Available healthcare services in rur...
Article
Full-text available
Background: Farmers are a vulnerable population for developing depression or other mental health disorders due to a variety of risk factors in their work context. Beyond face-to-face resources, preventive internet- and tele-based interventions could extend available treatment options to overcome barriers to care. The German Social Insurance Company...
Article
Full-text available
Background Major depressive disorder (MDD) is highly prevalent and often managed by general practitioners (GPs). GPs mostly prescribe medication and show low referral rates to psychotherapy. Many patients remain untreated. Blended psychotherapy (bPT) combines internet-based interventions with face-to-face psychotherapy and could increase treatment...
Preprint
BACKGROUND Major depressive disorder (MDD) is highly prevalent and often managed by general practitioners (GPs). GPs mostly prescribe medication and show low referral rates to psychotherapy. Many patients remain untreated. Blended psychotherapy (bPT) combines internet-based interventions with face-to-face psychotherapy and could increase treatment...
Article
Full-text available
Background: Farmers show high levels of depressive symptoms and mental health problems in various studies. This study is part of a nationwide prevention project carried out by a German social insurance company for farmers, foresters, and gardeners (SVLFG) to implement internet- and tele-based services among others to improve mental health in this p...
Preprint
Background: Farmers show high levels of depressive symptoms and mental health problems in various studies. This study is part of a nationwide prevention project carried out by a German social insurance company for farmers, foresters and gardeners (SVLFG ) to implement internet- and tele-based services among others to improve mental health in this p...
Article
Full-text available
Background: Blended psychotherapy (bPT) is a treatment that integrates internet- and mobile-based interventions into out-/inpatient psychotherapy. It can enrich the therapy by using online-based treatment modules as therapeutic extension that patients use time- and location-independently between face-to-face sessions. It could potentially improve t...
Article
Full-text available
Background: People in green professions are exposed to a variety of risk factors, which could possibly enhance the development of depression. Amongst possible prevention approaches, internet- and mobile-based interventions (IMIs) have been shown to be effective and scalable. However, little is known about the effectiveness in green professions. Th...
Article
Hintergrund: Blended Psychotherapy (bPT) ist ein Behandlungskonzept zur Integration von Internet-/Mobil-basierten Interventionen in die ambulante/stationäre Psychotherapie. Es kann den Therapieprozess bereichern, indem Online-basierte Behandlungselemente als verlängerter therapeutischer Arm genutzt und zwischen den Therapiesitzungen von PatientInne...
Article
Background: Blended treatments, combining digital components with face-to-face (FTF) therapy, are starting to find their way into mental health care. Knowledge on how blended treatments should be set up is, however, still limited. To further explore and optimize blended treatment protocols, it is important to obtain a full picture of what actually...
Article
Full-text available
Introduction Blended therapies (BT) combine face-to-face (f2f) sessions with internet and mobile-based interventions (IMIs). However, the use of blended interventions in routine care is still rare and depends on the acceptance of key health care professionals such as the therapists. Little is yet known about the therapists' perspective on and exper...
Data
Consolidated criteria for reporting qualitative studies (COREQ): 32-item checklist
Poster
Background: The majority of patients with depression in Germany are treated in primary care by general practitioners, mainly with prescribed medication. There are long waiting lists for therapy, thus only a small proportion gets CBT. Internetbased therapist-guided self-help interventions could be a promising complement in primary care for depressio...
Presentation
Introduction: Internet-based interventions have shown to be effective for a wide range of mental health conditions. However, while studies have demonstrated the positive effects of internet-based guided self-help, little is known about potential negative effects. This is not unique for internet interventions, as limited data is available regarding...
Poster
Effectiveness of an Internet- and mobile-based intervention for a severely impaired population: Treatment of comorbid depression in chronic back pain patients on sick leave.
Poster
Poster - Blended Therapy bei Depression als neue Versorgungsform im Gesundheitssystem? Barrieren und Förderfaktoren für die Anwendung und Implementation aus der Perspektive von Therapeutinnen
Article
Introduction: High relapse rates in Major Depressive Disorder (MDD) indicate the need for interventions enhancing the sustainability of treatment outcomes. Primary aim of the present study was to evaluate the effectiveness of a text-message-based maintenance intervention for depression (TMMI-D). Additionally, we aimed to clarify whether the use of...
Poster
Internet- and mobile-based treatment of comorbid depression in chronic back pain patients on sick leave - study design and usability.
Poster
Wirksamkeit einer Internet- und Mobile-basierten Behandlung der komorbiden Depression bei arbeitsunfähigen Rückenschmerzpatienten Studiendesign einer randomisiert kontrollierten Studie und Usability der Intervention.
Poster
Wirksamkeit einer Internet- und Mobile-basierten Behandlung der komorbiden Depression bei arbeitsunfähigen Rückenschmerzpatienten. Studiendesign einer randomisiert kontrollierten Studie und Usability der Intervention.
Poster
Full-text available
Die ökonomischen Konsequenzen von chronischen Rückenschmerzen sind beträchtlich und die Häufigkeit hat in den letzten Jahren zugenommen. Depressionen zählen zu den Krankheiten die am meisten Krankheitslast in Industrienationen verursachen. Versicherte mit chronischen Rückenschmerzen haben ein zwei- bis dreifach erhöhtes Risiko an einer Depression z...

Network

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Projects

Projects (9)
Project
Farmers are a vulnerable population for developing depression or other mental health disorders due to a variety of risk factors in their work context. Beyond face-to-face resources, preventive internet- and tele-based interventions could extend available treatment options to overcome barriers to care. The German Social Insurance Company for Agriculture, Forestry and Horticulture (SVLFG) implements several guided internet- and mobile-based interventions and personalised tele-based coaching for this specific target group provided by external companies within a nation-wide prevention project for their insured members. The current study aims to evaluate the implementation process and to identify determinants of successful implementation on various individual and organisational levels. The results will show to what extent the implementation of the internet- and tele-based services as a preventive offer will be accepted by the participants and involved employees and which critical implementation aspects will occur within the process. If the implementation of the internet- and tele-based services succeeds, these services may be feasible in the long-term.
Project
Chronic pain is a common problem in people working in green professions and impacts the ability to cope with everyday life and work. Specific interventions are indicated to reduce impairment of chronic pain and improve pain-related limitations. In this pragmatic two-armed randomized controlled trial PACT-A (n=286) a guided internet-based intervention is compared against enhanced treatment as usual (TAU+). The study is located at the Department of Clinical Psychology and Psychotherapy of the University of Ulm in cooperation with the Chair of Clinical Psychology and Psychotherapy of the Friedrich-Alexander-University Erlangen-Nuremberg. The target group are agriculturists, foresters and horticulturists (green professions) working as entrepreneurs, as well as collaborating spouses, family members and pensioners with chronic pain symptomology (at least Grade II according to the CPG) for a duration of least 6 months and adequate insurance status. The aim is to evaluate the effectiveness and cost-effectiveness of an internet-based intervention based on acceptance and commitment therapy (ACT) to reduce pain-related impairment. The intervention consisted of 7 modules over the course of 7 weeks and was guided by a trained eCoach. The intervention phase was followed by a 12-month consolidating phase with monthly contact to a trained eCoach. The control group had unrestricted access to standard care and additionally received information material on stress, depression and chronic pain as well as treatment offers in standard care. Assessments take place at baseline (T0), 9 weeks post-randomization (T1), and 6 (T2), 12 (T3), 24 (T4) and 36 months (T5) after randomization. The primary outcome is pain interference (Multidimensional Pain Interference scale; MPI) at T1. Secondary outcomes include depressive symptom severity (QIDS-SR16), psychological flexibility (CPAQ) and quality of life (AQoL-8D). The results of the study will provide valuable insights into short, medium and long-term (cost)effectiveness of an internet intervention for reduction of pain interference in chronic pain in the target group of green professions.
Project
Due to their living and working conditions, farmers are exposed to numerous psychological burdens (e.g. high workload, financial problems, bureaucracy). Depressive disorders often occur and are very stressful for those affected and their relatives. Specific preventive measures are indicated to reduce depressive burden and improve mental health in this occupational group. In this pragmatic two-armed randomized controlled trial PROD-A (n=360) a tailored and therapeutically guided preventive internet-based intervention (IMI) program is compared against enhanced treatment as usual (TAU+). The study is conducted at the Department of Clinical Psychology and Psychotherapy of the University of Ulm in cooperation with the Chair of Clinical Psychology and Psychotherapy of the Friedrich-Alexander-University Erlangen-Nuremberg. The target group are agriculturists, foresters and horticulturists (summarized as “green professions”) working as entrepreneurs, as well as collaborating spouses, family members and pensioners with at least subthreshold depression (PHQ-9 ≥ 5) and adequate insurance status. The aim is to evaluate the effectiveness and cost-effectiveness of a tailored IMI program for indicated prevention of depression consisting of six IMIs provided by an external service provider targeting depressive symptoms (GET.ON Mood Enhancer), depressive symptoms in diabetes (Mood Enhancer Diabetes), perceived stress (GET.ON Stress), insomnia (GET.ON Recovery), panic and agoraphobia (GET.ON Panic) and problematic alcohol consumption (GET.ON Be smart - Drink less). IMIs were assigned based on symptom screening and preference of participants. The intervention phase was followed by a 12-month consolidating phase with monthly contact to a trained eCoach. The control group had unrestricted access to standard care and additionally received information material on stress, depression and chronic pain as well as treatment offers in standard care. Assessments take place at baseline (T0), 9 weeks post-randomization (T1), and 6 (T2), 12 (T3), 24 (T4) and 36 months (T5) after randomization. The primary outcome was depressive symptom severity (QIDS-SR16) at T1. Secondary outcomes include incidence of depression (QIDS-SR16), quality of life (AQoL-8D) and negative effects (INEP). The results will provide valuable insights into short, medium and long-term (cost)effectiveness of an online-based program for depression prevention in the target group of green professions.