Jeroen RuwaardGGZ inGeest · Research & Innovation
Jeroen Ruwaard
Dr
About
68
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Introduction
dr Jeroen Ruwaard works as a researcher at the department of Research & Innovation at GGz InGeest, Amsterdam.
Uploaded articles are not for mass dissemination but for students and colleagues.
Additional affiliations
March 2017 - present
June 2013 - June 2017
January 2007 - December 2012
Publications
Publications (68)
Background
Ecological momentary assessment (EMA) is a useful method to tap the dynamics of psychological and behavioral phenomena in real-world contexts. However, the response burden of (self-report) EMA limits its clinical utility.
Objective
The aim was to explore mobile phone-based unobtrusive EMA, in which mobile phone usage logs are considered...
Randomized controlled trails have identified online cognitive behavioral therapy as an efficacious intervention in the management of common mental health disorders.
To assess the effectiveness of online CBT for different mental disorders in routine clinical practice.
An uncontrolled before-after study, with measurements at baseline, posttest, 6-wee...
Post-traumatic stress disorder (PTSD) and complicated grief are related disorders for which well-described and effective cognitive-behavioural therapeutic procedures exist that are fi rmly rooted in theoretical work. As a result, several research groups have been able to successfully translate these procedures into e-mental health applications for...
Background
In recent years, armed conflicts in the Middle East have resulted in high rates of exposure to traumatic events. Despite the increasing demand of mental health care provision, ongoing violence limits conventional approaches of mental health care provision. Internet-based interventions for posttraumatic stress disorder (PTSD) have proved...
In reviews of the eMental health field, the Netherlands are often hailed as a forerunner nation, a shining example for the rest of the European Union. All that glitters, however, may not be gold. Dutch eMental health upscaling efforts are currently characterized by one of the most dubious mottos of the old Wild West, ‘Shoot first, ask questions lat...
Introduction
We evaluated a classroom-based sensitisation intervention that was designed to reduce demand-side barriers affecting referrals to a school counselling programme. The sensitisation intervention was offered in the context of a host trial evaluating a low-intensity problem-solving treatment for common adolescent mental health problems.
M...
Background
Internet-based Cognitive Behavioural Therapy (iCBT) is found effective in treating common mental disorders. However, the use of these interventions in routine care is limited. The international ImpleMentAll study is funded by the European Union’s Horizon 2020 programme. It is concerned with studying and improving methods for implementing...
Background
Internet-based cognitive-behavioral therapy (iCBT) is more effective when it is guided by human support than when it is unguided. This may be attributable to higher adherence rates that result from a positive effect of the accompanying support on motivation and on engagement with the intervention. This protocol presents the design of a p...
Background:
The System Usability Scale (SUS) is used to measure usability of internet-based Cognitive Behavioural Therapy (iCBT). However, whether the SUS is a valid instrument to measure usability in this context is unclear. The aim of this study is to assess the factor structure of the SUS, measuring usability of iCBT for depression in a sample...
This study investigates working alliance in blended cognitive behavioral therapy (bCBT) for depressed adults in specialized mental health care. Patients were randomly allocated to bCBT (n = 47) or face-to-face CBT (n = 45). After 10 weeks of treatment, both patients and therapists in the two groups rated the therapeutic alliance on the Working Alli...
Background:
Cognitive behavioral therapy (CBT) is an effective treatment, but access is often restricted due to costs and limited availability of trained therapists. Blending online and face-to-face CBT for depression might improve cost-effectiveness and treatment availability.
Objective:
This pilot study aimed to examine the costs and effective...
The huge wealth of data in the health domain can be exploited to create models that predict development of health states over time. Temporal learning algorithms are well suited to learn relationships between health states and make predictions about their future developments. However, these algorithms: (1) either focus on learning one generic model...
Background:
Conduct, anxiety, and depressive disorders account for over 75% of the adolescent mental health burden globally. The current protocol will test a low-intensity problem-solving intervention for school-going adolescents with common mental health problems in India. The protocol also tests the effects of a classroom-based sensitization int...
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...
Background Conduct, anxiety and depressive disorders account for over 75% of the adolescent mental health burden globally. The current protocol will test a low-intensity problem-solving intervention for school-going adolescents with common mental health problems in India. The protocol also tests the effects of a classroom-based sensitization interv...
Introduction:
Sentiment analysis may be a useful technique to derive a user's emotional state from free text input, allowing for more empathic automated feedback in online cognitive behavioral therapy (iCBT) interventions for psychological disorders such as depression. As guided iCBT is considered more effective than unguided iCBT, such automated...
The huge wealth of data in the health domain can be exploited to create models that predict development of health states over time. Temporal learning algorithms are well suited to learn relationships between health states and make predictions about their future developments. However, these algorithms: (1) either focus on learning one generic model...
Background
Conduct, anxiety and depressive disorders account for over 75% of the adolescent mental health burden globally. The current protocol will test a low-intensity problem-solving intervention to improve mental health symptoms and recovery rates for school-going adolescents in India. The protocol also tests the effects of a classroom-based se...
Given known limitations of retrospective self-report questionnaires, such as recall bias and poor generalizability of assessment results to real-life situations, mental health researchers increasingly adopt alternative assessment methods. One of the promising alternatives is Ecological Momentary Assessment (EMA), in which emotions and behaviors are...
BACKGROUND
The implementation of eMental health interventions (eMH) in routine healthcare constitutes a major challenge, and reliable instruments to assess implementation processes are lacking. The Normalisation MeAsure Development project (NoMAD) developed a 20-item self-report questionnaire to overcome this gap. Based on the Normalisation Process...
Background
Successfully implementing eMental health (eMH) interventions in routine mental health care constitutes a major challenge. Reliable instruments to assess implementation progress are essential. The Normalization MeAsure Development (NoMAD) study developed a brief self-report questionnaire that could be helpful in measuring implementation p...
Background:
To investigate potential facilitators and barriers for patients receiving specialised mental healthcare using a longitudinal design.
Methods:
Longitudinal data on 701 adult participants with a depressive and/or anxiety disorder were derived from the Netherlands Study of Depression and Anxiety (NESDA). Demographic, clinical and treatm...
Human support is thought to increase adherence to internet-based interventions for common mental health disorders, but can be costly and reduce treatment accessibility. Embodied virtual agents may be used to deliver automated support, but while many solutions have been shown to be feasible, there is still little controlled research that empirically...
Background
It remains difficult to predict and prevent suicidal behaviour, despite growing understanding of the aetiology of suicidality. Clinical guidelines recommend that health care professionals develop a safety plan in collaboration with their high-risk patients, to lower the imminent risk of suicidal behaviour. Mobile health applications prov...
Recent developments in mobile technology, sensor devices, and artificial intelligence have created new opportunities for mental health care research. Enabled by large datasets collected in e-mental health research and practice, clinical researchers and members of the data mining community increasingly join forces to build predictive models for heal...
Introduction
Clinical trials of blended Internet-based treatments deliver a wealth of data from various sources, such as self-report questionnaires, diagnostic interviews, treatment platform log files and Ecological Momentary Assessments (EMA). Mining these complex data for clinically relevant patterns is a daunting task for which no definitive bes...
Initial internet-based cognitive behavioral therapy (iCBT) programs for anxiety disorders in children and young people (CYP) have been developed and evaluated, however these have not yet been widely adopted in routine practice. The lack of guidance and formalized approaches to the development and dissemination of iCBT has arguably contributed to th...
Technology driven interventions provide us with an increasing amount of fine-grained data about the patient. This data includes regular ecological momentary assessments (EMA) but also response times to EMA questions by a user. When observing this data, we see a huge variation between the patterns exhibited by different patients. Some are more stabl...
In this paper, we explore the potential of predicting therapy success for patients in mental health care. Such predictions can eventually improve the process of matching effective therapy types to individuals. In the EU project E-COMPARED, a variety of information is gathered about patients suffering from depression. We use this data, where 276 pat...
In this paper we introduce a new Android library, called ULTEMAT, for the delivery of ecological momentary assessments (EMAs) on mobile devices and we present its use in the MoodBuster app developed in the H2020 E-COMPARED project. We discuss context-aware, or event-based, triggers for the presentation of EMAs and discuss the potential they have to...
Background:
Embodied conversational agents (ECAs) are computer-generated characters that simulate key properties of human face-to-face conversation, such as verbal and nonverbal behavior. In Internet-based eHealth interventions, ECAs may be used for the delivery of automated human support factors.
Objective:
We aim to provide an overview of the...
Suicidal behaviour remains difficult to predict and prevent, even for experienced mental health care professionals. The known distal risk factors for suicidal behaviour are not sufficiently specific to fully understand the complex dynamic processes that precede a suicide attempt. Real-time mobile monitoring data can be used to analyse proximal risk...
Predictive modeling of future health states can greatly contribute to more effective health care. Healthcare professionals can for example act in a more proactive way or predictions can drive more automated ways of therapy. However, the task is very challenging. Future developments likely depend on observations in the (recent) past, but how can we...
Background
Ecological momentary assessment (EMA) of mental health symptoms may influence the symptoms that it measures, i.e. assessment reactivity. In the field of depression, EMA reactivity has received little attention. We aim to investigate whether EMA of depressive symptoms induces assessment reactivity. Reactivity will be operationalised as an...
Introduction
Although older adults are just as likely to benefit from e-mental health as their younger counterparts, there are virtually no applications specifically designed to accommodate the needs of older adults with recurrent depression or bipolar disorder. Recurrent mood disorders constitute a large and rising proportion of the global disease...
Background:
Almost nothing is known about the potential negative effects of Internet-based psychological treatments for depression. This study aims at investigating deterioration and its moderators within randomized trials on Internet-based guided self-help for adult depression, using an individual patient data meta-analyses (IPDMA) approach.
Met...
Background
Effective, accessible, and affordable depression treatment is of high importance considering the large personal and economic burden of depression. Internet-based treatment is considered a promising clinical and cost-effective alternative to current routine depression treatment strategies such as face-to-face psychotherapy. However, it is...
Mental health related problems are responsible for great sorrow for patients and social surrounding involved. The costs for society are estimated to be 2.5 trillion dollar worldwide. More detailed data about the mental states and behaviour is becoming available due to technological developments, e.g. using Ecological Momentary Assessments. Unfortun...
Background: Blended care combines face-to-face treatment with web-based components in mental health care settings. Blended treatment could potentially improve active patient participation, by letting patients work though part of the protocol autonomously. Further, blended treatment might lower the costs of mental health care, by reducing treatment...
Background: People with mild intellectual disabilities or chronic psychiatric disorders often experience challenges in important aspects of life and need support in daily functioning. In this study, we examined the feasibility of a web-based program enabling professional support of patients with chronic conditions in their daily functioning.
Method...
BACKGROUND: Depression is a prevalent disorder, associated with a high disease burden and substantial societal, economic and personal costs. Cognitive behavioural treatment has been shown to provide adequate treatment for depression. By offering this treatment in a blended format, in which online and face-to-face treatment are combined, it might be...
Background
Turkish migrants in the Netherlands have a high prevalence of depressive and/or anxiety disorders. Acculturation has been shown to be related to higher levels of psychological distress, although it is not clear whether this also holds for depressive and anxiety disorders in Turkish migrants. This study aims to clarify the relationship be...
Terwijl medicijnen pas in de handel komen na uitgebreid onderzoek naar veiligheid, werkzaamheid en doelmatigheid, introduceren GGz-instellingen ongevalideerde e-health op steeds grotere schaal. Shoot first, ask questions later, eerst invoeren en dan valideren, is de onbeschreven wet van de Wild West e-health-praktijk. Daar zijn wel argumenten voor,...
Huiswerk is een centraal onderdeel van vrijwel elke psychotherapie, ook in de kinder- en jeugdpsychiatrie. Veel jongeren zijn voor dit huiswerk lastig te motiveren. Het wordt al snel afgeraffeld: nog even snel, vlak voor de wekelijkse sessie. De oefeningen zijn vaak ook wel erg saai. Bieden serious games een uitkomst?
In 1997, researchers at the University of Amsterdam developed one of the first psychotherapeutic applications of the World Wide Web. They implemented a standardized
cognitive behavioural treatment (CBT) of posttraumatic stress symptoms in a website,
and used this site to treat a small number of students with matching symptoms. To the
surprise of th...
Manualized cognitive–behavioural treatment (CBT) is underutilized in the treatment of bulimic symptoms. Internet-delivered treatment may reduce current barriers.
This study aimed to assess the efficacy of a new online CBT of bulimic symptoms.
Participants with bulimic symptoms (n = 105) were randomly allocated to online CBT, bibliotherapy or waitin...
E-health biedt een schat aan mogelijkheden voor de jeugd-ggz. Maar een professionele benadering en vooral een betere samenwerking zijn strikt noodzakelijk om ook daadwerkelijk successen te kunnen boeken. E-health heeft in elk geval veel meer potentie dan alleen voorlichting en preventieve programma’s: digitale toepassingen zullen binnen afzienbare...
Eerder presenteerden Renteria-Agirre en Lange in Directieve therapie een Interapy-protocol voor de online behandeling van bulimia nervosa. Dit artikel beschrijft een gecontroleerd onderzoek waarin de effecten van deze online behandeling worden vergeleken met die van zelfhulp en een wachtlijst. De resultaten zijn
positief. Online cognitieve gedragst...
Since 1996, researchers of the Interapy research group of the University of Amsterdam have been examining the effects of online cognitive behavioral treatment (online CBT). Over the years, the group conducted nine controlled trials of online CBT for a variety of mental health disorders, among a total of 840 participants. These studies suggest that...
In a recent uncontrolled trial of a new therapist-assisted Web-based treatment of adolescent victims of sexual abuse, the treatment effects were found to be promising. However, the study suffered a large pretreatment withdrawal rate that appeared to emanate from reluctance among the participants to disclose their identity and obtain their parents'...
Depression is common but undertreated. Web-based self-help provides a widely accessible treatment alternative for mild to moderate depression. However, the lack of therapist guidance may limit its efficacy. The authors assess the efficacy of therapist-guided web-based cognitive behavioural treatment (web-CBT) of mild to moderate depression. Fifty-f...
Depression is common but undertreated. Web-based self-help provides a widely accessible treatment alternative for mild to moderate depression. However, the lack of therapist guidance may limit its efficacy. The authors assess the efficacy of therapist-guided web-based cognitive behavioural treatment (web-CBT) of mild to moderate depression. Fifty-f...
Experiments with online therapy date back to the beginning of the internet. But eMental health really took off with the emergence of the World Wide Web, in the mid 90s. Presently, there are many eHealth initiatives, and clients may find it difficult to see the wood for the trees. Available programs vary from pure self-help (does any clinician to pa...
Background: Depression is common but undertreated. Web-based self-help provides a widely accessible treatment alternative for mild to moderate depression. However, the lack of therapist guidance may limit its e cacy. Objective: To assesses the e cacy of therapist-guided web- based Cognitive Behavioural Treatment (Web-CBT) of mild to moderate depres...
The aim of this study was to assess the effects of a 7-week standardized cognitive behavioural treatment of work-related stress conducted via e-mail. A total of 342 people applied for treatment in reaction to a newspaper article. Initial screening reduced the sample to a heterogeneous (sub)clinical group of 239 participants. Participants were assig...
Samenvatting Het aantal publicaties over de gecomputeriseerde en online psychotherapie is de laatste jaren sterk toegenomen. Hoewel er
over een aantal klachtgebieden literatuurstudies verschenen (bijvoorbeeld: Copeland & Martin, 2004; Spek et al., 2007), ontbreekt
het aan een totaaloverzicht. Isaac Marks, Kate Cavanagh en Linda Gega beogen deze lac...
Dit artikel beschrijft een via een website uitgevoerde geprotocolleerde cognitieve gedragstherapie voor paniekklachten. Het
artikel beschrijft de behandeling, de resultaten van een gerandomiseerde gecontroleerde effectstudie en, ter illustratie,
de wederwaardigheden van één deelnemer. In de RCT werden de deelnemers aselect toegewezen aan ‘onmiddell...
De eerste Interapy-behandeling via het internet is in 1999 gepubliceerd. Die betrof posttraumatische stress. Daarna zijn vele studies en publicaties
gevolgd. Dit artikel beschrijft de achtergrond van de Interapy-behandelingen, de screening, de procedures, de instrumenten, de interventies en de resultaten van de drie behandelprotocollen die in geran...
Summary For the last 5 years students, taking the course 'Instrumentation in Psychology', were tested on-line for their final grading. On-line examinations pose stringent criteria to the software used. It is mandatory that the student has the feeling that the on-line aspect does not hinder the expression of the student's knowledge. At any time the...
In this contribution we present the INTERAPIE system for counselling via the WWW. Based on existing protocols for face-to-face treatment of traumatic or stressful life events, an application has been developed that allows patients and counsellors to interact via the WWW. The interaction mainly consists of patients writing essays following assignmen...
Projects
Projects (4)
The MasterMind project aims to implement and upscale evidence-based computerised Cognitive Behavioural Therapy (cCBT) and videoconferencing enabled collaborative care services (ccVC) in routine mental healthcare practice and targets to reach over 5,230 patients in routine care in 15 European regions.
The effectiveness of these implementation projects will be evaluated with the objective to identify the factors that promote or inhibit implementation and up scaling of cCBT and ccVC for treating depression in routine practice.
The resulting summative evaluation will provide insight into the factors that influence the implementation and up-scaling of cCBT and ccVC in a variety of real political, social, economic and clinical contexts. It will provide insight into the perspectives of involved stakeholders, and result in concrete recommenda