A Comprehensive Review and a Meta-Analysis of the Effectiveness of Internet-Based Psychotherapeutic Interventions

ABSTRACT

Internet-based psychotherapeutic interventions have been used for more than a decade, but no comprehensive review and no extensive meta-analysis of their effectiveness have been conducted. We have collected all of the empirical articles published up to March 2006 (n = 64) that examine the effectiveness of online therapy of different forms and performed a meta-analysis of all the studies reported in them (n = 92). These studies involved a total of 9,764 clients who were treated through various Internet-based psychological interventions for a variety of problems, whose effectiveness was assessed by different types of measures. The overall mean weighted effect size was found to be 0.53 (medium effect), which is quite similar to the average effect size of traditional, face-to-face therapy. Next, we examined interacting effects of various possible relevant moderators of the effects of online therapy, including type of therapy (self-help web-based therapy versus online communication-based etherapy), type of outcome measure, time of measurement of outcome (post-therapy or follow-up), type of problem treated, therapeutic approach, and communication modality, among others. A comparison between face-to-face and Internet intervention as reported on in 14 of the studies revealed no differences in effectiveness. The findings of this meta-analysis, and review of additional Internet therapy studies not included in the meta-analysis, provide strong support for the adoption of online psychological interventions as a legitimate therapeutic activity and suggest several insights in regard to its application. Limitations of the findings and recommendations concerning Internet-based therapy and future research are discussed.     

Why Do Older Adults Have Sex? Approach and Avoidance Sexual Motives Among Older Women and Men

Although many older adults reportedly maintain an active sex life, limited research has focused on the reasons they engage in sex. The present study identified and described sexual motives in the second half of life reported by 47 older adults. Twenty-four men (51%) and 23 women (49%) aged 60–91 (M = 66, SD = 8.1) were interviewed. In-depth interviews were thematically analyzed using the theory of motivational approach-avoidance and personal-interpersonal motivational framework. Five main themes were identified: (a) to maintain overall functioning, (b) to feel young again, (c) to feel attractive and desirable, (d) from lust to love, and (e) from “getting sex” to “giving sex.” Investigating sexual motives in the second half of life can improve the understanding of older adults’ sexual behavior, function, and satisfaction.     

Greenhouse gases and green roofs: carbon dioxide and methane fluxes in relation to substrate characteristics

Green roof systems have been increasingly implemented to enhance vegetation cover and associated ecosystem services in urban spaces, with primary goals being the reduction of peak surface runoff, enhanced water quality, and mitigation of urban heat island effects. Recently, green roofs have also received attention as a means to enhance carbon sequestration, but direct measurements of greenhouse gas fluxes from established green roof systems are largely lacking. Here we present observations of CO₂ and CH₄ fluxes from substrates of experimental extensive green roof units that varied in vegetation type (Sedum spp., and a native meadow species mix), substrate depth, substrate type (high vs. low organic matter content), and irrigation. We predicted that substrate CO₂ effluxes would be higher in high-organic-matter substrates and that systems with high organic matter would potentially act as CH₄ sources. Substrate fluxes were low compared to natural soils, with seasonal means ranging from an efflux of 0.1–0.4 µmol CO₂ m^-2.s^-1 and uptake of ~0.00–0.04 nmol CH₄ m^-2.s^-1, with higher fluxes late in the growing season. CO₂ fluxes showed large increases in response to irrigation and were higher from the high-organic-matter substrate and with increased substrate depth. The strength of the CH₄ sink increased in response to prior irrigation treatments, and CH₄ emissions were detected only on low-organic-matter substrates early in the growing season. No effects of vegetation type were detected for either CO₂ or CH₄ flux. Our results indicate that high levels of organic matter in green roof substrates may enhance aerobic soil respiration but are not associated with CH₄ emissions, which instead were only detected in low-organic-matter substrates.