Acceptability of Online Self-Help to People With Depression: Users’ Views of MoodGYM Versus Informational Websites

Abstract

BackgroundLittle is known about the factors that influence acceptability of and adherence to online psychological interventions. Evidence is needed to guide further development of promising programs.ObjectiveOur goal was to investigate users’ views of two online approaches to self-help for depression: computerized cognitive behavior therapy (cCBT) and informational websites, in a workplace context. Computerized CBT offers an inexpensive and accessible alternative to face-to-face therapy, and employers have an interest in reducing the working time lost to depression or stress. Yet little is known about how employees, who have actual experience of using online approaches, judge the intervention as a process.MethodsThe qualitative data reported here were collected within an online randomized controlled trial whose participants had diagnosable depression. The experimental intervention was a 5-week cCBT program called MoodGYM, and the control condition was five informational websites about mental health. Data were collected via online questionnaires. There was no evidence of the superiority of either in terms of treatment outcomes. In parallel, using brief rating scales and open-ended questions designed for this purpose, we examined the relative acceptability of each approach over time, including perceptions of cCBT compared to seeing a health care professional.ResultsAt least 60% of participants held online therapy to be at least as acceptable as seeing a professional about mental health issues, and they were more likely to retain this opinion over time if they used the interactive program, MoodGYM, rather than informational websites alone. Barriers to cCBT use fell into four categories: intrinsic, intrapersonal problems; extrinsic technical problems; generic issues mostly pertaining to perceptions of cCBT; and specific issues about the intervention or control condition. These indicate strategies for improving engagement.ConclusionsAs first-aid for mild to moderate mental health problems, evidence-based computerized approaches have broad acceptability. This could be increased by attending to the barriers noted here and by proactively managing users’ expectations at individual and organizational levels. The findings have implications for occupational health providers and others addressing the needs of working-age adults with depression. They also raise methodological issues for online research.Trial RegistrationInternational Standard Randomized Controlled Trial Number (ISRCTN): 24529487; http://www.controlled-trials.com/ISRCTN24529487 (Archived by Webcite at http://www.webcitation.org/6O8cCL4mh).

Mobile-Application Based Cognitive Behavior Therapy (CBT) for Identifying and Managing Depression and Anxiety

“…We do not have any association or relation to the MoodGYM website, and only use it as a conceptual base for the intervention that is developed through this mobile application. The effectiveness of MoodGYM for depression and anxiety symptoms in individuals suffering from depression has been demonstrated in several studies [14,15,16]. Twomey et al evaluated the effectiveness of the MoodGYM and suggest that CBT delivered by MoodGYM is effective in alleviating the depression symptoms.…”

The Internet and CBT: A New Clinical Application of an Effective Therapy

“…FearFighter has been shown to be superior to computer-guided non-exposure controls and as good as clinician-guided CBT for at least 3 months, though adherence to FearFighter was lower than clinician-guided therapy [56]. Both patients and clinicians were satisfied with how easy FearFighter was to use and the results of the program [52,[54][55][56][57][58].…”

Measuring the Implementation of Behavioral Intervention Technologies: Recharacterization of Established Outcomes (Preprint)

“…Some BITs are primarily consumer-facing products, designed to be used by consumers alone for care that is not facilitated by a healthcare providers ("self-care" or "fullyautomated" BITs; e.g., MoodGYM). [8,29] Other BITs are intended to be used as a component of care that is led by a provider ("adjunctive" BITs; e.g., the CBTi Coach mobile application as an adjunct to provider led cognitive-behavioral therapy for insomnia). [30] Since implementation research is focused on how practices are integrated into care settings, the level of provider integration with BIT use has critical implications for implementation outcome measurement.…”