CBT for depression: a pilot RCT comparing mobile phone vs. computer

Abstract

BackgroundThis paper reports the results of a pilot randomized controlled trial comparing the delivery modality (mobile phone/tablet or fixed computer) of a cognitive behavioural therapy intervention for the treatment of depression. The aim was to establish whether a previously validated computerized program (The Sadness Program) remained efficacious when delivered via a mobile application.Method35 participants were recruited with Major Depression (80% female) and randomly allocated to access the program using a mobile app (on either a mobile phone or iPad) or a computer. Participants completed 6 lessons, weekly homework assignments, and received weekly email contact from a clinical psychologist or psychiatrist until completion of lesson 2. After lesson 2 email contact was only provided in response to participant request, or in response to a deterioration in psychological distress scores. The primary outcome measure was the Patient Health Questionnaire 9 (PHQ-9). Of the 35 participants recruited, 68.6% completed 6 lessons and 65.7% completed the 3-months follow up. Attrition was handled using mixed-model repeated-measures ANOVA.ResultsBoth the Mobile and Computer Groups were associated with statistically significantly benefits in the PHQ-9 at post-test. At 3 months follow up, the reduction seen for both groups remained significant.ConclusionsThese results provide evidence to indicate that delivering a CBT program using a mobile application, can result in clinically significant improvements in outcomes for patients with depression.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN 12611001257954

Mental health: There’s an app for that

“…The evidence supporting the use of such apps is building [5][6][7] . But this is a science in its infancy.…”

Internet Cognitive–Behavioral Therapy for Depression in Older Adults With Knee Osteoarthritis: A Randomized Controlled Trial

“…The iCBT Sadness Program consists of 6 online lessons representing best practice CBT, as well as regular homework assignments and access to supplementary resources. The Sadness Program has been validated in a number of clinical efficacy and effectiveness trials (28,(32)(33)(34)(35). Each lesson comprises a cartoon narrative in which a character gains mastery over MDD symptoms by learning and implementing CBT skills.…”

Use of a Smartphone Application in the Treatment of Depression : The New Wave of Digital Tools in Psychological Treatment

“…At this point, a number of studies had investigated treatments administered via smartphones, showing that the format has a potential to be effective in the treatment of depression (Burns et al, 2011;Proudfoot et al, 2013;Reid et al, 2011;Watts et al, 2013), as well as for other conditions (Dagöö et al, 2014;Donker et al, 2013). However, there was still limited knowledge available about how patients experience this treatment format (Kok, Bockting, Burger, Smit, & Riper, 2014), even though patient satisfaction with smartphone applications has been measured (Burns et al, 2011;Watts et al, 2013).…”

“…In light of the research support for BA , as well as of the initial promising findings of smartphone-delivered psychological treatment for depression Watts et al, 2013), it was assumed that a combination of these two formats might be useful to explore. Therefore, a new blended approach in which the smartphone application was used as an add-on to face-to-face therapy, was investigated in Study IV.…”