Effectiveness of guided internet-delivered cognitive behavior therapy for depression in routine psychiatry: A randomized controlled trial

Abstract

Depression is one of the most common health problems worldwide but is often undertreated. Internet-delivered cognitive behavioral therapy (ICBT) appears to be an effective treatment option, with the potential to reach a larger proportion of individuals suffering from depression. While many studies have examined the efficacy of ICBT for depression in randomized controlled trials, fewer have focused on the effectiveness of ICBT when used as an integral part of routine health care. In this study the effectiveness of an 8-week ICBT program was examined when delivered in a routine psychiatric setting. A total of 108 patients were referred and 54 were then included and randomized to either ICBT or a waitlist control condition. The sample had a lower education level and a higher proportion of individuals were on sick leave than comparable previous efficacy trials of ICBT for depression conducted in Sweden. Measures assessing depression, anxiety and psychiatric symptoms were administered before and after treatment, follow up was performed at 6- and 12 months after treatment had ended. ICBT resulted in significant reductions of depressive symptoms in the treatment group when compared to a waitlist control group with a large effect size (Cohen's d = 1.6). Treatment gains were maintained at 6- and 12 months after the treatment had ended. In terms of clinical significance, 58% of the sample had improved or recovered after treatment. The study was small, and patients received general psychiatric care after the ICBT treatment had ended which limits the implications. We conclude that ICBT appears to be an effective treatment for depression when delivered as an integral part of routine psychiatric care.

Guidance on defining the scope and development of text-based coaching protocols for digital mental health interventions

“…Prescribed coach outreach can vary considerably. Many existing protocols use weekly 10-15-minute outreach; [13][14][15][16] however, this can vary from no outreach (coaches are available but there is little to no outreach 17,18 ) to contacts multiple times per week. 19 To prepare an appropriate protocol, it is important to consider the workflow and availability of coaches, including coaching-related tasks and any other duties related to the position, such as intake interviews or collection of follow-up questionnaires to assess outcome.…”

Online psychosocial group intervention for adolescents with a chronic illness: A randomized controlled trial

“…Cognitive Behavioral Therapy (CBT) is known as an effective evidence-based psychological treatment for youth with a CI ( Compton et al, 2004 ; Johansson et al, 2019 ) in improving psychosocial wellbeing ( Serlachius et al, 2016 ) and in teaching positive coping skills ( Dorris et al, 2017 ). Coping skills are important mediators of effects of a CI on adaptive psychosocial functioning ( Plante et al, 2001 ).…”

Evidence on Technology-Based Psychological Interventions in Diagnosed Depression: Systematic Review

“…Overall, the identified studies (N=83) included 14,080 participants, ranging from 14 to 1089 per study. The mean age of the participants was 44.9 (SD 12.1) years, and two-thirds were female (67%; see Multimedia Appendix 1 for details [ 15 - 17 , 29 - 108 ]).…”

“…Most studies (70/83, 84%) reported dropout rates. However, reporting on dropouts is heterogeneous, as studies differed in their definitions on dropouts: there were studies reporting dropouts from treatment (or treatment completion rates; 38/83, 46%), whereas other studies applied other definitions of dropouts, for instance, treatment completers as defined by authors or withdrawals from the study (32/83, 39%), and approximately 16% (13/83) of included studies did not report any extractable dropouts ( Table 4 ; see Multimedia Appendix 6 [ 15 - 17 , 29 - 108 ] for an overview on negative events). On average, the included trials reported on 1.67 (SD 1.06; range 0-5) categories of negative events (out of 7 potential categories).…”