Effects of an internet-based self-help intervention for psychological distress due to COVID-19: Results of a randomized controlled trial

Abstract

Background The COVID-19 pandemic and its far-reaching impact on physical and mental health generate high demand and, accordingly, a great need for treatment opportunities that promote well-being and manage psychological distress. Internet-based interventions are particularly suitable for this purpose. They are easily scalable, readily accessible, and the online format allows for adherence to social distancing. For this reason, we developed an internet-based self-help intervention called ROCO to address psychological distress due to the COVID-19 pandemic. This randomized controlled trial aimed to examine the efficacy of the ROCO intervention. Methods A total of 107 German-speaking adults with at least mild depressive symptoms were randomized either to the intervention group with direct access to the three-week ROCO intervention plus care as usual or the waiting control group receiving care as usual. Primary outcome (depressive symptoms) and secondary outcomes (stress, anxiety, resilience, emotion regulation, health-related quality of life, embitterment, loneliness, optimism, and self-efficacy) were assessed pre- and post-treatment and at a 6-week follow-up using self-report questionnaires (e.g. Patient Health Questionnaire-9 for depressive symptoms). Results The average age was 40.36 years (SD = 14.59) and 81.3% of participants were female. The intervention did not significantly reduce primary depressive symptoms (between-group effect size: d = 0.04) and secondary outcomes such as anxiety and stress symptoms (between-group effect size: d = −0.19). However, the intervention led to a significant increase in emotion regulation skills (between-group effect size d = 0.35) and resilience (between-group effect size d = 0.38). Conclusions The internet-based self-help intervention cannot be recommended for the purpose of reducing depressive symptoms. However, the increase in emotion regulation skills and resilience suggest that the intervention may be suitable for preventive purposes, like improving overall coping with psychological distress or potential stressors. Future research is needed to examine for whom and how the intervention is most effective.

Development of Flow State Self-Regulation Skills and Coping With Musical Performance Anxiety: Design and Evaluation of an Electronically Implemented Psychological Program

“…Furthermore, for the first time, the global impact of the COVID-19 pandemic has increased the demand for mental health services, and internet-based interventions may be particularly suitable for this purpose (Brog et al, 2022). For the same reason, as a consequence of COVID-19, schools have implemented many Internet-based educational platforms (Okmawati, 2020).…”

The effectiveness and associated factors of online psychotherapy on COVID-19 related distress: A systematic review and meta-analysis

“…All included studies were conducted in populations without previously identified mental or severe physical illnesses. Three studies were conducted among COVID-19 patients with mild symptoms (Liu et al, 2020 ; Khah et al, 2021 ; Shaygan et al, 2021 ), two were in health care workers (Nourian et al, 2021 ; Otared et al, 2021 ), three were in undergraduates (Krifa et al, 2021 ; MacDonald and Neville, 2022 ; Rackoff et al, 2022 ), and others were in the general population (Al-Refae et al, 2021 ; Aminoff et al, 2021 ; Brog et al, 2022 ; Carbone et al, 2022 ).…”

“…If more than one instrument were used to measure the same outcome, the more valid and commonly used one was adopted. One study used the total score rather than the subscales of DASS to measure general psychological distress (Brog et al, 2022 ), and thus, this total score was considered as a measure of stress. All outcomes were continuous variables in this meta-analysis, and SMD with a 95% confidence interval (CI) were used to present the pooled results.…”

Evaluating the Efficacy of a Guided and Unguided Internet-Based Self-help Intervention for Chronic Loneliness: Protocol for a 3-Arm Randomized Controlled Trial

“…Secure Sockets Layer encryption will be used to secure internet-based communication with the program and guides, and participants will be identified with anonymous log-in names and passwords. The platform on which the program runs has been successfully used for several research projects in our research unit [ 63 , 64 ].…”