Guided Internet-Delivered Treatment for Depression: Scoping Review

Abstract

Background Studies on guided internet-delivered treatment have demonstrated promising results for patients with depressive disorder. Objective The aim of this study was to provide an overview of this research area and identify potential gaps in the research. Methods In this scoping review, web-based databases were used to identify research papers published between 2010 and 2022 where guided internet-delivered treatment was administered to participants with depressive disorders, a standardized rating scale of depressive symptoms was used as the primary outcome measure, and the treatment was compared with a control condition. Results A total of 111 studies were included, and an overview of the studies was provided. Several gaps in the research were identified regarding the design of the studies, treatments delivered, participant representation, and treatment completion. Conclusions This review provides a comprehensive overview of the research area, and several research gaps were identified. The use of other designs and active control conditions is recommended. Future studies should provide access to treatment manuals, and more replications should be conducted. Researchers should aim to include underrepresented populations and provide reports of comorbidities. Definitions of adequate dosage, reports of completion rates, and reasons for treatment dropout are recommended for future studies.

Feasibility, Acceptability, and Preliminary Efficacy of a Smartphone App–Led Cognitive Behavioral Therapy for Depression Under Therapist Supervision: Open Trial

“…Future research in real-world clinical settings is warranted. Third, although the large proportion of White women in the sample is consistent with past work and higher MDD prevalence and rate of treatment seeking in women [ 10 ], greater representation of patients with other racial and gender identities would strengthen our conclusions and ongoing treatment improvements. Fourth, we had adequate power to detect moderate to large treatment effects; a larger replication is needed to explore moderators and mediators, which are important for tiered care models.…”

“…Our findings add to an emerging literature demonstrating the potential of guided smartphone-based CBT to mitigate these challenges. However, although numerous seemingly efficacious therapist-supported digital treatments have been created for depression [ 10 ], few are available outside of research settings or integrated into a health care system [ 25 ]. Created in collaboration with an industry partner to accelerate the dissemination pipeline and allow for ongoing technical maintenance and improvements, Mindset for Depression is commercially available and poised to be truly scalable and successful in real clinical settings.…”

“…The technology could bridge such gaps. Smartphone apps or other digital tools could reduce the time and frequency of sessions by supplementing clinician effort with automated, validated support that can be used flexibly between sessions [ 10 , 11 ]. However, standalone apps are not sufficient or appealing for many patients [ 12 , 13 ].…”

Use of tailoring features and reasons for dropout in a guided internet-based transdiagnostic individually-tailored cognitive behavioral therapy for symptoms of depression and/or anxiety in college students

“…Developing and tailoring transdiagnostic digital interventions would benefit greatly from identifying individuals more likely to drop out and the exact reasons for their dropout. Differing expectations, improvement or worsening of health, preference for face-to-face CBT, negative perceptions about iCBT, low motivation, lack of time, internet delivery problems, and unexpected personal circumstances were reported as reasons for dropout in general populations, while the last three have also been reported in college students ( Børtveit et al, 2022 ; Kaltenthaler et al, 2008 ; Marks et al, 2003 ; Melville et al, 2010 ; Noone and Hogan, 2018 ; Rost et al, 2017 ; Schneider et al, 2014 ; Treanor et al, 2021 ; Waller and Gilbody, 2009 ). However, reasons for intervention dropout have been severely under-investigated in college students whose digital literacy may be higher and who may differ in lifestyle from general adult populations and thus in reasons for dropout ( Abdulai et al, 2021 ; Ferrari et al, 2022 ; Moreno-Gómez et al, 2012 ).…”

Dropout or Drop-In Experiences in an Internet-Delivered Intervention to Prevent Depression and Enhance Subjective Well-Being During the Perinatal Period: Qualitative Study

“…Recent studies have demonstrated their usability, feasibility [ 16 - 18 ], and effectiveness in reducing depressive symptoms [ 19 - 24 ]. However, treatment dropout is often reported, both in unguided and guided internet-delivered interventions [ 25 , 26 ]. Dropout is often preceded by missed sessions or ending without completing the treatment components [ 27 ].…”