Online Cognitive Behavioral Therapy for Depressed Primary Care Patients: A Pilot Feasibility Project

Whiteside, Ursula; Richards, Julie; Steinfeld, Bradley; Simon, Gregory E.; Caka, Selin; Tachibana, Chris; Stuckey, Sarah; Ludman, Evette

doi:10.7812/tpp/13-155

Cited by 22 publications

(18 citation statements)

References 26 publications

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“…Clarke et al (2005) invited a large number of patients identified as suffering from depression (receiving either medication or psychotherapy in the previous 30 days) to ICBT, 2-4% responded. Mead et al (2005) offered internet-treatment to primary care patients waiting for psychological therapy, one in five responded and the same response rate was found by Whiteside et al (2014) when primary care patients identified as experiencing a new episode of depression were invited to ICBT. Studies reporting no problems with ICBT treatment in patients referred by general practitioners (GPs) exist (Williams and Andrews, 2013), but have primarily been carried out at a centralized health care unit.…”

Section: Introductionmentioning

confidence: 52%

Experiences and attitudes of primary care therapists in the implementation and use of internet-based treatment in Swedish primary care settings

Kivi

Eriksson

Hange

et al. 2015

Internet Interventions

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Background: The current knowledge of internet-based cognitive behavior therapy (ICBT) implemented in primary care settings is sparse. Our objective was to explore primary care therapists' experiences and attitudes of ICBT, the opportunities and conditions for research in primary care, and to identify potential barriers to the implementation of ICBT treatment in primary care. Methods: Eleven therapists (of 14) participating in the research and implementation project PRIM-NET completed a survey. Four of them were selected also for a detailed semi-structured interview. Data from the interviews were analyzed qualitatively and according to methods used in implementation science. Results: Six general themes were identified in which the therapists considered ICBT as a good treatment that ought to be introduced in primary care. To optimize procedure in primary care settings, several adaptations of ICBT were suggested. Integrating and blending ICBT and face-to-face therapies, for example, would render primary care psychology more efficient. The PRIM-NET study and research within primary care was seen as rewarding and necessary, but challenging. To a large extent primary care still revolves around the general practitioner, with a focus on production, finances, and a somatic aspect of the patients. Five possible barriers to implementation of ICBT were identified which perhaps explains why psychological procedures are not fully integrated into primary care. Conclusions: Although the implementation of new methods and routines is typically accompanied by challenges, the overall experience of the therapists supports the implementation of ICBT as an additional treatment in primary care.

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Section: Introductionmentioning

confidence: 52%

Experiences and attitudes of primary care therapists in the implementation and use of internet-based treatment in Swedish primary care settings

Kivi

Eriksson

Hange

et al. 2015

Internet Interventions

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“…One-fifth (22.0%) did not complete treatment. Whiteside, 2014 [ 43 ] Pre-test/Post-test USA 39 Primary care patients receiving treatment for a new episode of depression and who were not already receiving either pharm-acotherapy or psycho-therapy. Those who had received treatment for a depressive episode in the last six months were not eligible to participate.…”

Section: Resultsmentioning

confidence: 99%

“…Only two evaluated the effectiveness of mobile telephone apps [ 40 , 50 ]. Most programs were developed for the self-management of depression [ 37 , 38 , 42 , 43 , 45 , 46 , 48 , 49 ]. However, as these studies assessed the effectiveness of these programs on to at least one suicide-related primary or secondary outcome (i.e., suicidal ideation, self-harm, attempted and/or completed suicide) they were nonetheless eligible for inclusion in this review.…”

Section: Resultsmentioning

confidence: 99%

“…In terms of study design, eight were randomised controlled trials [ 37 , 40 , 41 , 44 , 46 , 47 , 49 , 50 ], four were observational pre-test/post-test studies [ 38 , 39 , 43 , 48 ], and one was a pseudo-randomised controlled trial in which sequential participants were alternately allocated to the intervention and control conditions [ 45 ]. For one RCT, although participants were randomised to the intervention and control conditions, all participants received access to the digital intervention [ 42 ].…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies reported data on suicidal ideation scores using a number of different psychometric instruments, including: the BSSI [ 44 , 47 , 49 ], the Depressive Symptom Inventory–Suicidality Subscale (DSI-SS; [ 60 ]) [ 40 ], the Suicide Behaviors Questionnaire–Revised (SBQ–R; [ 61 ]) [ 45 ], the Suicidal Ideation Questionnaire–Junior (SIQ–J; [ 62 ]) [ 39 ], the four item suicidal ideation sub-scale of the General Health Questionnaire (GHQ–28; [ 63 ]) [ 37 ], and the suicidal ideation item of the Hopkins Symptom Checklist (HSCL–20; [ 64 ]) [ 43 ]. As raw means and standard deviations were not reported for suicidal ideation scores in one RCT, data were instead estimated from graphics in the original report for this study [ 37 ].…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness of online and mobile telephone applications (‘apps’) for the self-management of suicidal ideation and self-harm: a systematic review and meta-analysis

et al. 2017

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BackgroundOnline and mobile telephone applications (‘apps’) have the potential to improve the scalability of effective interventions for suicidal ideation and self-harm. The aim of this review was therefore to investigate the effectiveness of digital interventions for the self-management of suicidal ideation or self-harm.MethodsSeven databases (Applied Science & Technology; CENTRAL; CRESP; Embase; Global Health; PsycARTICLES; PsycINFO; Medline) were searched to 31 March, 2017. Studies that examined the effectiveness of digital interventions for suicidal ideation and/or self-harm, or which reported outcome data for suicidal ideation and/or self-harm, within a randomised controlled trial (RCT), pseudo-RCT, or observational pre-test/post-test design were included in the review.ResultsFourteen non-overlapping studies were included, reporting data from a total of 3,356 participants. Overall, digital interventions were associated with reductions for suicidal ideation scores at post-intervention. There was no evidence of a treatment effect for self-harm or attempted suicide.ConclusionsMost studies were biased in relation to at least one aspect of study design, and particularly the domains of participant, clinical personnel, and outcome assessor blinding. Performance and detection bias therefore cannot be ruled out. Digital interventions for suicidal ideation and self-harm may be more effective than waitlist control. It is unclear whether these reductions would be clinically meaningful at present. Further evidence, particularly with regards to the potential mechanisms of action of these interventions, as well as safety, is required before these interventions could recommended.

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An Online Mental Health and Wellness Intervention Supplementing Standard Care of Depression and Anxiety

Ahmedani

Belville-Robertson

Hirsch

et al. 2016

Archives of Psychiatric Nursing

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Online Cognitive Behavioral Therapy for Depressed Primary Care Patients: A Pilot Feasibility Project

Cited by 22 publications

References 26 publications

Experiences and attitudes of primary care therapists in the implementation and use of internet-based treatment in Swedish primary care settings

Experiences and attitudes of primary care therapists in the implementation and use of internet-based treatment in Swedish primary care settings

Effectiveness of online and mobile telephone applications (‘apps’) for the self-management of suicidal ideation and self-harm: a systematic review and meta-analysis

An Online Mental Health and Wellness Intervention Supplementing Standard Care of Depression and Anxiety

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