Comparative randomised trial of online cognitive-behavioural therapy and an information website for depression: 12-month outcomes
ABSTRACT An earlier paper reported positive outcomes immediately following access to a cognitive-behavioural therapy (CBT) internet intervention and a depression information website.
To determine 6-month and 12-month outcomes of the interventions relative to a placebo control condition.
Participants allocated to the depression information website condition, the CBT internet intervention and the placebo control condition were followed up at 6 and 12 months by survey. The primary outcome measure was the Center for Epidemiologic Studies-Depression (CES-D) scale. Of 525 participants recruited, 79% completed their assigned intervention and 60% were retained at 12-month follow-up. Attrition was handled using mixed-model repeated-measures ANOVA.
Both the CBT site and depression information sites were associated with statistically significant benefits in CES-D score reduction compared with controls at post-test. At 6-months follow-up, the reduction seen for the people allocated to the CBT arm remained significant, whereas that for the depression information website arm was not. At 12 months, both active interventions were statistically significantly superior to the control condition.
There is some evidence that benefits of these brief internet interventions are retained beyond their endpoint. The impact of human support provided by interviewers in the trial must be considered when comparing these outcomes to routine use of both internet interventions.
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ABSTRACT: Current global concerns regarding the mental well-being (MWB) of young males have called for fresh approaches to social work service delivery. This study investigates the efficacy of adopting more ‘online’ approaches within social work practice by examining the current impact of online help-seeking behaviours on the MWB of adolescent males. A survey questionnaire comprised of validated scales measuring mental well-being and self-efficacy, combined with questions examining online help-seeking attitudes and behaviours was completed by 527 respondents aged 14–16 years within a school environment. The internet was used by 42 per cent of respondents to retrieve health information. In general, respondents appeared knowledgeable regarding the importance of trusted and quality online health information, yet were more likely to use search engines (57 per cent) or social networking sites (48 per cent) to find information rather than a government-sponsored website (23 per cent). Young males who reported speaking to online friends regarding personal problems recorded statistically significantly higher levels of mental well-being (p < 0.02). This may suggest that being able to communicate online how you are feeling is a positive for male mental health. Social work practitioners need to recognise this generational shift in help-seeking, in terms of providing and commissioning interpersonal helping via social mediaBritish Journal of Social Work 11/2014; DOI:10.1093/bjsw/bcu130 · 1.19 Impact Factor
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ABSTRACT: Despite the growth in computer and Internet use, marriage and family therapists’ (MFT) use of such technologies to communicate with clients has received limited attention. The purpose of the current research was to understand the frequency and ways in which MFTs are communicating online with clients and identify their level of comfort with online treatments. We administered a survey to practicing MFTs across the US to identify the frequency with which they used online communications with their clients, and the extent to which they felt comfortable using online communications in various treatment modalities. Implications for research, training, and practice are discussed.Contemporary Family Therapy 01/2014; 36(1). DOI:10.1007/s10591-013-9284-0
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ABSTRACT: BACKGROUND: Although there is some evidence on the effectiveness and cost-effectiveness of computerised cognitive behavioural therapy (CCBT) for treating anxiety and depression in primary care, alternative low-cost psychosocial interventions have not been investigated. METHODS: The cost-effectiveness of an audio based resilience training (Positive Mental Training, PosMT) was examined using a decision model. Patient level cost and effectiveness data from a trial comparing a CCBT treatment and usual care and effectiveness data from a study on PosMT were used to inform this. RESULTS: Net benefits of CCBT and PosMT were approximately equal in individuals with 'moderate' depression at baseline and markedly in favour of PosMT for the 'severe' depression subgroup. With only four observations in the 'mild' depression category for PosMT, the existing evidence base remains unaltered. LIMITATIONS: Efficacy data for the PosMT arm was derived from a study using a partially randomised preference design and the model structure contains simplifications due to lack of data availability. CONCLUSION: PosMT may represent good value for money in treatment of depression for certain groups of patients. More research in this area may be warranted.Journal of Affective Disorders 03/2013; 149(1-3). DOI:10.1016/j.jad.2013.01.044 · 3.71 Impact Factor