Comparative randomised trial of online cognitive-behavioural therapy and an information website for depression: 12-month outcomes. The British Journal of Psychiatry, 192(2), 130-134

Centre for Mental Health Research, The Australian National University, Canberra, ACT, 0200, Australia.
The British Journal of Psychiatry (Impact Factor: 7.99). 03/2008; 192(2):130-4. DOI: 10.1192/bjp.bp.106.032078
Source: PubMed


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.

2 Reads
    • "Programmes may provide support in the form of clinician input to encourage adherence and resolve difficulties, although this type of support may also be provided by lay staff or in the form of automated (email or SMS) motivational reminders. There is some divergence on the level of support required for effective outcomes (Andersson and Cuijpers, 2008), as unguided programmes can be effective without requiring support staff (Christensen et al., 2006; Mackinnon et al., 2008). However, the intensity and nature of support that might be offered alongside e-mental health services is significantly less than what is currently required from clinicians in traditional services. "
    [Show abstract] [Hide abstract]
    ABSTRACT: e-Mental health services have been shown to be effective and cost-effective for the treatment of depression. However, to have optimal impact in reducing the burden of depression, strategies for wider reach and uptake are needed. A review was conducted to assess the evidence supporting use of e-mental health programmes for treating depression. From the review, models of dissemination and gaps in translation were identified, with a specific focus on characterising barriers and facilitators to uptake within the Australian healthcare context. Finally, recommendations for promoting the translation of e-mental health services in Australia were developed. There are a number of effective and cost-effective e-health applications available for treating depression in community and clinical settings. Four primary models of dissemination were identified: unguided, health service-supported, private ownership and clinically guided. Barriers to translation include clinician reluctance, consumer awareness, structural barriers such as funding and gaps in the translational evidence base. Key strategies for increasing use of e-mental health programmes include endorsement of e-mental health services by government entities, education for clinicians and consumers, adequate funding of e-mental health services, development of an accreditation system, development of translation-focused activities and support for further translational research. The impact of these implementation strategies is likely to include economic gains, reductions in disease burden and greater availability of more interventions for prevention and treatment of mental ill-health complementary to existing health and efficient evidence-based mental health services. © The Royal Australian and New Zealand College of Psychiatrists 2015.
    Australian and New Zealand Journal of Psychiatry 04/2015; 49(9). DOI:10.1177/0004867415582054 · 3.41 Impact Factor
  • Source
    • "It provides a valuable framework in which to conceptualise and evaluate the efficacy of online technologies within the help-seeking process. Despite vigorous debate within the field, a number of studies have postulated the mental health support benefits of online technologies (Mackinnon et al., 2008; Barak and Grohol, 2011; Burns et al., 2013). Murphy and colleagues (2009, p. 635), in a comparative study of both online and face-to-face counselling, reported that 'cyber-counselling [was] equivalent in impact to face to face counselling'. "
    [Show abstract] [Hide abstract]
    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 media
    British Journal of Social Work 11/2014; DOI:10.1093/bjsw/bcu130 · 1.19 Impact Factor
  • Source
    • "The primary way the Internet is discussed within the field of psychotherapy is in telemental health. Telemental health, defined as the delivery of mental health care services over technology, has demonstrated itself to be an effective treatment option for many presenting problems, such as panic disorders, depression, obsessive compulsive disorder, eating disorders, and anxiety (Carlbring et al. 2005; Hailey et al. 2008; Mackinnon et al. 2008; Robinson and Serfaty 2001; Spek et al. 2007; Wiersma et al. 2011; Wooton et al. 2011). Telemental health literature focuses on the efficacy of clinical interventions provided over web-based services as compared to face-to-face services (Reese and Stone 2005; Ruskin et al. 2004), perceptions of telemental health (Simms et al. 2011), and the impact of telemental health on the therapeutic alliance (Reese and Stone 2005; Schopp et al. 2000). "
    [Show abstract] [Hide abstract]
    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 03/2014; 36(1). DOI:10.1007/s10591-013-9284-0
Show more


2 Reads
Available from