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.

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    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.
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    • "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'. "
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    • "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). "
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