None listed
Conditions
Brief summary
Background: Psychological treatments via the internet have proven effective and applicable for a number of mental-health issues such as anxiety, eating disorders and depression. However meta-analysis of internet-intervention-studies show that effects are better, when they are aimed at reducing anxiety than depressive symptoms. Yet knowledge about how and why these interventions work and for whom they work best is still scarce. A central variable that predicts treatment effectiveness in depression is the amount of client-psychologist-contact. The study at hand seeks to increase knowledge about mechanisms of effectiveness in online-interventions against depression with special focus on the relationship between clients and psychologists. Intervention: Depressed participants are allocated at random to a cognitive-behavioral online-intervention with regular weekly contact to a psychologist (guided intervention) or with contact-on-demand only (i.e. having to explicitly ask for contact). Over the course of 6 weeks both groups receive psychoeducational information about their symptoms and different tasks in order to reduce them (e.g. positive activation, cognitive restructuring, emotional insight). Engaging tools on the website help participants with the completion of these tasks. While the guided group receives weekly individualized feedback, the contact-on-demand group automatically receives standardized feedback that contains general instructions and motivates participants to continue with the intervention. Method: Both groups are compared with regard to therapeutic outcomes (e.g. depressive symptoms) and predictors of treatment-success (e.g. adherence to treatment, social support, perceived quality of relationship to the psychologist).
Interventions
Type of intervention: Guided online-intervention.
Participants gain individualized password-protected access to an online-platform.
Duration and general information:
The intervention lasts 6 weeks. Every week a different topic relevant to depression is presented and the participants are instructed to perform cognitive-behavioral tasks in order to reduce their symptom severity. Tools on the website as well as psychoeducation help with completing these tasks.
Participants need to invest approxim
Type of intervention: Guided online-intervention. Participants gain individualized password-protected access to an online-platform. Duration and general information: The intervention lasts 6 weeks. Every week a different topic relevant to depression is presented and the participants are instructed to perform cognitive-behavioral tasks in order to reduce their symptom severity. Tools on the website as well as psychoeducation help with completing these tasks. Participants need to invest approximately 90minutes per week. Participants receive weekly written feedback from a psychologist (personally assigned). The task of the psychologists is to comment on participants' letters/activities and to provide further instruction. Certain parts of their feedback are standardized, others are individualized depending on the activities of the participant. Additionally participants are able to contact a psychologist at any time if they need to via electronic mail on the website (additional contact on demand). They receive an answer within two working days. Adherence: Login of participants is monitored. Inactive participants will automatically receive login-reminders via e-mail after 3, 7, 14 and 20 days of inactivity. Training of psychologists: A team of psychologists is trained before the treatment starts. Training takes 3 days (8 hours each) and gives theoretical background regarding online-interventions for depression and concrete instructions as to how to use the platform and to interact with participants. Additional information on how to react in critical situations (e.g. suicidal participants online) are provided. Afterwards psychologists work on the basis of an intervention-manual. Meetings for supervision-purposes are sheduled weekly. The team of study-psychologists remains the same throughout the whole year of intervention. Contents, aims and methods of the intervention in detail: Week 1: Topic: Symptoms of depression Aim: Insight into own symptoms. Method: Expressive writing Week 2: Topic: Positive activation Aim: Insight into own behavior related to depressive symptoms, increasing own level of activity. Method: Calendar of daily activities, diary of positive daily events Week 3: Topic: Lack of motivation, difficulties to perform positive activities. Aim: Coping with difficulties, increasing own level of activity. Method: Written coping plans in the calendar of daily activities Week 4: Topic: Thought processes that worsen depressive symptoms. Aim: Insight into own thoughts related to depression; cognitive restructuring. Method: Cognitive bias modification training Week 5: Topic: Distorted perceptions that worsen depressive symptoms. Aim: Insight into own perceptions related to depression; cognitive restructuring Method: Thought protocols Week 6: Topic: "Alarm signals" that indicate relapse Aim: Developing strategies to prevent relapse, summing up own participation in program. Method: Expressive writing
Sponsors
Freie Universitaet Berlin
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
German-speaking adults suffering from depression with access to the internet
Exclusion criteria
Schizophrenia, schizotypal and delusional disorders (F20-F29) Sucidal participants Severely depressed participants Patients in concurrent psychotherapeutic treatment
Outcome results
None listed