Rau Mahara Rongomau: Online mental health support while waiting for in-person therapy

Participants will be patients at a primary health practice in Auckland, New Zealand, who are on the waitlist for an in-person therapy appointment for mental distress and whose first in-person appointment is at least five weeks away. When they join the waitlist, those in the intervention group will be provided with access to Just a Thought, which is a free online tool that offers evidence-based cognitive behavioural therapy courses. Just a Thought is derived from THIS WAY UP, a series of online cognitive behavioural therapy courses designed by a team of clinicians and researchers in Australia, and tested for efficacy in over 30 randomised controlled trials (see https://crufad.org/our-research/). Just a Thought purchased the licence for THIS WAY UP courses but redeveloped the content to ensure equitable accessibility and cultural responsiveness across the New Zealand population, while retaining the evidence-based cognitive behavioural therapy content. The Just a Thought courses that will be available for participants to choose from are the Depression, Generalised Anxiety Disorder, Mixed Depression and Anxiety, and Social Anxiety courses, all of which include six lessons, and the Insomnia course, which has four lessons. Participants will be instructed to choose the course that is most relevant to them. Each lesson comprises a narrative story of a fictionalised character who is experiencing a particular type of mental distress and takes approximately 30 minutes to complete. The character’s story and journey teaches psychoeducational and skill-based cognitive behavioural therapy content to the participant. Each lesson is supported by ‘homework’, which takes the information learned and supports the user to apply it to their own challenges and experiences in a worksheet format. Each set of lesson 'homework' takes approximately 60 minutes to complete. Each course has its own frequently asked questions, extra resources, and worksheets that support the user to enhance the skills and techniques outlined. Intervention group participants can go through the lessons at their own pace (i.e., no formal time restriction), but will be encouraged via regular contact from the Study Project Manager to complete one lesson per week. Participants who have not yet completed their chosen course before their first in-person therapy appointment will still be able to continue using the course once their in-person therapy sessions have started. Participants will also be able to continue to access the lessons indefinitely following their completion in the study. Intervention adherence will be monitored via website analytics that provide information on lesson engagement and completion rates.