Abstract
BackgroundDue to limited resources, waiting periods for psychotherapy are often long and burdening for those in need of treatment and the health care system. In order to bridge the gap between initial contact and the beginning of psychotherapy, web-based interventions can be applied. The implementation of a web-based depression intervention during waiting periods has the potential to reduce depressive symptoms and enhance well-being in depressive individuals waiting for psychotherapy.MethodsIn a two-arm randomized controlled trial, effectiveness and acceptance of a guided web-based intervention for depressive individuals on a waitlist for psychotherapy are evaluated. Participants are recruited in several German outpatient clinics. All those contacting the outpatient clinics with the wish to enter psychotherapy receive study information and a depression screening. Those adults (age ≥ 18) with depressive symptoms above cut-off (CES-D scale > 22) and internet access are randomized to either intervention condition (treatment as usual and immediate access to the web-based intervention) or waiting control condition (treatment as usual and delayed access to the web-based intervention). At three points of assessment (baseline, post-treatment, 3-months-follow-up) depressive symptoms and secondary outcomes, such as quality of life, attitudes towards psychotherapy and web-based interventions and adverse events are assessed. Additionally, participants’ acceptance of the web-based intervention is evaluated, using measures of intervention adherence and satisfaction.DiscussionThis study investigates a relevant setting for the implementation of web-based interventions, potentially improving the provision of psychological health care. The results of this study contribute to the evaluation of innovative and resource-preserving health care models for outpatient psychological treatment.Trial registrationThis trial has been registered on 13 February 2017 in the German clinical trials register (DRKS); registration number DRKS00010282.
Highlights
Due to limited resources, waiting periods for psychotherapy are often long and burdening for those in need of treatment and the health care system
Participants are individuals with elevated depressive symptoms on a waitlist for psychotherapy at several psychotherapeutic outpatient clinics, who consent to applying an intervention for mood improvement
We expect the intervention group to benefit from the web-based intervention with regard to depressive symptoms, psychological symptoms and quality of life at post intervention and 3-months follow up
Summary
Design A two-arm randomized controlled trial (RCT) of parallel design is conducted in order to investigate the research questions. T1 baseline, T2 post-treatment, T3 follow-up, x intervention and control group, (x) only intervention group, SR self-report, CES-D Center for Epidemiologic Studies Depression Scale, BSI Brief Symptom Inventory, PHQ-9 Patient Health Questionnaire, SF-12 Health Survey, ATSPPH-SF Attitude Towards Seeking Professional Psychological Help- Short Form, INEP Inventory for the Assessment of Negative Effects of Psychotherapy, CSQ-8 Client Satisfaction Questionnaire, IAS Internet Affinity Scale, FIMA Questionnaire for Health-Related Resource Use in an Elderly Population. Additional per protocol analyses will include only those participants who have not started psychotherapy until the end of all study procedures, completing all three assessments, and, regarding the intervention group, at least five intervention modules. Potential predictors influencing intervention adherence and intervention satisfaction (e.g., age, depressive symptoms, internet affinity, former psychotherapy) will be assessed in an exploratory multiple regression analysis
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