Effectiveness of Blended Internet-based Self-help and Face-to-face Intervention for Depression: A Pilot Study from India

Abstract

Background: Depression is a common mental health disorder with a wide treatment gap despite the availability of a number of effective treatment options. Blended interventions adopt a novel approach in combining internet-based self-help with brief face-to-face sessions thereby combining the advantages of both approaches and offering scope to address the treatment gap. The present study examined the effectiveness of a blended intervention combining the use of guided internet-based self-help with four to six face-to-face sessions in the treatment of mild to moderate depression. Method: A single group, open-label design was adopted with baseline, postintervention, and three-month follow-up assessments. The sample comprised 60 individuals with a primary diagnosis of major depressive disorder, dysthymia, or recurrent depressive disorder of mild or moderate severity meeting eligibility criteria. Standardized measures (self-report and clinician-rated) were used to examine the effectiveness of the intervention in reducing depression, improving functioning, self-esteem, and psychological recovery. A total of 40 participants completed the intervention and follow-up assessments. Results: Significant improvements were noted from baseline to post-assessment for both completers’ and intent-to-treat samples, with medium to large effect size on most outcome measures and maintenance of gains at follow-up. Eighty-five percent of the completers showed clinically significant improvement. Subgroups of blended intervention participants with and without pharmacotherapy showed similar outcomes. Completers were higher on interest in learning self-help skills and on the Growth subscale of psychological recovery, compared to the dropouts at baseline. Conclusion: The blended intervention demonstrated effectiveness in reducing depression and improving self-esteem, and functional and psychological recovery.