Abstract
BackgroundAdjustment disorder is one of the most common mental health diagnoses. Still it receives relatively little attention from researchers trying to establish best interventions to treat it. With high prevalence of stressful life events, which might be leading to adjustment disorder, and limited resources of mental health service providers, online interventions could be a very practical way of helping people who have these disorders or are in the risk to develop them. The proposed study protocol is aimed to describe a randomized controlled trial of an internet-based modular intervention for adjustment disorder as it is defined in a proposal for the ICD-11.Methods/designThis study is a two-armed Randomized Controlled Trial (RCT) to examine the effectiveness of a web-based intervention BADI (Brief Adjustment Disorder Intervention) for adjustment disorder symptoms. BADI has four modules: Relaxation, Time management, Mindfulness and Strengthening relationships. It is based on stress and coping research and integrates evidence-based treatment approaches such as Cognitive Behavioural therapy (CBT), mindfulness and body-mind practices, as well as exercises for enhancing social support. Primary outcome of the study are symptoms of adjustment disorder and well-being. Engagement into the program and motivation for change is a secondary outcome. All participants after completing the baseline assessment are randomly assigned to one of the two groups: either to the one in which participant will instantly gain access to the BADI intervention or a group in which participants will be given access to the BADI program after waiting one month. Participants of BADI can choose exercises of the program flexibly. There is no particular order in which the exercises should be completed.DiscussionStudy will provide new insights of modular internet-based interventions efficacy for adjustment disorders. The study will also provide information about the role of motivation and expectancies on engagement in modular internet-based interventions. In case this RCT supports effectiveness of fully automated version of BADI, it could be used very broadly. It could become a cost-effective and accessible intervention for adjustment disorder.Trial registrationThe study was retrospectively registered with the Australian and New Zealand Clinical Trials Registry with the registration number ACTRN12616000883415. Registered 5 July, 2016.
Highlights
Adjustment disorder is one of the most common mental health diagnoses
Intrusive preoccupations with the stressor, avoidance and failure to adapt should separate this disorder from normal reactions and no requirements for severity of the stressor should distinguish it from posttraumatic stress disorder (PTSD) [3, 4, 6]
E-health advantages in treating adjustment disorder Having in mind high prevalence of stressful life events, which might be leading to adjustment disorder, and limited resources of mental health service providers, online interventions could be a very practical way of helping people who have these disorders or are in the risk of developing them
Summary
Adjustment disorder might be a popular diagnosis [1], but there were only a few controlled clinical trials implemented to evaluate different treatment approaches for it [8]. We have developed BADI – a modular internet-based intervention for adjustment disorders Users of this intervention do not have to complete all four modules (twelve exercises) in order to improve their condition. BADI consists of 4 modules: Relaxation, Time management, Mindfulness and Strengthening relationships It is based on stress and coping research and integrates evidence based modern treatment approaches such as Cognitive Behavioural therapy (CBT), mindfulness and body-mind practices, as well as exercises for enhancing social support. We believe that is important to look for new ways how to understand and measure drop-outs and adherence in the context of fully automated internet-based interventions as they are very different from traditional face-to-face interventions In case this RCT supports effectiveness of a fully automated version of BADI, it could be used very broadly. Abbreviations BADI, brief adjustment disorder intervention; CBT, cognitive behavioural therapy; DSM, diagnostic and statistical manual of mental disorders; ICD, international classification of diseases; PTSD, post-traumatic stress disorder; RCT, randomized controlled trial
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