Telephone-supported computerised cognitive-behavioural therapy: REEACT-2 large-scale pragmatic randomised controlled...

Area of Science:

• Psychiatry
• Digital Health
• Clinical Psychology

Background:

• Computerised cognitive-behavioural therapy (cCBT) shows promise for depression treatment but suffers from low engagement in primary care settings.
• Poor engagement limits the effectiveness and scalability of digital mental health interventions.
• Optimizing delivery methods is crucial for maximizing the impact of cCBT.

Purpose of the Study:

• To evaluate the impact of adding telephone support to cCBT on patient engagement and clinical outcomes.
• To compare the effectiveness of telephone-facilitated cCBT versus minimally supported cCBT.
• To assess changes in depression, anxiety, and somatoform complaints over 12 months.

Main Methods:

• A pragmatic randomized trial comparing telephone-facilitated cCBT (MoodGYM) with minimally supported cCBT.
• Inclusion of 369 participants with outcomes measured using Patient Health Questionnaire (PHQ)-9, Generalized Anxiety Disorder Questionnaire (GAD)-7, and PHQ-15.
• Assessment of outcomes at 4 and 12 months post-intervention.

Main Results:

• Telephone facilitation increased cCBT usage by 1.5 to 2 times.
• At 4 months, telephone-supported cCBT showed a statistically significant reduction in depression severity (PHQ-9 scores 1.9 points lower).
• Improvements were also observed in anxiety and somatic complaint scores, though long-term depression effects were not statistically significant at 12 months.

Conclusions:

• Telephone facilitation enhances engagement with cCBT and accelerates initial depression symptom improvement.
• The observed effects, while small to moderate, align with other low-intensity psychological interventions.
• This blended approach represents a viable strategy for improving digital mental health intervention delivery and outcomes.