Pilot Study of Blended-Format Interpersonal Psychotherapy for Major Depressive Disorder

Blended-format interpersonal psychotherapy (IPT) is an integrated approach consisting of alternating face-to-face (in person or videoconferencing) and online sessions, and this format may increase access to care, empower patients, and improve quality and cost-effectiveness of care. This study, conducted in the Netherlands, was one of the first to investigate the feasibility of blended-format IPT in specialized mental health care.

Participants (ages 18-64, N=21) with a unipolar depressive episode were recruited at an outpatient mood disorder clinic. In this pre-post nonrandomized pilot study, the blended IPT consisted of six online sessions alternated with six to 10 in-person or videoconferencing sessions. Feasibility (defined as >60% of the participants having completed >50% of the online sessions), usability (via the System Usability Scale [SUS]), satisfaction (via the Client Satisfaction Questionnaire-8 [CSQ-8] and qualitative interviewing), and symptom reduction (via the nine-item Patient Health Questionnaire [PHQ-9]) were assessed.

Of the participants, 90% (95% CI=70%-99%) completed all online sessions. Mean±SD scores were 25.12±3.55 (of 32) on the CSQ-8 and 66.0±12.4 (of 100) on the SUS. PHQ-9 scores (N=21) decreased significantly, from 17.48±5.41 at baseline to 11.90±6.45 postintervention, indicating improvement (t=4.86, df=20, p=0.001). Hedges' g was 0.90 (95% CI=0.44-1.41), indicating a large effect size. The treatment response rate was 33% (95% CI=15%-57%); the remission rate was 19% (95% CI=6%-42%).

Blended-format IPT was feasible, and patients were satisfied with the intervention. The therapy described here may serve as a starting point for cost-effectiveness research on this promising format.