Integrated therapist and online CBT for depression in primary care (INTERACT): study protocol for a multi-centre...

Area of Science:

• Psychiatry
• Clinical Psychology
• Digital Health

Background:

• Cognitive Behavioural Therapy (CBT) is effective for depression but online self-directed interventions face adherence challenges.
• Existing online CBT often lacks therapist support and between-session activities, leading to modest outcomes.
• The INTERACT intervention integrates online CBT materials with real-time, high-intensity therapist support.

Purpose of the Study:

• To evaluate the clinical and cost-effectiveness of the integrated online CBT intervention.
• To assess the acceptability of the INTERACT intervention for both therapists and clients.
• To explore a novel model for delivering accessible and equitable CBT.

Main Methods:

• Pragmatic, multi-centre, individually randomised controlled trial with 434 adult participants diagnosed with depression.
• Participants recruited from primary care practices and randomised to integrated CBT or usual care.
• Primary outcome: Beck Depression Inventory (BDI-II) score at 6 months. Secondary outcomes include qualitative and health economic evaluations.

Main Results:

• Primary outcome data collection ongoing; results anticipated post-trial.
• A nested qualitative study will explore user and therapist experiences.
• Health economic evaluation will assess cost-effectiveness.

Conclusions:

• The integrated online CBT model has the potential to increase access to and equity of CBT services.
• If proven effective and cost-effective, this model could be implemented in existing psychological services.
• This approach addresses limitations of current self-directed online CBT interventions.