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Incorporating a Stepped Care Approach Into Internet-Based Cognitive Behavioral Therapy for Depression: Randomized
Jasleen Kaur Jagayat1, Anchan Kumar2, Yijia Shao2,3
1Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
JMIR Mental Health
|January 4, 2024
Summary
Internet-based cognitive behavioral therapy (i-CBT) effectively reduces depression symptoms. A stepped care model using i-CBT helps patients complete more treatment sessions, improving adherence and outcomes for depression.
Area of Science:
- Mental Health
- Digital Therapeutics
- Psychiatry
Background:
- Depression is a leading global cause of disability, yet less than one-third of patients receive adequate care.
- Internet-based cognitive behavioral therapy (i-CBT) offers an effective treatment for depression.
- A stepped care model integrates low-intensity interventions with adaptive care based on patient needs, enhancing scalability and effectiveness.
Purpose of the Study:
- To investigate the efficacy of a stepped care internet-based cognitive behavioral therapy (i-CBT) model for depression.
- To evaluate changes in self-reported depressive symptoms using a stepped care approach.
Main Methods:
- A single-blinded, randomized controlled trial allocated 56 participants to either i-CBT only or i-CBT with stepped care.
- Both groups received a 13-week i-CBT program via the Online Psychotherapy Tool.
- The stepped care group received additional interventions (SMS, phone, video calls) based on questionnaire scores and responses.
Main Results:
- The i-CBT program significantly reduced depressive symptoms, as measured by PHQ-9 and QIDS.
- No significant differences in symptom reduction were found between the i-CBT only and stepped care groups.
- Participants in the stepped care group completed more sessions on average compared to those who terminated early in the i-CBT group.
Conclusions:
- A stepped care approach integrated with i-CBT is an effective treatment strategy for depression.
- The stepped care model can improve patient engagement and treatment completion rates in i-CBT programs.
- This model offers a scalable and effective method for delivering depression treatment.
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