Cognitive Behavioural Therapy through PowerPoint: Efficacy in an Adolescent Clinical Population with Depression and Anxiety

Abstract

Background Limited help-seeking behaviours, among adolescents with mental health concerns and many barriers to accessing mental health services, make innovative approaches to administering mental health therapies crucial. Therefore, this study evaluated the efficacy of e-CBT given via PowerPoint slides to treat adolescents with anxiety and/or depression. Method 15 adolescents referred to an outpatient adolescent psychiatry clinic to treat a primary DSM-IV diagnosis of anxiety and/or depression chose between 8 weeks of e-CBT (n=7) or 7 weeks of live CBT (n=8). The e-CBT modules were presented using PowerPoint delivered weekly through email by either a senior psychiatry resident or an attending physician. Within each session, participants in both groups had personalized feedback on their mandatory weekly homework assignment from the previous week's module. BYIs were completed before treatment and and after final treatment within both groups to assess changes in depression, anxiety, anger, disruption, and self-concept. Findings Before treatment, BYI scores did not sig. differ between groups. After treatment, e-CBT participants reported sig. improved depression, anger, anxiety, and self-concept BYI scores while live CBT participants did not report any sig. changes. Only the Beck Anxiety Inventory sig. differed between groups after CBT. Conclusion Despite the low sample size within this study, using email to deliver e-CBT PowerPoint slides and individualized homework feedback shows promise as an alternate method of CBT delivery that reduces barriers to receiving mental health treatment that occur internationally.

Self-evaluation as an active ingredient in the experience and treatment of adolescent depression; an integrated scoping review with expert advisory input

“…Young people also highlighted that working on their sense of self might feel less pressured in an online format. Interestingly, this supports one study that found better effects for CBT in an online format [ 63 ].…”

“…Improvement in depression was marked by increases in global self-worth and some subscales. Intervention studies Study N (depressed) % Female Age Sample Self Terminology Self Measure Depression Status Intervention Effects Alavi et al (2018) [ 63 ] 15 86 14–17 Outpatient facility Self-concept BSCI-Y Diag. (DSM-IV) Face to face vs e-CBT Mixed effects.…”

“…Rosello et al [ 73 ] found a greater improvement in self-concept for those who received CBT compared to Interpersonal Psychotherapy (IPT). One small, uncontrolled study reported that e-CBT showed improvements pre- to post-treatment, but face to face CBT did not [ 63 ].…”

Using the Online Psychotherapy Tool to Address Mental Health Problems in the Context of the COVID-19 Pandemic: Protocol for an Electronically Delivered Cognitive Behavioral Therapy Program

“…E-CBT content can be conveniently accessed anytime and anywhere, thereby providing flexible access to care, even for people who live in remote areas. A major benefit of e-CBT is that by delivering predesigned therapy content, clinicians can skip repeating similar general concepts to multiple patients and reduce their time commitment to a fraction of that in in-person therapy [ 12 , 13 ]. This not only reduces the cost of care delivery, but also allows more people to receive care from existing clinical resources and shortens waiting times.…”

“…The main disadvantage to using e-CBT as a treatment delivery modality is that some individuals might not have access to the necessary technology (eg, phones, tablets, or laptops) or proper internet connectivity. Furthermore, there are different methods of delivering e-CBT, which range from unguided self-help [ 14 , 15 ] to guided programs that consist of a standardized content delivery modality with support from a mental health professional [ 12 , 13 , 16 ]. Although these different methods have been shown to be effective to some extent, their efficacy varies depending on the level of care provider engagement during the therapy process [ 17 ].…”