Examining an internet-delivered intervention for anxiety and depression when delivered as a part of routine care for university students: A phase IV trial

Dear, Blake F.; Johnson, Bareena; Singh, Ashwin; Wilkes, B; Brkic, Tamara; Gupta, Richa; Jones, Michael; Bailey, Steve; Dudeney, Joanne; Gandy, Milena; Fogliati, Rhiannon; Titov, Nickolai

doi:10.1016/j.jad.2019.06.044

Cited by 24 publications

(19 citation statements)

References 40 publications

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“…Minor and major improvements were defined as clinically meaningful improvements. This approach was used based on the findings of an earlier study ( Dear et al, 2019 ).…”

Section: Methodsmentioning

confidence: 99%

Internet-based cognitive behavioral therapy for psychological distress in older adults without cognitive impairment living in nursing homes during the COVID-19 pandemic: A feasibility study

Ying

Kong

et al. 2021

Internet Interventions

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Background The COVID-19 pandemic has had a detrimental effect on the mental health of older adults living in nursing homes. Very few studies have examined the effects of Internet-based Cognitive Behavioral Therapy (ICBT) on older adults living in nursing homes during the pandemic. We conducted a feasibility study using a single-group design, to explore the effectiveness of ICBT on psychological distress in 137 older adults (without cognitive impairment) from 8 nursing homes in 4 southeast cities in China, between January and March 2020. Methods Symptoms of depression, anxiety, general psychological distress, and functional disability were measured at baseline, post-treatment (5 weeks) and at a 1-month follow-up. Mixed-effects model was used to assess the effects of ICBT. Results Statistically significant changes with large effect sizes were observed from pre- to post-treatment on the PHQ-9 ( p < .001, Cohen's d = 1.74), GAD-7 ( p < .001, d = 1.71), GDS ( p < .001, d = 1.30), K-10 ( p < .001, d = 1.93), and SDS ( p < .001, d = 2.03). Furthermore, improvements in treatment outcomes were sustained at 1-month follow-up, and high levels of adherence and satisfaction were indicated. Conclusion ICBT was effective in reducing psychological distress in older adults without cognitive impairments living in nursing homes during the COVID-19 pandemic. Thus, it could be applied in improving the mental health of this vulnerable group during the pandemic.

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“…Minor and major improvements were defined as clinically meaningful improvements. This approach was used based on the findings of an earlier study ( Dear et al, 2019 ).…”

Section: Methodsmentioning

confidence: 99%

Internet-based cognitive behavioral therapy for psychological distress in older adults without cognitive impairment living in nursing homes during the COVID-19 pandemic: A feasibility study

Ying

Kong

et al. 2021

Internet Interventions

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“…Importantly, web-based interventions have been identified as acceptable in difficult-to-reach populations such as farmers [ 20 ], young people [ 21 ], and culturally and linguistically diverse groups [ 22 , 23 ]. They can be successfully integrated into routine primary care [ 24 , 25 ], and many Australian GPs support the notion of aiding their patients’ mental well-being through these resources [ 26 ]. In addition, web-based interventions have been found to be cost-effective for development and delivery; many are offered for free to consumers [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Web-Based Interventions to Help Australian Adults Address Depression, Anxiety, Suicidal Ideation, and General Mental Well-being: Scoping Review

Skaczkowski¹,

Kruk²,

Loxton³

et al. 2022

JMIR Ment Health

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Background A large number of Australians experience mental health challenges at some point in their lives. However, in many parts of Australia, the wait times to see general practitioners and mental health professionals can be lengthy. With increasing internet use across Australia, web-based interventions may help increase access to timely mental health care. As a result, this is an area of increasing research interest, and the number of publicly available web-based interventions is growing. However, it can be confusing for clinicians and consumers to know the resources that are evidence-based and best meet their needs. Objective This study aims to scope out the range of web-based mental health interventions that address depression, anxiety, suicidal ideation, or general mental well-being and are freely available to Australian adults, along with their impact, acceptability, therapeutic approach, and key features. Methods The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for scoping reviews (PRISMA-ScR [PRISMA extension for Scoping Reviews]) guided the review process. Keywords for the search were depression, anxiety, suicide, and well-being. The search was conducted using Google as well as the key intervention databases Beacon, Head to Health, and e-Mental Health in Practice. Interventions were deemed eligible if they targeted depression, anxiety, suicidal ideation, or general mental well-being (eg, resilience) in adults; and were web-based, written in English, interactive, free, and publicly available. They also had to be guided by an evidence-based therapeutic approach. Results Overall, 52 eligible programs were identified, of which 9 (17%) addressed depression, 15 (29%) addressed anxiety, 13 (25%) addressed general mental well-being, and 13 (25%) addressed multiple issues. Only 4% (2/52) addressed distress in the form of suicidal ideation. The most common therapeutic approach was cognitive behavioral therapy. Half of the programs guided users through exercises in a set sequence, and most programs enabled users to log in and complete the activities on their own without professional support. Just over half of the programs had been evaluated for their effectiveness in reducing symptoms, and 11% (6/52) were being evaluated at the time of writing. Program evaluation scores ranged from 44% to 100%, with a total average score of 85%. Conclusions There are numerous web-based programs for depression, anxiety, suicidal ideation, and general well-being, which are freely and publicly available in Australia. However, identified gaps include a lack of available web-based interventions for culturally and linguistically diverse populations and programs that use newer therapeutic approaches such as acceptance and commitment therapy and dialectical behavior therapy. Despite most programs included in this review being of good quality, clinicians and consumers should pay careful attention when selecting which program to recommend and use, as variations in the levels of acceptability and impact of publicly available programs do exist.

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“…A recent meta-analysis included 48 internet interventions for post-secondary students, 35 of which were ICBT (Harrer et al, 2019) and found small effects for improvement in depression and anxiety. Among those developed, the UniWellbeing Course has shown promising results in treating students who show signs of stress, anxiety or depression (Dear et al, 2019;Mullin et al, 2015). Implementation trials reveal high levels of satisfaction, and significant pre-to post-treatment improvements on measures of anxiety and depression that are maintained at 3-month followup (Dear et al, 2019;Mullin et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

“…Among those developed, the UniWellbeing Course has shown promising results in treating students who show signs of stress, anxiety or depression (Dear et al, 2019;Mullin et al, 2015). Implementation trials reveal high levels of satisfaction, and significant pre-to post-treatment improvements on measures of anxiety and depression that are maintained at 3-month followup (Dear et al, 2019;Mullin et al, 2015). While results are promising, only about half of clients offered the UniWellbeing Course complete the program (Dear et al, 2019;Mullin et al, 2015) and over one-third of students do not demonstrate significant gains (i.e.…”

Section: Introductionmentioning

confidence: 99%

“…Implementation trials reveal high levels of satisfaction, and significant pre-to post-treatment improvements on measures of anxiety and depression that are maintained at 3-month followup (Dear et al, 2019;Mullin et al, 2015). While results are promising, only about half of clients offered the UniWellbeing Course complete the program (Dear et al, 2019;Mullin et al, 2015) and over one-third of students do not demonstrate significant gains (i.e. reduction of ≥30% of symptoms), suggesting there is room for improving the treatment.…”

Section: Introductionmentioning

confidence: 99%

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Transdiagnostic internet-delivered therapy among post-secondary students: exploring student use and preferences for booster lessons post-treatment

Patterson

Peynenburg

Hadjistavropoulos

2022

tCBT

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Internet-delivered cognitive behaviour therapy (ICBT) is effective for treating anxiety and depression among post-secondary students, although outcomes are modest. Booster lessons have been proposed for maintaining and improving outcomes but have not been investigated following ICBT for students. This study used a mixed-methods approach to examine student (N = 146) use of a self-guided booster lesson offered 1 month after a 5-week ICBT course, whereby the booster lesson provided a review of ICBT skills and suggestions for maintaining motivation and problem solving. A survey about the booster was administered shortly after the booster to understand student preferences for the booster lessons, reasons for completing/not completing the booster, and satisfaction with the booster. Approximately one-third of students (n = 47) utilized the booster lesson. Completing a greater number of lessons during the main ICBT course was associated with uptake of the booster. The booster survey was completed by 20 of the 47 (∼43%) students who completed the booster lesson and 42 of the 99 who did not (∼42%). Students varied in perceptions of the ideal timing of the booster (1–2 weeks to 3–6 months) and approximately 60% expressed preference for completing the booster independently. Among non-completers of the booster, academic-related time constraints were the primary barrier to booster completion. Among those who completed the booster, the booster lesson was perceived as worthwhile, satisfaction was high, and the length was perceived as appropriate. Future research should examine if flexible delivery of booster lessons in terms of timelines and therapist support would increase booster uptake. Key learning aims As a result of reading this paper, readers should: (1) Understand the uptake of a self-guided booster lesson in internet-delivered cognitive behaviour therapy (ICBT) among post-secondary students. (2) Understand students’ preferences for the content, timing, and therapist support for booster lessons. (3) Understand the need for alternative delivery methods of booster lessons to reach students who might benefit the most from a booster.

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Examining an internet-delivered intervention for anxiety and depression when delivered as a part of routine care for university students: A phase IV trial

Cited by 24 publications

References 40 publications

Internet-based cognitive behavioral therapy for psychological distress in older adults without cognitive impairment living in nursing homes during the COVID-19 pandemic: A feasibility study

Internet-based cognitive behavioral therapy for psychological distress in older adults without cognitive impairment living in nursing homes during the COVID-19 pandemic: A feasibility study

Web-Based Interventions to Help Australian Adults Address Depression, Anxiety, Suicidal Ideation, and General Mental Well-being: Scoping Review

Transdiagnostic internet-delivered therapy among post-secondary students: exploring student use and preferences for booster lessons post-treatment

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