IDTWO: A Protocol for a Randomised Controlled Trial of a Web-Based Mental Health Intervention for Australians with Intellectual Disability

Abstract

People with intellectual disability (ID) experience higher rates of mental illness and reduced access to appropriate care and treatment. Tailored electronic mental health (eMH) programs offer opportunities to address these disparities. The aim of this study is to examine whether a fully automated and self-guided eMH program tailored to the needs of people with ID can reduce symptoms of anxiety and depression and improve daily functioning in people with borderline-to-mild ID. Australians with borderline-to-mild ID, aged 16 years and older with mild-to-moderate depression and/or anxiety symptoms will be eligible to participate with the help of a nominated carer, if necessary. A randomised controlled trial with a sample size of 150 participants divided into treatment and waitlist control arms will be conducted. Participants randomised to the intervention group will have full access to the Healthy Mind program for eight weeks. The waitlist control group will gain full access to the program following the eight-week treatment period. Efficacy will be assessed on the Anxiety, Depression, and Mood Scale; Kessler-10; and the World Health Organisation Disability Assessment Schedule 2.0 across three time-points (baseline, eight weeks, and three months). We expect that people who use the intervention will report reduced depression and anxiety, relative to the control group. To our knowledge, this is the first study to examine the effectiveness of a fully automated eMH program for improving mental health in people with ID. We expect our study to render new knowledge on the delivery and effects of internet-based cognitive behaviour therapy (CBT) tools for people with ID.

Intervenções Cognitivo-Comportamentais Baseadas Na Internet Autoguiadas Para Adolescentes: Uma Revisão

“…The 19 articles describe the 13 interventions through: seven efficacy studies with at least two groups (Calear et al, 2009;Hetrick et al, 2017;O'Kearney et al, 2006;Perry et al, 2017;Rapoff et al, 2014;Saulsberry et al, 2013;Van Voorhees et al, 2009), five efficacy studies protocols (Baldwin et al, 2021;Gladstone et al, 2015;Hides et al, 2020;Palermo et al, 2018;Rees et al, 2015), four pilot or preliminary data studies (Chillemi et al, 2020;Hill e Pettit, 2016;Rees et al, 2016;Wade et al, 2019), two complementary aspects studies -such as lessons learned and adherence (Anderson et al, 2017;Calear et al, 2013), and three case studies (March et al, 2019). Interventions and their main characteristics are described in Table 1.…”

“…The main therapeutic focuses of the interventions were: anxiety (Anderson et al, 2017;Baldwin et al, 2021;Calear et al, 2009;Calear et al, 2013;March et al, 2019;O'Kearney et al, 2006;Rees et al, 2015;Rees et al, 2016), depression (Baldwin et al, 2021;Calear et al, 2009;Calear et al, 2013;Gladstone et al, 2015;O'Kearney et al, 2006;Perry et al, 2017;Saulsberry et al, 2013;Van Voorhees et al, 2009) and suicide (Hetrick et al, 2017;Hill and Pettit, 2016). Drug use and psychotic experiences (Hides et al, 2020), cyberbullying (Chillemi et al, 2020), psychological well-being improvement in clinical conditions such as sickle cell anemia (Palermo et al, 2018), migraine (Rapoff et al, 2014), and rehabilitation after brain tumor (Wade et al, 2019) were also targets of these interventions.…”

“…The interventions are both offered exclusively on a website (n = 9) (Anderson et al, 2017;Baldwin et al, 2021;Calear et al, 2009;Calear et al, 2013;Gladstone et al, 2015;Hetrick et al, 2017;Hides et al, 2020;March et al, 2019;O'Kearney et al, 2006;Perry et al, 2017;Rees et al, 2015;Rees et al, 2016;Saulsberry et al, 2013;Van Voorhees et al, 2009;Wade et al, 2019), such as via website with a smartphone app (n = 1) (Palermo et al, 2018), and also via online program (n = 1) (Chillemi et al, 2020), online web platform (n = 1) (Hill and Pettit, 2016), or even CD-ROM (n = 1) (Rapoff et al, 2014). Almost all of these interventions can be delivered on mobile devices, following World Health Organization (WHO, 2019) guidelines that digital health interventions be accessible through these technologies.…”

“…Eight of these interventions were entirely self-guided (Anderson et al, 2017;Baldwin et al, 2021;Calear et al, 2009;Calear et al, 2013;Chillemi et al, 2020;Hides et al, 2020;Hill and Pettit, 2016;O'Kearney et al, 2006;Palermo et al, 2018;Perry et al 2017;Rees et al, 2015;Rees et al, 2016); three relied on human support (Gladstone et al, 2015;Rapoff et al, 2014;Saulsberry et al, 2013;Van Voorhees et al, 2009;Wade at el., 2019); one allowed support from a professional, if needed (Hetrick et al, 2017); and one had two possibilities: 1) to be performed entirely self-guided; or 2) self-guided, and from halfway through the treatment, if indicated, with the assistance of a therapist (March et al, 2019). When professional support was provided, it took place weekly, synchronously (by phone, videoconference, or synchronous chat) or asynchronously (via e-mail).…”

“…Across the studies, five interventions include some level of caregiver participation (Anderson et al, 2017;Baldwin et al, 2021;Palermo et al, 2018;Rapoff et al, 2014;Rees et al, 2015;Rees et al, 2016;Gladstone et al, 2015;Saulsberry et al, 2013;Van Voorhees et al, 2009) and eight do not (Calear et al, 2009;Calear et al, 2013;Chillemi et al, 2020;Hetrick et al, 2017;Hides et al, 2020;Hill and Pettit, 2016;March et al, 2019;O'Kearney et al, 2006;Perry et al, 2017;Wade et al, 2019). Even in more traditional ways of offering mental health interventions to adolescents, the importance that parents and caregivers can have in acting adjunctively to treatment is recognized.…”