Web-Based Intervention Programs for Depression: A Scoping Review and Evaluation

Abstract

BackgroundAlthough depression is known to affect millions of people worldwide, individuals seeking aid from qualified health care professionals are faced with a number of barriers to treatment including a lack of treatment resources, limited number of qualified service providers, stigma associated with diagnosis and treatment, prolonged wait times, cost, and barriers to accessibility such as transportation and clinic locations. The delivery of depression interventions through the Internet may provide a practical solution to addressing some of these barriers.ObjectiveThe purpose of this scoping review was to answer the following questions: (1) What Web-delivered programs are currently available that offer an interactive treatment component for depression?, (2) What are the contents, accessibility, and usability of each identified program?, and (3) What tools, supports, and research evidence are available for each identified program?MethodsUsing the popular search engines Google, Yahoo, and Bing (Canadian platforms), two reviewers independently searched for interactive Web-based interventions targeting the treatment of depression. The Beacon website, an information portal for online health applications, was also consulted. For each identified program, accessibility, usability, tools, support, and research evidence were evaluated and programs were categorized as evidence-based versus non-evidence-based if they had been the subject of at least one randomized controlled trial. Programs were scored using a 28-point rating system, and evidence- versus non-evidence-based programs were compared and contrasted. Although this review included all programs meeting exclusion and inclusion criteria found using the described search method, only English language Web-delivered depression programs were awarded an evaluation score.ResultsThe review identified 32 programs meeting inclusion criteria. There was a great deal of variability among the programs captured in this evaluation. Many of the programs were developed for general adolescent or adult audiences, with few (n=2) focusing on special populations (eg, military personnel, older adults). Cognitive behavioral therapy was the most common therapeutic approach used in the programs described. Program interactive components included mood assessments and supplementary homework sheets such as activity planning and goal setting. Only 12 of the programs had published evidence in support of their efficacy and treatment of depressive symptoms.ConclusionsThere are a number of interactive depression interventions available through the Internet. Recommendations for future programs, or the adaptation of existing programs include offering a greater selection of alternative languages, removing registration restrictions, free trial periods for programs requiring user fees, and amending programs to meet the needs of special populations (eg, those with cognitive and/or visual impairments). Furthermore, discussion of specific and relevant topics to the target audience while also enhancing overall...

Web-Based Interventions for Depression in Individuals with Diabetes: Review and Discussion (Preprint)

“…Four interventions had a CBT only approach. CBT is the most commonly used approach in web-based depression interventions [49][50][51] and with a guided self-help methodology have shown the same effects when compared directly to face-to-face CBT therapy [28]. However, all interventions are multicomponent with a number of hypothesized mechanisms (e.g.…”

“…This is a reflection of the small number of web-based depression interventions that offer this kind of support [50]. A meta-analysis on web-based interventions for diabetes management showed that online peer support was a successful approach [59], but in interventions for depression the evidence is limited and show inconsistent findings [65].…”

“…However, face-to-face CBT is the most extensively researched psychotherapeutic treatment for depression [46] and have also shown to be effective in depression symptomatology [47] and glycemic control [48] in individuals with diabetes. Congruently with this review, CBT is also the most commonly used approach in web-based depression interventions [49][50][51]. Furthermore, web-based guided self-help CBT, is the only approach that has been compared directly to face-to-face CBT, showing same effects [28].…”

“…A review of web-based programs for depression currently available in English showed that 20/32 (62%) had a crisis link defined as email addresses, phone numbers, and/or hotlines connected to distress centers providing counseling services to atrisk users [50]. Because of the oscillating course of depression there is always the risk of deterioration or moments of crisis, so it is important to be able to detect it in time and determine courses of action.…”

“…A scoping review on web-based programs for depression showed that only 8/32 offered a peer-support forum, interestingly, they all were non-evidence-based programs [50]. Faceto-face peer support interventions for depression have been observed to improve depression symptoms more than usual care alone [61].…”