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Online Self-Help as an Add-On to Inpatient Psychotherapy: Efficacy of a New Blended Treatment Approach
Open accessAbstract
BACKGROUND: Depression is one of the most frequent and costly mental disorders. While there is increasing evidence for the efficacy of online self-help to improve depression or prevent relapse, there is little evidence in blended care settings, especially combined with inpatient face-to-face psychotherapy. Therefore, we evaluated whether an evidence-based online self-help program improves the efficacy of inpatient psychotherapy. METHODS: A total of 229 depressed patients were randomly allocated either to an online self-help program (intervention group [IG]; Deprexis) or an active control group (CG; weekly online information on depression) in addition to inpatient psychodynamic psychotherapy. Both groups had access to their respective experimental intervention for 12 weeks, regardless of inpatient treatment duration. Reduction of depressive symptoms, as measured with the Beck Depression Inventory-II, was the primary outcome at the end of the intervention (T2). RESULTS: Depressive symptoms were statistically significantly lower in the IG compared to the active CG at T2 with a moderate between-group effect size of d = 0.44. The same applied to anxiety (d = 0.33), quality of life (d = 0.34), and self-esteem (d = 0.38) at discharge from inpatient treatment (T1). No statistically significant differences were found regarding dysfunctional attitudes (d = 0.14) and work ability (d = 0.08) at T1. CONCLUSIONS: This is the first evidence for blended treatment combining online self-help with inpatient psychotherapy. The study opens new and promising avenues for increasing the efficacy of inpatient psychotherapy. Future studies should determine how integration of online self-help into the therapeutic process can be developed further.
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“Only one RCT (N = 229) by Zwerenz and colleagues [18] investigated a blended therapy concept for people with depressive symptoms in a psychosomatic clinic and found small to medium effect sizes in comparison to an active control group (d = 0.44).”
From Blended care in in-patient acute psychiatric care. The example of a group training for social competences in adults—A pretest–posttest feasibility study (2021) · cites this paper as [18]
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Metadata
- Authors
- Zwerenz, R., Becker, J., Knickenberg, R. J., Siepmann, M., Hagen, K., & Beutel, M. E.
- Affiliations
- Johannes Gutenberg University Mainz (DE)
- Rhön-Klinikum (DE)
- Venue
- Psychotherapy and Psychosomatics
- Publisher
- S. Karger AG
- Published
- 2017
- Volume
- 86
- Issue
- 6
- Pages
- 341-350
- ISSN
- 0033-3190 (ISSN-L)
- 1423-0348
- OpenAlex
- W2765390755
- Cited by
- 108
- References
- 48
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 9 · 2023: 19 · 2022: 13 · 2021: 13 · 2020: 17 · 2019: 11 · 2018: 11 · 2017: 2
- FWCI
- 12.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychotherapy and Psychosomatics (publishedVersion)
- PubMed (publishedVersion)
- Qucosa (Saxon State and University Library Dresden) (submittedVersion, other-oa)
- Funders
- Rhön-Klinikum
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- online self-help, blended care, inpatient psychotherapy, depression, Deprexis, psychodynamic psychotherapy, depressive symptoms, anxiety, quality of life, self-esteem, dysfunctional attitudes, work ability
- MeSH terms
- Adult, Depressive Disorder, Female, Humans, Inpatients, Male, Middle Aged, Psychiatric Status Rating Scales, Self Care, Therapy, Computer-Assisted, Treatment Outcome, Internet, Psychotherapy, Psychodynamic
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