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Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial
Open accessAbstract
BACKGROUND: Telephone helplines are frequently and repeatedly used by individuals with chronic mental health problems and web interventions may be an effective tool for reducing depression in this population. AIM: To evaluate the effectiveness of a 6 week, web-based cognitive behaviour therapy (CBT) intervention with and without proactive weekly telephone tracking in the reduction of depression in callers to a helpline service. METHOD: 155 callers to a national helpline service with moderate to high psychological distress were recruited and randomised to receive either Internet CBT plus weekly telephone follow-up; Internet CBT only; weekly telephone follow-up only; or treatment as usual. RESULTS: Depression was lower in participants in the web intervention conditions both with and without telephone tracking compared to the treatment as usual condition both at post intervention and at 6 month follow-up. Telephone tracking provided by a lay telephone counsellor did not confer any additional advantage in terms of symptom reduction or adherence. CONCLUSIONS: A web-based CBT program is effective both with and without telephone tracking for reducing depression in callers to a national helpline. TRIAL REGISTRATION: Controlled-Trials.comISRCTN93903959.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
In a national helpline RCT, a 6-week web CBT program (BluePages + MoodGYM) reduced depression more than treatment as usual at post-intervention and 6-month follow-up, with large effect sizes. Adding weekly telephone tracking by a lay counsellor did not improve symptom reduction or adherence, and tracking alone was not effective.
Key findings
- Among 155 callers randomised, web CBT conditions showed greater decline in CES-D depression than control at post-intervention and 6 months. Effect sizes were large: web only vs control g = 0.76 post-intervention and 1.19 at 6 months; web with tracking vs control g = 1.04 post-intervention and 1.26 at 6 months.
- Tracking alone did not differ significantly from control at post-intervention or 6 months, and telephone tracking did not confer additional benefit over web CBT alone for symptom reduction or adherence.
- At 6-month follow-up, clinical caseness on the CES-D was 43.5% in web only, 50.0% in web with tracking, and 90.9% in control. NNT was 6.03 for web only and 4.43 for web with tracking.
- Adherence did not differ significantly between web conditions: average MoodGYM modules completed were 1.5 (SD = 1.89) for web only and 2.0 (SD = 1.88) for web with tracking; 15.8% and 17.8%, respectively, completed all five modules.
Methods
- Randomised controlled trial recruiting callers to Lifeline’s 24-hour telephone counselling service in four major Australian cities; eligibility included age ≥18, English, Internet access, and K10 score ≥22.
- Participants were randomised to web only, web with tracking, tracking only, or treatment as usual; the web intervention combined BluePages psychoeducation in Week 1 with five MoodGYM CBT modules over Weeks 2–6, and tracking consisted of weekly 10-minute calls from a telephone counsellor.
- Primary outcome was CES-D depression, analysed on an intention-to-treat basis using mixed models repeated measures ANOVA with planned contrasts; effect sizes used Hedges’ g, and logistic/linear regressions examined dropout and caseness.
Limitations
- Stated: intervention completion rates were lower than in some other web-based depression trials; symptom severity remained high post-intervention; greater dropout in the web with tracking condition may have inflated effects in that condition; two outliers were excluded from primary analyses; and depression caseness was estimated by CES-D cutoff rather than diagnostic interview.
- Stated: the trial was a true effectiveness trial using a volunteer workforce, which may contribute to recruitment and adherence issues relative to efficacy studies.
- Evident from the text: the achieved sample of 155 was below the original target of 400, although the authors state it maintained above 80% power to detect differences of less than 0.5 SD units in planned comparisons between individual treatment arms.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Depression was lower in participants in the web intervention conditions both with and without telephone tracking compared to the treatment as usual condition both at post intervention and at 6 month follow-up.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Abstract > Results
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At 6 month follow-up, those who completed more MoodGYM modules also had reduced odds of missingness (odds ratio 0.56, 95% CI: 0.41 to 0.75, p<.001).”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Participation rates and sample characteristics
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Those who completed more MoodGYM modules had reduced odds of missingness at post intervention (odds ratio 0.49, 95% CI: 0.35 to 0.69, p<.001).”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Participation rates and sample characteristics
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Telephone tracking provided by a lay telephone counsellor did not confer any additional advantage in terms of symptom reduction or adherence.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Abstract > Results
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The odds of missingness at post intervention were greater for participants in the Internet plus tracking condition, relative to participants in the control condition (odds ratio 6.46, 95% CI: 2.01 to 20.77, p = .002).”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Participation rates and sample characteristics
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A univariate logistic regression analysis revealed that the odds of caseness were significantly lower in participants in the web with tracking condition compared to participants in the control condition (odds ratio 0.16, 95% CI: 0.03 to 0.91, p = .039).”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Clinical caseness
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Rests on an assumption: The CES-D cutoff used adequately identifies clinical caseness of depression.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Post intervention, large effect sizes were observed between the web only and the control condition (g = 0.76) and the web with tracking and the control condition (g = 1.04).”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Depression symptoms
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Approximately one quarter of participants in the web only (15.8%) and web with tracking (17.8%) conditions completed all five modules of the MoodGYM program.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Dropout and adherence
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the context of web delivered programs, weekly telephone support provided by a lay telephone counsellor did not confer any additional advantage in terms of symptom reduction or adherence.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Summary findings
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The sizes of these effects increased at 6 month follow-up (g = 1.19 and 1.26, respectively).”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Depression symptoms
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Web-based CBT, whether delivered with or without tracking, was found to be effective in reducing symptoms of depression both post intervention and at 6 months within a national helpline service.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Summary findings
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Similarly, there was no significant difference in the number of MoodGYM modules completed for the web only and web with tracking conditions (Mann-Whitney U = 696.0, p = .13).”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Dropout and adherence
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Post intervention, large effect sizes were observed between the web only and the control condition (g = 0.76) and the web with tracking and the control condition (g = 1.04).”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Depression symptoms
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At 6 month follow-up, numbers of participants meeting the criteria for clinical caseness on the CES-D were halved in those who received the web intervention compared to those in the control intervention.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Summary findings
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Rests on an assumption: The CES-D cutoff used adequately identifies clinical caseness of depression.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“we found no evidence that tracking increased program adherence.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Summary findings
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Decline in symptoms did not differ significantly between the web only and web with tracking conditions from baseline to post intervention.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Depression symptoms
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Tracking alone did not differ significantly from the control condition at post intervention or 6 months.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Summary findings
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants who received the web with tracking intervention were less likely to complete a survey at post intervention (odds ratio 0.13, 95% CI: 0.03 to 0.66, p = .013), compared with those in the control condition.”
- Also stated in: § Summary findings · plain
“telephone tracking was associated with decreased participant retention in the trial from baseline to post intervention for the web with tracking condition.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Dropout and adherence
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Summary findings · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The sizes of these effects increased at 6 month follow-up (g = 1.19 and 1.26, respectively).”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Depression symptoms
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This pattern of results was repeated in all contrasts comparing change from baseline to the 6 month follow-up.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Depression symptoms
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Moderate effects were observed when the web intervention conditions were compared to the tracking only condition at post intervention and at 6 month follow-up.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Depression symptoms
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Web with tracking vs control | 1.04 | 0.40–1.67 | 1.26 | 0.57–1.94”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Depression symptoms
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Web only vs control | 0.76 | 0.21–1.31 | 1.19 | 0.55–1.83”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Depression symptoms
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Web with tracking vs control | 0.65 | 0.06–1.24 | 0.60 | 0.02–1.20”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Depression symptoms
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Web only vs control | 0.76 | 0.21–1.31 | 1.19 | 0.55–1.83”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Depression symptoms
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Web with tracking vs control | 1.04 | 0.40–1.67 | 1.26 | 0.57–1.94”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Depression symptoms
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Web with tracking vs control | 0.65 | 0.06–1.24 | 0.60 | 0.02–1.20”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Depression symptoms
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Web only vs Tracking only | 0.38 | 0.14–0.89 | 0.58 | 0.01–1.15”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Depression symptoms
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Web only vs Tracking only | 0.38 | 0.14–0.89 | 0.58 | 0.01–1.15”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Depression symptoms
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesWhat the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“There were no significant differences across trial conditions on any baseline variables (Table 1).”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Participation rates and sample characteristics
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“Cognitive behaviour therapy (CBT) offered through the telephone has been shown to significantly reduced depression [10].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Introduction
What the sources say
- Not checked yetcites [10] DC Mohr, 2005, Telephone-administered psychotherapy for depression Archives of General., Psychiatry
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“Due to distortion of the variance and violation of the assumption of normality [35], these participants were deleted for the primary analyses.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Methods > Statistical analysis
What the sources say
- Not checked yetcites [35] G Verbeke, 2000, Linear mixed models for longitudinal data
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesWhat the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The achieved sample size of 155 participants maintained power above 80% to detect differences of means of less than 0.5 standard deviation (SD) units in planned comparisons between individual treatment arms.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Methods > Power
Strength:plain· not yet calibratedn = 155Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“However, few studies have compared supported and unsupported interventions in the same trial [11] and so the issue of whether support adds unequivocal benefit has not yet been resolved.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Introduction
What the sources say
- Not checked yetcites [11] KM Griffiths, 2010, The efficacy of internet interventions for depression and anxiety disorders: a review of randomised controlled trials., Med J Aust source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“Reviews of Internet-based interventions for depression have shown that treatments delivered with therapist support show larger between-group effect sizes than unsupported treatments [6], [8].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Introduction
What the sources say
- Not checked yetcites [6], [8]
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesWhat the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The total target sample size was 400 with 100 participants assigned to each intervention arm. This would enable the detection of differences of means of less than 0.3 standard deviation (SD) units comparing treatment arms, with 80% power and ά = .05, conservatively assuming a correlation of 0.5 between measurements on different occasions.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Methods > Power
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“Like therapist supported treatments, there is evidence to suggest that treatments involving assistance from a non-professional are more effective than control conditions for depression [7], [15], [16], [17].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Introduction
What the sources say
- Not checked yetcites [7], [15], [16], [17]
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“Mixed modelling allows the use of all available data for each participant to yield unbiased estimates of effects under the assumption that missingness is either completely at random (MCAR) or at random conditional on observed data (MAR) [30].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Methods > Statistical analysis
What the sources say
- Not checked yetcites [30] RM Hamer, 2009, Last observation carried forward versus mixed models in the analysis of psychiatric clinical trials., American Journal of Psychiatry source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- The authors state this as an assumption: Missingness is either completely at random or at random conditional on observed data.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“From a policy perspective, the volunteer sector was able to provide evidence-based care to individuals with anxiety or depression.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Future directions
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The current trial offers support for an additional model.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Future directions
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The trial demonstrates the potential for individuals in remote or rural locations, those unable to leave home (because of carer responsibilities or mental health symptom severity), and those not wishing to seek traditional medical contact to receive an effective intervention through the telephone and the Internet.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Future directions
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At the same time, the trial demonstrates that volunteer counsellors trained to provide “one off” telephone counselling were able to offer a new form of service within their organisation.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Future directions
Strength:boosted· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“However, this accords with data on the effectiveness of antidepressants for depression, where overall only about 50% of patients randomised to active treatment were considered improved using intention to treat analyses at post test [50].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Limitations
What the sources say
- Not checked yetcites [50] P Bollini, 1999, Effectiveness of antidepressants. Meta-analysis of dose-effect relationships in randomised clinical trials., Br J Psychiatry source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“Similar rates are reported following face to face CBT [51].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Limitations
What the sources say
- Not checked yetcites [51] RJ DeRubeis, 2005, Cognitive therapy vs medications in the treatment of moderate to severe depression., Arch Gen Psychiatry source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is noteworthy, however, that dropout was not greater in the web only condition, so that the finding of differential dropout from the web with tracking condition does not undermine the primary finding that the web programs were more effective than either tracking alone or the control condition.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Limitations
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Effects were also larger than any previous reported effect sizes across 11 RCTs comparing Internet interventions to waitlist, treatment as usual or placebo control conditions for depression [6], [15], [17], [38], [39], [40], [41], [42], [43], [44], [45].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Summary findings
What the sources say
- Not checked yetcites [6] V Spek, 2007, Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis., Psychol Med source
- Not checked yetcites [15] H Christensen, 2004, Delivering interventions for depression by using the internet: randomised controlled trial., British Medical Journal source
- Not checked yetcites [17] L Warmerdam, 2008, Internet-based treatment for adults with depressive symptoms: randomized controlled trial., J Med Internet Res source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“The effect sizes exceeded those previously reported for the MoodGYM and BluePages programs [15].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Summary findings
What the sources say
- Not checked yetcites [15] H Christensen, 2004, Delivering interventions for depression by using the internet: randomised controlled trial., British Medical Journal source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesWhat the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Greater dropout in the web with tracking condition may have inflated the effects observed in this condition.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Limitations
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As far as we can ascertain, the present study is the first to demonstrate that web-based CBT can be effective in the context of a generic, national helpline.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Future directions
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes? Based: unclear
- It may state two separate claims as one. 29
- Probably not a substantial claim. 22
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A significant occasion by condition interaction was found for depression symptoms, F(6,100.5) = 2.97, p = .01), indicating different patterns of change between conditions across measurement occasion.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Depression symptoms
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Trial condition and number of MoodGYM modules completed were significant predictors of missingness (failure to complete a questionnaire) at post intervention.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Participation rates and sample characteristics
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Pre intervention psychological distress, sex, age, pre intervention depression symptoms, pre intervention anxiety symptoms and whether participants received their “preferred” trial condition did not predict missingness at post intervention or 6 month follow-up.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Participation rates and sample characteristics
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At 6 months, comparable outcomes were (t(107.7) = −1.72, p = .089) and (t(107.7) = −2.83, p = 0.006) respectively.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Depression symptoms
Strength:plain· not yet calibratedn = 2Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Neither trial condition nor symptom severity predicted dropout at 6 month follow up.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Dropout and adherence
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Post intervention, the number needed to be treated (NNT) under the web only intervention was estimated to be 6.03 (95% CI: 2.72 – ∞ – NNH 27.15) and for the web with tracking intervention 4.43 (95% CI: 2.22–265.75).”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Clinical caseness
Load-bearingStrength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Rests on an assumption: The CES-D cutoff used adequately identifies clinical caseness of depression.
In the paper
“This yields NNTs of 6.09 (95% CI: 3.07 – ∞ – NNH 90.15) and 3.63 (95% CI: 2.23–12.29) [33] respectively.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Clinical caseness
What the sources say
- Not checked yetcites [33] DG Altman, 1998, Confidence intervals for the number needed to treat., BMJ source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Rests on an assumption: The CES-D cutoff used adequately identifies clinical caseness of depression.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The odds of meeting caseness criteria were lower in the web with tracking (odds ratio 0.10, 95% CI: 0.02 to 0.56, p = .009) and web only (odds ratio 0.08, 95% CI: 0.01 to 0.41, p = .003) conditions, compared with the control condition.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Clinical caseness
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Rests on an assumption: The CES-D cutoff used adequately identifies clinical caseness of depression.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“It was of interest, however, that in the context of the current trial, callers were willing to forgo anonymity to receive the intervention.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Limitations
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“pre to post intervention change remained significantly different comparing web with tracking to control (t(112.6) = −2.09, p = .039) and nearly so for web only condition compared to the control condition (t(109.0) = −1.98, p = .051).”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Depression symptoms
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Of those for whom post intervention data were available, 92.6% of those in the control condition continued to meet clinical caseness, compared to 70.4% in the web only and 66.7% in the web with tracking condition.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Clinical caseness
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Rests on an assumption: The CES-D cutoff used adequately identifies clinical caseness of depression.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No significant differences were found in average number of BluePages visits (t(81) = 0.388, p = .70) or average visit duration (t(81) = 0.728, p = .47) between participants in the web only and web with tracking conditions”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Dropout and adherence
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Half of participants in the web only condition (50.0%) and approximately one third of participants in the web with tracking condition (31.1%) did not complete any modules of the program.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Dropout and adherence
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Compared to the control condition, decline in depression symptoms from baseline to post intervention was greater for participants in the web only and web with tracking conditions.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Depression symptoms
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“as the odds of achieving caseness status were lower in participants in the web only (odds ratio 0.17, 95% CI: 0.04 to 0.67, p = .010) and web with tracking conditions (odds ratio 0.28, 95% CI: 0.07 to 11.1, p = .072), compared to the control condition.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Clinical caseness
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Rests on an assumption: The CES-D cutoff used adequately identifies clinical caseness of depression.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Despite the strong effect sizes associated with the intervention, symptom severity remained quite high at post intervention.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Limitations
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“31.6% of participants in the web only and 37.7% of participants in the web with tracking conditions completed 3 or more MoodGYM modules.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Dropout and adherence
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Symptoms for participants in the tracking only condition fell between the control and the web only conditions, and did not differ significantly from either.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Depression symptoms
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At 6 month follow up, 43.5% in the web only condition and 50.0% in the web plus tracking condition met clinical caseness compared with 90.9% in the control condition.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Clinical caseness
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Rests on an assumption: The CES-D cutoff used adequately identifies clinical caseness of depression.
In the paper
“A range of software applications available on the web have also delivered effective CBT to depressed samples [11], reduced depression in school settings [12] and in general practice environments [13], [14], either with or without support from mental health professionals, paraprofessionals or teachers [11].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Introduction
What the sources say
- Not checked yetcites [13], [14]
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“A range of software applications available on the web have also delivered effective CBT to depressed samples [11], reduced depression in school settings [12] and in general practice environments [13], [14], either with or without support from mental health professionals, paraprofessionals or teachers [11].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Introduction
What the sources say
- Not checked yetcites [12] AL Calear, 2009, The YouthMood Project: A cluster randomized controlled trial of an online cognitive behavioral program with adolescents., Journal of Consulting and Clinical Psychology source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A block randomisation procedure with stratification based on sex, site of recruitment and severity of psychological distress at screening was used.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Methods > Design and procedures
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Over 40% of callers phone the service 20 times or more, 78% of callers experience depressive symptoms, and the prevalence of anxiety in this group is between 2 to 6 times that of the population [2], [3], [4].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Introduction
What the sources say
- Not checked yetcites [2], [3], [4]
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“A range of software applications available on the web have also delivered effective CBT to depressed samples [11], reduced depression in school settings [12] and in general practice environments [13], [14], either with or without support from mental health professionals, paraprofessionals or teachers [11].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Introduction
What the sources say
- Not checked yetcites [11] KM Griffiths, 2010, The efficacy of internet interventions for depression and anxiety disorders: a review of randomised controlled trials., Med J Aust source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A web-based CBT program is effective both with and without telephone tracking for reducing depression in callers to a national helpline.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Abstract > Conclusions
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Based on reviews of the evidence, the provision of support or tracking (ongoing contact with users during an intervention) has been proposed to increase adherence to treatment, prevent dropout, and improve efficacy [6].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Introduction
What the sources say
- Not checked yetcites [6] V Spek, 2007, Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis., Psychol Med source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“Over 40% of callers phone the service 20 times or more, 78% of callers experience depressive symptoms, and the prevalence of anxiety in this group is between 2 to 6 times that of the population [2], [3], [4].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Introduction
What the sources say
- Not checked yetcites [2], [3], [4]
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Based on reviews of the evidence, the provision of support or tracking (ongoing contact with users during an intervention) has been proposed to increase adherence to treatment, prevent dropout, and improve efficacy [6].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Introduction
What the sources say
- Not checked yetcites [6] V Spek, 2007, Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis., Psychol Med source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“Based on reviews of the evidence, the provision of support or tracking (ongoing contact with users during an intervention) has been proposed to increase adherence to treatment, prevent dropout, and improve efficacy [6].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Introduction
What the sources say
- Not checked yetcites [6] V Spek, 2007, Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis., Psychol Med source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“Both BluePages and MoodGYM have been shown to reduce depressive symptoms in community users [15].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Methods > Intervention and trial conditions
What the sources say
- Not checked yetcites [15] H Christensen, 2004, Delivering interventions for depression by using the internet: randomised controlled trial., British Medical Journal source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Allocation of participants to trial conditions was conducted independently by a research assistant not otherwise involved with the trial.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Methods > Design and procedures
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“A range of software applications available on the web have also delivered effective CBT to depressed samples [11], reduced depression in school settings [12] and in general practice environments [13], [14], either with or without support from mental health professionals, paraprofessionals or teachers [11].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Introduction
What the sources say
- Not checked yetcites [11] KM Griffiths, 2010, The efficacy of internet interventions for depression and anxiety disorders: a review of randomised controlled trials., Med J Aust source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“Over 40% of callers phone the service 20 times or more, 78% of callers experience depressive symptoms, and the prevalence of anxiety in this group is between 2 to 6 times that of the population [2], [3], [4].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Introduction
What the sources say
- Not checked yetcites [2], [3], [4]
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Evidence from Titov and colleagues suggests that treatments supported by professionals and non-professionals are equally effective in the treatment of depression [18].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Introduction
What the sources say
- Not checked yetcites [18] N Titov, 2010, Internet treatment for depression: a randomized controlled trial comparing clinician vs. technician assistance., PLoS One source
Load-bearingStrength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“However, additional analyses were conducted with these cases included.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Methods > Statistical analysis
Strength:plain· not yet calibratedn = 2Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The primary outcome variable was analysed on an intention to treat (ITT) basis using mixed models repeated measures ANOVA, with measurement occasion as a within groups factor and intervention condition as a between groups factor.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Methods > Statistical analysis
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“Depression symptoms were measured by the Center for Epidemiologic Studies Depression Scale [20] (CES-D), a widely used, 16 item scale with strong reliability and validity [20], [21], [22], [23], [24], [25], with a range of scores of 0 to 60.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Methods > Measures
What the sources say
- Not checked yetcites [20], [21], [22], [23], [24], [25]
Load-bearingStrength:boosted· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may state two separate claims as one.
In the paper
“Studies have estimated reasonable sensitivity (84%–93%) and specificity (69%–74%) of the CES-D using this cutoff [26], [27].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Methods > Measures
What the sources say
- Not checked yetcites [26], [27]
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The telephone and the Internet have been used separately to effectively treat physical and mental health problems [6], [7], [8], [9].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Introduction
What the sources say
- Not checked yetcites [6], [7], [8], [9]
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“The effect sizes associated with the web interventions were large, with effects at post intervention and at 6 months equal to those reported for face to face clinician delivered CBT programs for depression [36] and online CBT programs delivered by professionals [37].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Summary findings
What the sources say
- Not checked yetcites [36] AC Butler, 2006, The empirical status of cognitive-behavioral therapy: a review of meta-analyses., Clin Psychol Rev source
- Not checked yetcites [37] G Andrews, 2010, Computer Therapy for the Anxiety and Depressive Disorders Is Effective, Acceptable and Practical Health Care: A Meta-Analysis., PLoS ONE source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“The current trial was a true effectiveness trial employing a volunteer workforce for recruitment and tracking, and hence would be expected to be associated with recruitment and adherence issues relative to the more controlled environment of an efficacy study [49].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Limitations
What the sources say
- Not checked yetcites [49] BR Flay, 1986, Efficacy and effectiveness trials (and other phases of research) in the development of health promotion programs., Prev Med source
Strength:hedged· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Moreover, the intervention was short, delivered by non-health professionals, and may have constituted the only service received.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Limitations
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Repeating these analyses under the conservative assumption that all participants who discontinued the trial (i.e. failed to complete a post intervention or follow-up questionnaire) retained their last assessed caseness status attenuated effects post intervention. However, 6 month follow-up effects retained, or only narrowly escaped, significance”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Clinical caseness
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Rests on an assumption: The CES-D cutoff used adequately identifies clinical caseness of depression.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Secondary analyses with outliers included confirmed the direction of findings, although we acknowledge that effect sizes were attenuated.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Limitations
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Intervention completion rates were lower in our study relative to some other trials of web-based treatments for depression [47] but not of other telephone-based services [48].”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Limitations
What the sources say
- Not checked yetcites [47] H Christensen, 2009, Adherence in Internet interventions for anxiety and depression: Systematic review., Journal of Medical Internet Research source
- Not checked yetcites [48] WK Rhee, 2005, Efficacy of brief telephone psychotherapy with callers to a suicide hotline., Suicide Life Threat Behav source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The findings were consistent with those reported above but resulted in slightly attenuated effect sizes and reduced or quasi significant test results.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Results > Depression symptoms
Strength:plain· not yet calibratedn = 2Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In addition, the study demonstrated that a generic helpline could deliver a brief effective intervention within its current service model, and that users of the service were willing to give up their anonymity to participate in the program.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Future directions
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This suggests that call centres may be a particularly appropriate setting in which to place evidence-based web programs.”
§ Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial > Discussion > Summary findings
Tests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence.
- Rests on an assumption: Helpline users prefer to treat themselves, manage their own health, and retain a greater sense of control over their treatment.
The authors state this as an assumption.
Missingness is either completely at random or at random conditional on observed data.
“Mixed modelling allows the use of all available data for each participant to yield unbiased estimates of effects under the assumption that missingness is either completely at random (MCAR) or at random conditional on observed data (MAR) [30].”
The paper relies on this without support.
No studies have directly compared the relative efficacy of an Internet-based self-help treatment monitored by non-professionals with a non-guided treatment.
“However, to-date, no studies have directly compared the relative efficacy of an Internet-based self-help treatment monitored by non-professionals (such as volunteer telephone counsellors) with a non-guided treatment.”
The paper relies on this without support.
No trials have evaluated the effectiveness of web based interventions within existing helpline or call centre services.
“To our knowledge, no trials have evaluated the effectiveness of web based interventions within existing helpline or call centre services.”
The paper relies on this without support.
Mainstream mental health services are often difficult to access because of cost, structured consultation times, waiting list length, and location, and may not inspire trust.
“However, mental health services are often difficult to access because of cost, structured consultation times, waiting list length, and location. In addition, mainstream mental health services may not inspire trust.”
The paper relies on this without support.
Volunteer counsellors constitute a ready made workforce to refer and/or guide callers, making it possible to use the existing call centre structure to deliver immediate, cost-effective, evidence-based help.
“Volunteer counsellors constitute a ready made workforce to refer and/or guide callers, making it possible to use the existing call centre structure to deliver immediate, cost-effective, evidence-based help.”
The paper relies on this without support.
The CES-D cutoff used adequately identifies clinical caseness of depression.
“depression caseness was estimated using a cutoff on the CES-D.”
The paper relies on this without support.
Helpline users prefer to treat themselves, manage their own health, and retain a greater sense of control over their treatment.
“Helpline users in particular may prefer to treat themselves, to manage their own health, and to retain a greater sense of control over their treatment.”
The paper relies on this without support.
High baseline depression symptom levels enabled greater change in symptoms from pre- to post-intervention.
“the high baseline depression symptom levels observed in this sample may have enabled greater change in symptoms from pre to post-intervention.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source doesn’t support the claim as written.
In the citing paper
“the results so far indicate a small but significant effect size of these self-help interventions compared to a control condition [43–47].”
From An Internet-based treatment for flying phobia (NO-FEAR Airlines): Study protocol for a randomized controlled trial (2016) · cites this paper as [46]
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredIn the citing paper
“For example, two recent studies on unguided treatments showed medium-to-large effects when including a contact by telephone before treatment [16,17].”
From Internet-based psychological treatments for depression (2012) · cites this paper as [17]
Statistics recomputed
Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.
- ConsistentF(6, 100.5) = 2.97reported p = .01 · recomputed p = .010
“F(6,100.5) = 2.97, p = .01”
- Consistentt(109.2) = -3.34reported p = 0 · recomputed p = .001
“t(109.2) = −3.34, p = .00”
- Consistentt(109.5) = -2.23reported p = .03 · recomputed p = .028
“t(109.5) = −2.23, p = .03”
- Consistentt(109.2) = 1.38reported p = .17 · recomputed p = .170
“t(109.2) = 1.38, p = .17”
- Consistentt(105.8) = -2.16reported p = .03 · recomputed p = .033
“t(105.8) = −2.16, p = .03”
- Consistentt(105.7) = -0.89reported p = .37 · recomputed p = .375
“t(105.7) = −0.89, p = .37”
- Consistentt(105.4) = -1.35reported p = .18 · recomputed p = .180
“t(105.4) = −1.35, p = .18”
- Consistentt(100.5) = -2.97reported p = 0 · recomputed p = .004
“t(100.5) = −2.97, p = .00”
- Consistentt(100.7) = -1.43reported p = .16 · recomputed p = .156
“t(100.7) = −1.43, p = .16”
- Consistentt(100) = -0.01reported p = 1 · recomputed p = .992
“t(100.0) = −0.01, p = 1.00”
- Consistentt(100.3) = -3.16reported p = 0 · recomputed p = .002
“t(100.3) = −3.16, p = .00”
- Consistentt(100.4) = -1.54reported p = .13 · recomputed p = .127
“t(100.4) = −1.54, p = .13”
- Consistentt(100.7) = -1.74reported p = .09 · recomputed p = .085
“t(100.7) = −1.74, p = .09”
- Consistentt(112.6) = -2.09reported p = .039 · recomputed p = .039
“t(112.6) = −2.09, p = .039”
- Consistentt(109) = -1.98reported p = .051 · recomputed p = .050
“t(109.0) = −1.98, p = .051”
- Consistentt(107.7) = -1.72reported p = .089 · recomputed p = .088
“t(107.7) = −1.72, p = .089”
- Consistentt(107.7) = -2.83reported p = .006 · recomputed p = .006
“t(107.7) = −2.83, p = .006”
- Consistentt(81) = 0.388reported p = .7 · recomputed p = .699
“t(81) = 0.388, p = .70”
- Consistentt(81) = 0.728reported p = .47 · recomputed p = .469
“t(81) = 0.728, p = .47”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Tracking-only never-married percentage does not match the group size
MinorTable 1 reports 7 never-married participants among 37 in the tracking-only group. That is 18.92%, which rounds to 19%, not 18%.
Reported 18 · recomputed 18.918919
“Never married | 17 (45) | 13 (29) | 7 (18) | 11 (31)”
Same comparison has two different effect sizes in Table 4
MinorTable 4 labels two rows "Web with tracking vs control," but reports different effect sizes for that comparison at both time points. The fourth row appears to describe a different comparison.
“Web with tracking vs control | 0.65 | 0.06–1.24 | 0.60 | 0.02–1.20”
“Web with tracking vs control | 1.04 | 0.40–1.67 | 1.26 | 0.57–1.94”
Citations
Cites
Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007) · Behavior Research Methods · doi:10.3758/bf03193146 · Cited by 65,971
The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
Radloff, L. S. (1977) · Applied Psychological Measurement · doi:10.1177/014662167700100306 · Cited by 53,267
(1998) · The Journal of Clinical Psychiatry · Cited by 19,139
Wasserman, S. S., Hedges, L. V., & Olkin, I. (1988) · Journal of Educational Statistics · doi:10.2307/1164953 · Cited by 10,377
KESSLER, R. C., ANDREWS, G., COLPE, L. J., HIRIPI, E., MROCZEK, D. K., NORMAND, S.-L. T., WALTERS, E. E., & ZASLAVSKY, A. M. (2002) · Psychological Medicine · doi:10.1017/s0033291702006074 · Cited by 10,327
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The mini international neuropsychiatric interview
Lecrubier, Y., Sheehan, D. V., Hergueta, T., & Weiller, E. (1998) · European Psychiatry · doi:10.1016/s0924-9338(99)80239-9 · Cited by 5,899
Linear Mixed Models for Longitudinal Data
Verbeke, G. (1997) · Lecture Notes in Statistics · doi:10.1007/978-1-4612-2294-1_3 · Cited by 3,506
The empirical status of cognitive-behavioral therapy: A review of meta-analyses
Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006) · Clinical Psychology Review · doi:10.1016/j.cpr.2005.07.003 · Cited by 3,215
Robins, L. N. (1988) · Archives of General Psychiatry · doi:10.1001/archpsyc.1988.01800360017003 · Cited by 2,909
Flagged first, then by citations
1 of the 58 references couldn’t be matched to a known paper.
Research works printed but not linked: 2
- 2003, National Review of Tele Counselling and Web Counsellling Services: Final Report
- AL Calear, 2009, The YouthMood Project: a cluster randomized controlled trial of an online cognitive behavioral program with adolescents., J Consult Clin Psychol, 77, 1021, 10.1037/a0017391 · DOI · Paper page
Cited by
Sorted by citations
The impact of guidance on Internet-based mental health interventions — A systematic review
Baumeister, H., Reichler, L., Munzinger, M., & Lin, J. (2014) · Internet Interventions · doi:10.1016/j.invent.2014.08.003 · Cited by 1,037
Andrews, G., Basu, A., Cuijpers, P., Craske, M. G., McEvoy, P., English, C. L., & Newby, J. M. (2018) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2018.01.001 · Cited by 922
Karyotaki, E., Efthimiou, O., Miguel, C., Maas genannt Bermpohl, F., Furukawa, T. A., Cuijpers, P., Individual Patient Data Meta-Analyses for Depression (IPDMA-DE) Collaboration, Riper, H., Patel, V., Mira, A., et al. (2021) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2020.4364 · Cited by 866
Self-citationInteractive telemedicine: effects on professional practice and health care outcomes
Flodgren, G., Rachas, A., Farmer, A. J., Inzitari, M., & Shepperd, S. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002098.pub2 · Cited by 806
Karyotaki, E., Riper, H., Twisk, J., Hoogendoorn, A., Kleiboer, A., Mira, A., Mackinnon, A., Meyer, B., Botella, C., Littlewood, E., et al. (2017) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2017.0044 · Cited by 691
Self-citation
Metadata
- Authors
- Farrer, L., Christensen, H., Griffiths, K. M., & Mackinnon, A.
- Affiliations
- Australian National University (AU)
- The University of Melbourne (AU)
- Corresponding author
- Farrer, Louise
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2011-11-30
- Volume
- 6
- Issue
- 11
- Pages
- e28099
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3227639
- OpenAlex
- W2038169816
- Semantic Scholar
- 95651e02415cb99ae8dabe6dec5bcd2aaa8a2b11
- Cited by
- 140
- References
- 58
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 7 · 2023: 16 · 2022: 9 · 2021: 14 · 2020: 10 · 2019: 4 · 2018: 8 · 2017: 11 · 2016: 12 · 2015: 11 · 2014: 16 · 2013: 13 · 2012: 6
- FWCI
- 14.97
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- ANU Open Research (Australian National University) (submittedVersion, cc-by)
- Funders
- Medical Research Council
- Australian Research Council (LP0667970)
- National Health and Medical Research Council (525413, 525411)
- 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
- internet-based cognitive behavioral therapy, depression, telephone helpline, telephone counseling, online intervention, psychological distress, medication adherence
- MeSH terms
- Adult, Australia, Depression, Female, Follow-Up Studies, Humans, Male, Patient Compliance, Patient Dropouts, Patient Participation, Telephone, Cognitive Behavioral Therapy, Confidence Intervals, Internet
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-10, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-10 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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