A Service-Based Evaluation of a Therapist-Supported Online Cognitive Behavioral Therapy Program for Depression
Open accessAbstract
BACKGROUND: Evidence suggests that Internet-delivered cognitive behavioral therapy (CBT) may be as effective as face-to-face delivery for depression, but attrition and engagement rates remain a challenge. OBJECTIVE: This service-based study aimed to evaluate an online, therapist-supported, CBT-based program for depression. The program was specifically designed to address engagement issues, most notably by integrating online therapist support and communication within the platform. METHODS: Participants were 80 adults who were registered university students. Participants used the modular online program over 8 weeks, supported by a therapist. Engagement information was gathered automatically by the online system, and analyzed for all participants. Severity of participants' self-reported symptoms of depression were assessed preintervention and postintervention using the Beck Depression Inventory-II (BDI-II). Postintervention measures were completed by 53 participants. RESULTS: A high level of engagement was observed compared to a previous study within the same service, along with extensive use of a range of program features. A statistically significant (P<.001) decrease in self-reported depressive symptomatology from preintervention (mean BDI-II 25.47) to postintervention (mean BDI-II 15.53) with a large effect size (d=1.17) was also observed. CONCLUSIONS: The results indicate the potential of unintrusive and easily provided online support to enhance engagement with online interventions. The system described in the paper also illustrates how such online support can be tightly integrated with interactive online programs by using a range of design strategies intended to improve the user experience.
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Problems with adherence to online programs and translation of therapy content into daily life can be difficult for patients.
“Nevertheless, problems with adherence to the online program and translation of therapy content into daily life can be difficult for patients [8-10].”
The optimal level of support, the nature of support, and essential preconditions to make blended care acceptable and cost-effective have not been studied.
“The optimal level of support, the nature of the support, and essential preconditions to make blended care acceptable and cost-effective have not been studied as well [11,10,22].”
A number of small scale studies of online delivered treatments have been experimented with in Ireland.
“A number of small scale studies of online delivered treatments have been experimented with in Ireland [37,38].”
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- Authors
- Sharry, J., Davidson, R., McLoughlin, O., & Doherty, G.
- Affiliations
- Mater Misericordiae University Hospital (IE)
- University of Limerick (IE)
- Trinity College Dublin (IE)
- Corresponding author
- Doherty, Gavin
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2013-06-27
- Volume
- 15
- Issue
- 6
- Pages
- e121
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC3713925
- OpenAlex
- W2060656060
- Cited by
- 55
- References
- 41
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 2 · 2022: 5 · 2021: 3 · 2020: 3 · 2019: 4 · 2018: 4 · 2017: 3 · 2016: 8 · 2015: 6 · 2014: 9 · 2013: 1
- FWCI
- 12.32
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Internet Research (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Lenus, The Irish Health Repository (Dr Steevens Hospital Library) (submittedVersion)
- 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 › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- internet-based cognitive behavioral therapy, depression, user engagement, attrition, online therapy, university students, user experience design, Beck Depression Inventory-II
- MeSH terms
- Workforce, Adult, Depression, Humans, Mental Health Services, Cognitive Behavioral Therapy, Young Adult
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.
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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