For Whom Does It Work? Moderators of Outcome on the Effect of a Transdiagnostic Internet-Based Maintenance Treatment After Inpatient Psychotherapy: Randomized Controlled Trial
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BACKGROUND: Recent studies provide evidence for the effectiveness of Internet-based maintenance treatments for mental disorders. However, it is still unclear which participants might or might not profit from this particular kind of treatment delivery. OBJECTIVE: The study aimed to identify moderators of treatment outcome in a transdiagnostic Internet-based maintenance treatment (TIMT) offered to patients after inpatient psychotherapy for mental disorders in routine care. METHODS: Using data from a randomized controlled trial (N=400) designed to test the effectiveness of TIMT, we performed secondary analyses to identify factors moderating the effects of TIMT (intervention) when compared with those of a treatment-as-usual control condition. TIMT involved an online self-management module, asynchronous patient-therapist communication, a peer support group, and online-based progress monitoring. Participants in the control condition had unstructured access to outpatient psychotherapy, standardized outpatient face-to-face continuation treatment, and psychotropic management. Self-reports of psychopathological symptoms and potential moderators were assessed at the start of inpatient treatment (T1), at discharge from inpatient treatment/start of TIMT (T2), and at 3-month (T3) and 12-month follow-up (T4). RESULTS: Education level, positive outcome expectations, and diagnoses significantly moderated intervention versus control differences regarding changes in outcomes between T2 and T3. Only education level moderated change differences between T2 and T4. The effectiveness of the intervention (vs control) was more pronounced among participants with a low (vs high) education level (T2-T3: B=-0.32, SE 0.16, P=.049; T2-T4: B=-0.42, SE 0.21, P=.049), participants with high (vs low) positive outcome expectations (T2-T3: B=-0.12, SE 0.05, P=.02) and participants with anxiety disorder (vs mood disorder) (T2-T3: B=-0.43, SE 0.21, P=.04). Simple slope analyses revealed that despite some subgroups benefiting less from the intervention than others, all subgroups still benefited significantly. CONCLUSIONS: This transdiagnostic Internet-based maintenance treatment might be suitable for a wide range of participants differing in various clinical, motivational, and demographic characteristics. The treatment is especially effective for participants with low education levels. These findings may generalize to other Internet-based maintenance treatments.
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Up to 40% of patients do not appear to improve or only partially respond to psychological interventions.
“but up to 40% of patients do not respond to psychotherapy as expected”
From Using Artificial Intelligence to Enhance Ongoing Psychological Interventions for Emotional Problems in Real- or Close to Real-Time: A Systematic Review (2022) · cites this paper as [49]
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“Internet- and mobile-based interventions [8] might help to increase the utilization of psychological interventions, as they can be easily accessed, allow for high scalability, and can be provided at a low cost [9,10].”
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Internet- und mobilebasierte Psychotherapie der Depression
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Self-citation
- Authors
- Ebert, D. D., Gollwitzer, M., Riper, H., Cuijpers, P., Baumeister, H., & Berking, M.
- Affiliations
- Leuphana University of Lüneburg (DE)
- Philipps University of Marburg (DE)
- University of Freiburg (DE)
- Corresponding author
- Ebert, David Daniel
- ORCID
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2013-08-29
- Volume
- 15
- Issue
- 10
- Pages
- e191
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC3849694
- OpenAlex
- W2086624410
- Cited by
- 61
- References
- 54
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 8 · 2022: 3 · 2021: 3 · 2020: 5 · 2019: 6 · 2018: 7 · 2017: 10 · 2016: 6 · 2015: 5 · 2014: 4 · 2013: 1
- FWCI
- 8.15
- 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)
- Pure Amsterdam UMC (publishedVersion, other-oa)
- Multilingual Matters (Channel View Publications) (publishedVersion, cc-by)
- VU Research Portal (publishedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, cc-by)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- European Commission (2007DE161PR001, CCI 2007DE161PR001)
- European Regional Development Fund (CCI 2007DE161PR001, 2007DE161PR001)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- moderators of treatment outcome, inpatient psychotherapy, educational attainment, outcome expectations, anxiety disorders, mood disorders, peer support, mental illness
- MeSH terms
- Adult, Aftercare, Mental Disorders, Female, Humans, Inpatients, Male, Middle Aged, Psychotherapy, Treatment Outcome, Internet
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