Pragmatic quasi-experimental controlled trial evaluating the outcomes of blended cbt compared to face-to-face cbt and treatment as usual for adolescents with depressive disorders

Rasing, Sanne P.A.; Stikkelbroek, Yvonne A.J.; den Hollander, Wouter; Riper, Heleen; Deković, Maja; Nauta, Maaike H.; Creemers, Daan H.M.; Immink, Marianne C.P.; Spuij, Mariken; Bodden, Denise H.M.

doi:10.3390/ijerph18063102

Cited by 21Digital Mental Health InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and Access

Pragmatic quasi-experimental controlled trial evaluating the outcomes of blended cbt compared to face-to-face cbt and treatment as usual for adolescents with depressive disorders

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Rasing, Sanne P.A., Stikkelbroek, Yvonne A.J., den Hollander, Wouter, Riper, Heleen, Deković, Maja, Nauta, Maaike H., Creemers, Daan H.M., Immink, Marianne C.P. +2 more·2021·International Journal of Environmental Research and Public Health

DOI 10.3390/ijerph18063102PMC PMC8002752

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Abstract

Depression is a major problem in youth mental health. Current treatment is on average effective, but adolescents are hesitant to seek help. Blended treatment could lower the barriers to seeking treatment. Evidence on effectiveness is, however, scarce. The present pragmatic quasi-experimental controlled trial aimed to compare the outcomes of blended cognitive behavioral therapy (CBT) to face-to-face CBT and treatment as usual. A total of 129 adolescents with clinical depression (82.2% female), aged 13–22 (M = 16.60, SD = 2.03) received blended CBT, face-to-face CBT or treatment as usual. Clinical diagnosis, depressive symptoms, and secondary outcomes were assessed at baseline, post-intervention, and six-months follow-up. Participants receiving blended CBT were, compared to participants receiving face-to-face CBT and treatment as usual, evenly likely to be in remission from their depressive disorder at post-intervention and at six-month follow-up. Depressive symptoms decreased significantly over time in all three conditions, and changes were not significantly different between conditions. Other secondary outcomes (suicide risk, internalizing and externalizing symptoms, severity of depression, and global functioning) did not differ between treatment conditions at post-intervention and six-month follow-up. Since there was no evidence for favorable outcomes for face-to-face therapies above blended CBT, blended CBT may also be an effective treatment format in clinical practice.

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The non-completion rate (32.4%) is high but inferior to other studies on blended interventions and comparable to other studies of computerized and face-to-face treatments for depression.
“The non-completion rate is high, but inferior to that found in other studies on blended interventions (Rasing et al., 2021; Romijn et al., 2021) and comparable to that of other studies of both computerized and face-to-face treatments for depression (De Haan et al., 2013; Kaltenthaler et al., 2008).”
From Feasibility, acceptability, and preliminary efficacy of a blended transdiagnostic group CBT for the treatment of emotional disorders (2025) · cites this paper as Rasing et al., 2021

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Long Term Outcomes of Blended CBT Compared to Face-to-Face CBT and Treatment as Usual for Adolescents with Depressive Disorders: Analyses at 12 Months Post-Treatment
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Authors: Rasing, S. P. A., Stikkelbroek, Y. A. J., den Hollander, W., Riper, H., Deković, M., Nauta, M. H., Creemers, D. H. M., Immink, M. C. P., Spuij, M., & Bodden, D. H. M.
Affiliations: Utrecht University (NL)
Trimbos Institute, 3521 VS Utrecht, The Netherlands
Amsterdam Public Health (NL)
University of Groningen (NL)
Radboud University Nijmegen (NL)
GGZ Noord-Holland-Noord (NL)
Corresponding author: Rasing, Sanne P.A.
ORCID: Rasing, Sanne P.A.
Stikkelbroek, Yvonne A.J.
Riper, Heleen
Deković, Maja
Nauta, Maaike H.
Creemers, Daan H.M.
Spuij, Mariken
Bodden, Denise H.M.
Venue: International Journal of Environmental Research and Public Health
Publisher: MDPI AG
Published: 2021-03-17
Volume: 18
Issue: 6
Pages: 3102
ISSN: 1660-4601 (ISSN-L)
DOI: 10.3390/ijerph18063102
PMC: PMC8002752
OpenAlex: W3137015654
Cited by: 21
References: 64
Citations by year: 2026: 2 · 2025: 7 · 2024: 4 · 2023: 6 · 2022: 1 · 2021: 1
FWCI: 2.69
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (vor)
Locations: International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, cc-by)
VU Research Portal (publishedVersion, other-oa)
RePEc: Research Papers in Economics (submittedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
Pure Amsterdam UMC (submittedVersion, cc-by)
Radboud Repository (Radboud University) (submittedVersion)
Radboud Repository (Radboud University) (submittedVersion, other-oa)
University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Funders: ZonMw (70-72900-98-16144, 80-82435-98-10117)
Topics: Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords: adolescent depression, youth mental health, usual care, barriers to treatment seeking, depressive symptoms, remission, suicide risk, internalizing and externalizing symptoms, global functioning
MeSH terms: Adolescent, Adult, Cost-Benefit Analysis, Major Depressive Disorder, Depressive Disorder, Major, Female, Humans, Male, Mental Health, Cognitive Behavioral Therapy, Treatment Outcome, Young Adult

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Pragmatic quasi-experimental controlled trial evaluating the outcomes of blended cbt compared to face-to-face cbt and treatment as usual for adolescents with depressive disorders

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