Incorporating a Stepped Care Approach into Electronic Cognitive Behavioural Therapy for Depression: A Randomized Controlled Trial
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Authors
Jagayat, Jasleen K.
Date
2024-01-05
Type
thesis
Language
eng
Keyword
internet-based cognitive behavioral therapy , electronic cognitive behavioural therapy , major depressive disorder , stepped care , digital mental healthcare
Alternative Title
Abstract
Depression is a leading cause of disability, annually affecting up to 300 million people worldwide, yet fewer than one third of patients receive care. Electronic cognitive behavioural therapy (e-CBT) is an effective treatment for depression. A stepped care model is a care model that begins treatment with the least resource intensive, yet effective, method while adapting care based on patients’ needs. This study investigated the efficacy of a stepped care e-CBT model for depression through the reduction of depressive symptoms. We hypothesized that the stepped care group will outperform the e-CBT only group. Participants were randomized to either the e-CBT only group (n = 28) or the e-CBT with stepped care group (n = 28). Both groups received a 13-weeks e-CBT program tailored to depression through a secure, online mental health platform called the Online Psychotherapy Tool (OPTT). Participants in the stepped care group received additional interventions based on their standard questionnaire scores and textual data. From lowest to highest intensity, the interventions included messages, phone calls, video calls, or a video call with a psychiatrist. For this study, 56 participants were recruited to complete an e-CBT only program (mean age = 38.9, 26.9% male) or e-CBT with stepped care program (mean age = 40.6, 42.4% male). The e-CBT program was effective in significantly reducing depressive symptoms; however, there were no significant differences in the reduction of depressive symptoms between the two groups. Although there were no significant differences observed between the number of participants who completed the program between groups, participants in the stepped care group, on average, took part in two more sessions than those who prematurely terminated participation in the e-CBT only group. Implementing a stepped care approach into e-CBT is an effective treatment for depression and the stepped care model can assist patients to complete more sessions in their treatment.
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Queen's University's Thesis/Dissertation Non-Exclusive License for Deposit to QSpace and Library and Archives Canada
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This publication is made available by the authority of the copyright owner solely for the purpose of private study and research and may not be copied or reproduced except as permitted by the copyright laws without written authority from the copyright owner.
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ProQuest PhD and Master's Theses International Dissemination Agreement
Intellectual Property Guidelines at Queen's University
Copying and Preserving Your Thesis
This publication is made available by the authority of the copyright owner solely for the purpose of private study and research and may not be copied or reproduced except as permitted by the copyright laws without written authority from the copyright owner.
Attribution 4.0 International