Internet-Based Psychological Support for Depression

Overseen By Jay C Buckey, M.D

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Dartmouth-Hitchcock Medical Center

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 5 years

500 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests an internet-based program designed to help people manage depression, stress, and conflict. The program includes three parts: problem-solving therapy, stress management, and conflict resolution, all delivered online. The goal is to assess the effectiveness and user-friendliness of these programs in everyday life. Adults experiencing depression and participating in employee assistance programs at Dartmouth College or DHMC may be suitable candidates. As an unphased trial, this study offers participants the chance to contribute to innovative mental health solutions that could benefit many others in the future.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on psychological support, so you may not need to change your medication routine, but it's best to confirm with the trial organizers.

What prior data suggests that this internet-based psychological support is safe?

Research shows that online psychological support, such as the PATH program, is generally safe. Studies have found these treatments often work as well as in-person therapy and are cost-effective. Previous trials of the problem-solving therapy module demonstrated its effectiveness without negative side effects. Additionally, the stress management program, which uses cognitive behavioral therapy (CBT), successfully reduced stress levels in law and business students. Overall, online psychological treatments have significantly reduced anxiety and depression symptoms in many cases. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about internet-based psychological support for depression because it offers a flexible and accessible alternative to traditional therapy methods like in-person counseling and medication. This approach combines Problem Solving Therapy with stress and conflict management training, all delivered online, making it particularly appealing for people who may have difficulty accessing face-to-face therapy due to location or scheduling constraints. Unlike standard treatments that require office visits or prescriptions, this internet-based intervention can be accessed anytime, allowing users to engage with the content at their own pace and comfort level. This convenience and accessibility could lead to improved adherence and outcomes for individuals struggling with depression.

What evidence suggests that this internet-based psychological support is effective for depression?

Research has shown that online programs like the PATH program, which participants in this trial will receive, can help reduce depression symptoms. Studies have found that digital mental health tools significantly lower depression levels in users. Specifically, online cognitive behavioral therapy (iCBT) has proven effective, with 48% of participants in guided programs showing improvement. The stress management component of PATH has also reduced stress levels among law and business students. Overall, these findings suggest that PATH's online support can be a useful tool for managing depression and stress. ^{1 6 7 8 9}

Who Is on the Research Team?

Jay Buckey, MD

Principal Investigator

Dartmouth-Hitchcock Medical Center

Are You a Good Fit for This Trial?

This trial is for adults aged 18 or older who are experiencing depression, stress, or need help with conflict resolution. It's specifically designed for employees and faculty attending the EAP programs of DHMC and Dartmouth College.

Inclusion Criteria

I am an adult working or teaching at DHMC or Dartmouth College and feel depressed.

Exclusion Criteria

N/A

Timeline for a Trial Participant

Enrollment

Participants are referred to the PATH program and sign up online, providing electronic consent.

Ongoing

Treatment

Participants engage with the PATH program modules, including problem-solving, stress management, and conflict management.

5 years

Online sessions

Data Collection

Automatic collection of usage data, PHQ-9 scores, PSS scores, and acceptability questionnaires during program use.

5 years

Follow-up

Participants' progress and effectiveness of the program are monitored through self-reported measures over time.

5 years

What Are the Treatments Tested in This Trial?

Interventions

• Internet-based psychological support

Trial Overview The trial tests an internet-based support program called PATH, which includes modules on problem-solving therapy for depression, stress management using CBT techniques, and conflict management through interactive simulations and exercises.

How Is the Trial Designed?

Group I: Internet Based psychological support Experimental Treatment 1 Intervention

The internet-based psychological support intervention (PATH) is an internet based Problem Solving Therapy, stress management training and conflict management training program.

Who Is Running the Clinical Trial?

Dartmouth-Hitchcock Medical Center

Lead Sponsor

Trials

548

Recruited

2,545,000+

Published Research Related to This Trial

In a study of 263 participants with moderate to severe depressive symptoms, higher baseline depression levels and higher education were found to predict improvement in symptoms after 8 weeks of Internet-based cognitive behavioral therapy (CBT) or problem-solving therapy (PST).

The study revealed that while higher education, less avoidance behavior, and decreased rational problem-solving skills were associated with clinically significant changes in depressive symptoms, no specific factors were identified that predicted outcomes differently between CBT and PST, indicating both therapies may be similarly effective.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Predicting outcome of Internet-based treatment for depressive symptoms. Warmerdam, L., Van Straten, A., Twisk, J., et al.[2022]

Internet interventions based on cognitive behavioral therapy have been shown to effectively reduce symptoms of depression, with medium-to-large effect sizes (d=0.58-0.78) when guided by a therapist, and small-to-medium effect sizes (d=0.25-0.36) for self-help formats compared to usual care.

These interventions could help address the treatment gap for individuals with depression, as many do not receive adequate care, suggesting a promising avenue for integrating these tools into mental health care systems.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Internet interventions for depression: new developments. Schröder, J., Berger, T., Westermann, S., et al.[2022]

In a study involving 537 adults with mild to moderate anxiety and depression, only those receiving Internet-based problem solving treatment (PST) with weekly support showed significant improvement in depressive symptoms compared to a waitlist control group.

The findings highlight that having structured support during Internet-based interventions is crucial for effectively reducing symptoms of depression and potentially anxiety, emphasizing the need for human interaction in these treatments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized controlled trial on the role of support in Internet-based problem solving therapy for depression and anxiety. Kleiboer, A., Donker, T., Seekles, W., et al.[2022]

Internet-based cognitive-behavioral therapy (CBT) is an effective self-help program that allows patients to receive psychological support via the Internet, making therapy more accessible, especially for those unable to attend traditional sessions.

This form of therapy has shown particular effectiveness in treating conditions like panic disorder, social phobia, and depression, indicating its potential to reach and help a wider range of individuals in need of mental health support.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Internet-based cognitive-behavioral therapy in the treatment of psychiatric disorders]. Holmberg, N., Kähkönen, S.[2022]

A study involving 525 participants found that both a cognitive-behavioral therapy (CBT) internet intervention and a depression information website led to significant reductions in depression scores compared to a placebo control, with benefits lasting up to 12 months.

While the CBT intervention maintained its effectiveness at the 6-month follow-up, the depression information website's benefits were not significant at that time, suggesting that the CBT may provide more sustained support for depression management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparative randomised trial of online cognitive-behavioural therapy and an information website for depression: 12-month outcomes. Mackinnon, A., Griffiths, KM., Christensen, H.[2022]

Internet-based therapies for depression have been shown to be effective, with numerous randomized controlled trials confirming their efficacy and no significant differences in outcomes compared to traditional face-to-face treatments.

The future of mental health care may benefit from integrating these Internet-based interventions, especially with advancements in technology like smartphones and virtual reality, which could enhance treatment accessibility and effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Internet and mobile interventions for depression: Opportunities and challenges. Cuijpers, P., Kleiboer, A., Karyotaki, E., et al.[2018]

A pilot study involving 196 primary care patients found that 20% enrolled in an Internet-delivered cognitive behavioral therapy (CBT) program, indicating that integrating such programs into healthcare systems is feasible.

Participants who completed the program experienced a significant average reduction of 46% in depressive symptoms after four months, along with a decrease in suicidal thoughts, suggesting that Internet-delivered CBT can be an effective treatment for depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Online cognitive behavioral therapy for depressed primary care patients: a pilot feasibility project. Whiteside, U., Richards, J., Steinfeld, B., et al.[2021]

In a study involving 263 participants, both Internet-based cognitive behavioral therapy (CBT) and problem-solving therapy (PST) were effective in reducing depressive symptoms, with CBT showing a higher effect size at 12 weeks (0.69) compared to PST (0.65).

PST provided quicker results, with significant symptom reduction observed after just 5 weeks (effect size 0.47), making it a viable alternative to CBT for those seeking faster relief from depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Internet-based treatment for adults with depressive symptoms: randomized controlled trial. Warmerdam, L., van Straten, A., Twisk, J., et al.[2022]

A study involving 286 participants showed that four different therapist-supported internet treatments for depression significantly reduced depressive symptoms over a 12-week period, with a notable effect size (Hedges g = 1.01) compared to a control group.

The findings emphasize the importance of including psychoeducation in treatment, as it positively influences treatment outcomes and participant retention, suggesting that educational components should be integrated into future internet-based depression therapies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Behavioral activation versus physical activity via the internet: A randomized controlled trial. Nyström, MBT., Stenling, A., Sjöström, E., et al.[2018]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11261690/

Assessing the effectiveness of internet-based interventions for ... Five studies reported the dropout rate for depressive disorders, culminating in a combined rate of 47.59% (5981/12 567). Adherence was reported ...

2. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/33471111/

Internet-Based Cognitive Behavioral Therapy for Depression In this network meta-analysis with IPD, guided iCBT was associated with more effectiveness than unguided iCBT for individuals with depression.

3. sciencedirect.com sciencedirect.com/science/article/pii/S0165032724016793

Digital mental health interventions for the treatment of ... Our study provides robust evidence for the effectiveness of digital interventions for depression while highlighting important factors associated with treatment ...

4. bmcpsychiatry.biomedcentral.com bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-06046-x

Effectiveness of internet-based self-help interventions for ... Meta-analysis indicated that Internet-based self-help therapies significantly reduced depression scores in adolescents and young adults.

5. jamanetwork.com jamanetwork.com/journals/jamapsychiatry/fullarticle/2774861

Internet-Based Cognitive Behavioral Therapy for Depression Overall, 48% of participants receiving guided iCBT responded, while 37% responded in unguided iCBT. When splitting participants into severity ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3918007/

Advantages and limitations of Internet-based interventions for ... The evidence to date shows that these treatments often result in similar outcomes as in face-to-face psychotherapy and that they are cost-effective.

7. bmcpsychiatry.biomedcentral.com bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-025-06757-9

Comparative effectiveness and acceptability of internet-based ... This systematic review and network meta-analysis aims to rigorously assess the comparative efficacy and acceptability of internet-based psychological ...

8. sciencedirect.com sciencedirect.com/science/article/pii/S1697260024000528

Effectiveness of internet-delivered psychological ... Some meta-analyses have found significant reductions in anxiety and depression symptomatology after applying online psychological therapies in children and ...

9. withpower.com withpower.com/trial/phase-depression-1-2016-63a3f

Internet-Based Psychological Support for Depression Internet-based psychological support, like problem-solving therapy, is generally considered safe for humans. Studies suggest that it can be effective for ...