Internet Treatment for Depression: A Randomized Controlled Trial Comparing Clinician vs. Technician Assistance
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{"title"=>"Internet Treatment for Depression: A Randomized Controlled Trial Comparing Clinician vs. Technician Assistance", "type"=>"journal", "authors"=>[{"first_name"=>"Nickolai", "last_name"=>"Titov"}, {"first_name"=>"Gavin", "last_name"=>"Andrews"}, {"first_name"=>"Matthew", "last_name"=>"Davies"}, {"first_name"=>"Karen", "last_name"=>"McIntyre"}, {"first_name"=>"Emma", "last_name"=>"Robinson"}, {"first_name"=>"Karen", "last_name"=>"Solley"}], "year"=>2010, "source"=>"PLoS ONE", "identifiers"=>{"issn"=>"1932-6203", "arxiv"=>"e57447", "scopus"=>"2-s2.0-77956200567", "sgr"=>"77956200567", "pui"=>"368589202", "isbn"=>"1932-6203 (Electronic)\\n1932-6203 (Linking)", "pmid"=>"20544030", "doi"=>"10.1371/journal.pone.0010939"}, "id"=>"e8da8146-8f9f-3a34-83d8-3905f7cb2a85", "abstract"=>"BACKGROUND: Internet-based cognitive behavioural therapy (iCBT) for depression is effective when guided by a clinician, less so if unguided.\\n\\nQUESTION: Would guidance from a technician be as effective as guidance from a clinician?\\n\\nMETHOD: Randomized controlled non-inferiority trial comparing three groups: Clinician-assisted vs. technician-assisted vs. delayed treatment. Community-based volunteers applied to the VirtualClinic (www.virtualclinic.org.au) research program, and 141 participants with major depressive disorder were randomized. Participants in the clinician- and technician-assisted groups received access to an iCBT program for depression comprising 6 online lessons, weekly homework assignments, and weekly supportive contact over a treatment period of 8 weeks. Participants in the clinician-assisted group also received access to a moderated online discussion forum. The main outcome measures were the Beck Depression Inventory (BDI-II) and the Patient Health QUESTIONnaire-9 Item (PHQ-9). Completion rates were high, and at post-treatment, both treatment groups reduced scores on the BDI-II (p<0.001) and PHQ-9 (p<0.001) compared to the delayed treatment group but did not differ from each other. Within group effect sizes on the BDI-II were 1.27 and 1.20 for the clinician- and technician-assisted groups respectively, and on the PHQ-9, were 1.54 and 1.60 respectively. At 4-month follow-up participants in the technician group had made further improvements and had significantly lower scores on the PHQ-9 than those in the clinician group. A total of approximately 60 minutes of clinician or technician time was required per participant during the 8-week treatment program.\\n\\nCONCLUSIONS: Both clinician- and technician-assisted treatment resulted in large effect sizes and clinically significant improvements comparable to those associated with face-to-face treatment, while a delayed treatment control group did not improve. These results provide support for large scale trials to determine the clinical effectiveness and acceptability of technician-assisted iCBT programs for depression. This form of treatment has potential to increase the capacity of existing mental health services.\\n\\nTRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12609000559213.", "link"=>"http://www.mendeley.com/research/internet-treatment-depression-randomized-controlled-trial-comparing-clinician-vs-technician-assistan", "reader_count"=>225, "reader_count_by_academic_status"=>{"Unspecified"=>14, "Professor > Associate Professor"=>7, "Librarian"=>3, "Student > Doctoral Student"=>17, "Researcher"=>36, "Student > Ph. D. Student"=>46, "Student > Postgraduate"=>10, "Student > Master"=>52, "Other"=>9, "Student > Bachelor"=>23, "Lecturer"=>1, "Professor"=>7}, "reader_count_by_user_role"=>{"Unspecified"=>14, "Professor > Associate Professor"=>7, "Librarian"=>3, "Student > Doctoral Student"=>17, "Researcher"=>36, "Student > Ph. D. Student"=>46, "Student > Postgraduate"=>10, "Student > Master"=>52, "Other"=>9, "Student > Bachelor"=>23, "Lecturer"=>1, "Professor"=>7}, "reader_count_by_subject_area"=>{"Unspecified"=>25, "Nursing and Health Professions"=>1, "Medicine and Dentistry"=>30, "Agricultural and Biological Sciences"=>3, "Arts and Humanities"=>2, "Business, Management and Accounting"=>1, "Sports and Recreations"=>1, "Psychology"=>143, "Social Sciences"=>13, "Computer Science"=>4, "Economics, Econometrics and Finance"=>2}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>30}, "Social Sciences"=>{"Social Sciences"=>13}, "Sports and Recreations"=>{"Sports and Recreations"=>1}, "Psychology"=>{"Psychology"=>143}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>2}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>3}, "Computer Science"=>{"Computer Science"=>4}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>1}, "Unspecified"=>{"Unspecified"=>25}, "Arts and Humanities"=>{"Arts and Humanities"=>2}}, "reader_count_by_country"=>{"Canada"=>1, "Sweden"=>2, "Netherlands"=>2, "Norway"=>1, "United States"=>1, "Brazil"=>1, "United Kingdom"=>3, "Switzerland"=>1, "Spain"=>1}, "group_count"=>41}

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  • {"files"=>["https://ndownloader.figshare.com/files/421407", "https://ndownloader.figshare.com/files/421448"], "description"=>"<div><h3>Background</h3><p>Internet-based cognitive behavioural therapy (iCBT) for depression is effective when guided by a clinician, less so if unguided. Question: Would guidance from a technician be as effective as guidance from a clinician?</p><h3>Method</h3><p>Randomized controlled non-inferiority trial comparing three groups: Clinician-assisted vs. technician-assisted vs. delayed treatment. Community-based volunteers applied to the VirtualClinic (<a href=\"http://www.virtualclinic.org.au\">www.virtualclinic.org.au</a>) research program, and 141 participants with major depressive disorder were randomized. Participants in the clinician- and technician-assisted groups received access to an iCBT program for depression comprising 6 online lessons, weekly homework assignments, and weekly supportive contact over a treatment period of 8 weeks. Participants in the clinician-assisted group also received access to a moderated online discussion forum. The main outcome measures were the Beck Depression Inventory (BDI-II) and the Patient Health Questionnaire-9 Item (PHQ-9). Completion rates were high, and at post-treatment, both treatment groups reduced scores on the BDI-II (p<0.001) and PHQ-9 (p<0.001) compared to the delayed treatment group but did not differ from each other. Within group effect sizes on the BDI-II were 1.27 and 1.20 for the clinician- and technician-assisted groups respectively, and on the PHQ-9, were 1.54 and 1.60 respectively. At 4-month follow-up participants in the technician group had made further improvements and had significantly lower scores on the PHQ-9 than those in the clinician group. A total of approximately 60 minutes of clinician or technician time was required per participant during the 8-week treatment program.</p><h3>Conclusions</h3><p>Both clinician- and technician-assisted treatment resulted in large effect sizes and clinically significant improvements comparable to those associated with face-to-face treatment, while a delayed treatment control group did not improve. These results provide support for large scale trials to determine the clinical effectiveness and acceptability of technician-assisted iCBT programs for depression. This form of treatment has potential to increase the capacity of existing mental health services.</p><h3>Trial Registration</h3><p>Australian New Zealand Clinical Trials Registry <a href=\"http://www.anzctr.org.au/trial_view.aspx?ID=308167\">ACTRN12609000559213</a></p></div>", "links"=>[], "tags"=>["internet", "randomized", "controlled", "comparing", "clinician"], "article_id"=>143212, "categories"=>["Mental Health"], "users"=>["Nickolai Titov", "Gavin Andrews", "Matthew Davies", "Karen McIntyre", "Emma Robinson", "Karen Solley"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0010939.s001", "https://dx.doi.org/10.1371/journal.pone.0010939.s002"], "stats"=>{"downloads"=>10, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Internet_Treatment_for_Depression_A_Randomized_Controlled_Trial_Comparing_Clinician_vs_Technician_Assistance/143212", "title"=>"Internet Treatment for Depression: A Randomized Controlled Trial Comparing Clinician vs. Technician Assistance", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2010-06-08 00:53:32"}
  • {"files"=>["https://ndownloader.figshare.com/files/846180"], "description"=>"<p>Pre: Pre treatment, Post: Post-treatment; Follow-up: 4 month follow-up; PHQ-9: Patient Health Questionnaire 9-Item; BDI-II: Beck Depression Inventory Second Edition; K-10: Kessler 10-Item; SDS: Sheehan Disability Scale; TA: Technician assisted; CA: Clinician assisted. CI: Confidence Interval.</p><p>Note. *All effect sizes are absolute values.</p>", "links"=>[], "tags"=>["intervals", "sizes", "carried"], "article_id"=>516637, "categories"=>["Mental Health"], "users"=>["Nickolai Titov", "Gavin Andrews", "Matthew Davies", "Karen McIntyre", "Emma Robinson", "Karen Solley"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0010939.t002", "stats"=>{"downloads"=>1, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Results_of_outcome_measures_Means_standard_deviations_confidence_intervals_and_effect_sizes_Cohen_s_d_for_each_group_intention_to_treat_last_observation_carried_forward_/516637", "title"=>"Results of outcome measures: Means, standard deviations, confidence intervals and effect sizes (Cohen's <i>d</i>) for each group (intention to treat; last observation carried forward).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2010-06-08 01:50:37"}

PMC Usage Stats | Further Information

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Relative Metric

{"start_date"=>"2010-01-01T00:00:00Z", "end_date"=>"2010-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Medicine and health sciences/Mental health and psychiatry", "average_usage"=>[356, 698, 901, 1075, 1182, 1304, 1399, 1533, 1622, 1703, 1803, 1874, 1955, 2039, 2117, 2204, 2291, 2370, 2434, 2491, 2567, 2650, 2722, 2794, 2881, 2937, 2996, 3066, 3143, 3207, 3273, 3328, 3399, 3488, 3580, 3664, 3747, 3831, 3890, 3962, 4019, 4092, 4206, 4323, 4387, 4473, 4532, 4587, 4643]}, {"subject_area"=>"/People and places/Population groupings", "average_usage"=>[304, 560, 714, 827, 946, 1046, 1150, 1244, 1322, 1408, 1484, 1558, 1621, 1693, 1757, 1815, 1874, 1948, 2005, 2085, 2139, 2219, 2279, 2346, 2401, 2469, 2533, 2588, 2680, 2736, 2797, 2901, 2956, 2990, 3068, 3166, 3223, 3286, 3345, 3419, 3469, 3533, 3583, 3648, 3694, 3765, 3818, 3884]}]}
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