CClinicalTrials.gg
CompletedNCT03304392Updated Feb 20, 2020

Therapist-guided Internet-delivered Cognitive Behavioural Therapy

An interventional study of Personalized ICBT and Standard ICBT in Anxiety and Depression, sponsored by University of Regina. Completed at 1 site in Canada. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-02-20.

Sponsored by University of Regina · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
449
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Depression and anxiety are prevalent and disabling conditions that often go untreated. Internet-delivered Cognitive Behaviour Therapy (ICBT) is a relatively new approach to treatment that is a convenient way for patients to access care. ICBT is typically highly standardized and involves patients reviewing weekly lessons over the Internet. Patients also receive brief weekly support from a therapist via secure emails or phone calls. Past research shows that \~75% of patients complete ICBT and report large symptom improvements. Although these results are very promising, research also suggests that ICBT could potentially be improved by being more personalized in terms of amount of therapist contact, especially for clients with more severe symptoms. The current trial will involve therapists who work in a clinic that specializes in ICBT. Over one year, 440 patients with depression and/or anxiety will be randomized to either receive standardized (5 lessons completed in 8 weeks; once week therapist contact) or personalized ICBT (5 lessons completed in 8 weeks; personalized therapist contact depending on needs of patient). Psychosocial outcomes of patients in the two treatment arms will be compared post-treatment and at 3-month, 6-month, and 1-year follow-up from enrollment. Data on intervention usage, satisfaction measures, and costs will also be assessed.

02

Conditions studied

  • Anxiety
  • Depression

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Keywords

  • anxiety
  • depression
  • internet-delivered cognitive behaviour therapy
  • randomized controlled trial
  • patient-centered
  • knowledge implementation
  • mental health system
  • therapist-assistance
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • 18 years of age or older
  • residing in Saskatchewan, Canada
  • endorsing symptoms of anxiety or depression
  • able to access a computer and internet service
  • willing to provide a physician as emergency contact

Exclusion criteria

Exclusion Criteria:

  • high suicide risk
  • suicide attempt or hospitalization in the last year
  • primary problems with psychosis, alcohol or drug problems, mania
  • currently receiving active psychological treatment for anxiety or depression
  • not present in province during treatment; concerns about online therapy
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
449 participants (actual)

Study arms

  • Experimental
    Personalized ICBT

    An 8-week transdiagnostic internet-delivered cognitive behavioural therapy (ICBT) will be delivered to participants. All clients will receive support from registered social workers, psychologists or supervised graduate students, with experience delivering ICBT, with contact depending upon group allocation. In addition to the online program, therapists, registered social workers, psychologists or supervised graduate students, with experience delivering ICBT will provide support within one business day of client emails. Amount of contact will be personalized to patients' needs.

    Behavioral: Personalized ICBT

  • Active comparator
    Standard ICBT

    An 8-week transdiagnostic internet-delivered cognitive behavioural therapy (ICBT) will be delivered to participants. All clients will receive support from registered social workers, psychologists or supervised graduate students, with experience delivering ICBT, with contact depending upon group allocation. In addition to the online program, therapists, registered social workers, psychologists or supervised graduate students, with experience delivering ICBT will provide support by email only once a week. Therapist will spend approximately 15 minutes per week/per client.

    Behavioral: Standard ICBT

Interventions

  • BehavioralPersonalized ICBT

    An 8-week transdiagnostic internet-delivered cognitive behavioural therapy (ICBT) will be delivered to participants. All clients will receive support from registered social workers, psychologists or supervised graduate students, with experience delivering ICBT, with contact depending upon group allocation. In addition to the online program, therapists, registered social workers, psychologists or supervised graduate students, with experience delivering ICBT will provide support within one business day of client emails. Amount of contact will be personalized to patients' needs.

  • BehavioralStandard ICBT

    An 8-week transdiagnostic internet-delivered cognitive behavioural therapy (ICBT) will be delivered to participants. All clients will receive support from registered social workers, psychologists or supervised graduate students, with experience delivering ICBT, with contact depending upon group allocation. In addition to the online program, therapists, registered social workers, psychologists or supervised graduate students, with experience delivering ICBT will provide support by email only once a week. Therapist will spend approximately 15 minutes per week/per client.

05

What researchers measure

Primary outcomes

  1. Change in depression

    Measured by Patient Health Questionnaire - 9 Item (PHQ-9)

    Time frame: baseline, start of each Lesson 2-5, 8 weeks, 3 months, 6 months, and 1 year follow up

  2. Change in anxiety

    Measured by Generalize Anxiety Disorder - 7 Item (GAD7)

    Time frame: baseline, start of each Lesson 2-5, 8 weeks, 3 months, 6 months, and 1 year follow up

Secondary outcomes

  1. Change in psychological distress

    Measured by Kessler 10-Item Scale

    Time frame: baseline, 8 weeks, 3 months, 6 months, and 1 year follow up

  2. Change in disability

    Measure by Sheehan Disability Scale-3 Item

    Time frame: baseline, 8 weeks, 3 months, 6 months, and 1 year follow up

  3. Change in panic symptoms

    Measured by Panic Disorder Severity Scale-Self Report

    Time frame: baseline, 8 weeks, 3 months, 6 months, and 1 year follow up

  4. Change in social anxiety symptoms

    Measured by Social Interaction Anxiety Scale

    Time frame: baseline, 8 weeks, 3 months, 6 months, and 1 year follow up

  5. Change in social phobia symptoms

    Measured by Social Phobia Scale-Short form

    Time frame: baseline, 8 weeks, 3 months, 6 months, and 1 year follow up

  6. Change in post-traumatic symptoms

    Measured by PTSD Checklist 5

    Time frame: Administered to only those participants meeting criteria for post-traumatic stress based on the modified brief Life Events Checklist for DSM 5 (LEC-5) at each time point: baseline, 3 months, 6 months, and 1 year follow up

  7. Change in quality of life symptoms

    Measured by EQ-5D-5L

    Time frame: baseline, 8 weeks, 3 months, 6 months, and 1 year follow up

  8. Change in treatment costs

    Measured by Treatment Inventory of Costs in Psychiatric Patients (TIC-P) Adapted for Canada

    Time frame: Part 1 and 2: baseline, 3 months, 6 months, and 1 year follow up; Part 3: baseline and 1 year follow up

  9. Therapeutic alliance

    Measured by Working Alliance Inventory-Short Form

    Time frame: 8 weeks

  10. Treatment credibility

    Measured by Credibility Questionnaire

    Time frame: baseline and 8 weeks

  11. Treatment satisfaction

    Measured by Internet-CBT Treatment Satisfaction Measure

    Time frame: 8 weeks

  12. Engagement

    Measured by: number of lessons completed, number of days of access, number of emails sent to therapist, number of phone calls with therapist, number of emails from therapist to client, total words emailed to therapist, total words emailed from therapist to patient

    Time frame: 8 weeks

06

Study locations

1 site
  • Online Therapy Unit, University of Regina
    Regina, Saskatchewan S4S 0A2, Canada
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03304392
Lead sponsor
University of Regina
Collaborators
Canadian Institutes of Health Research (CIHR)
Responsible party
Sponsor
First posted
Oct 9, 2017
Start date
Oct 11, 2017
Primary completion
Oct 15, 2019
Completion
Oct 15, 2019
Last update
Feb 20, 2020

Study contacts

Heather D Hadjistavropoulos, PhD
principal investigator · University of Regina

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
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