Chat- and internet-based cognitive-behavioural therapy in treatment of adolescent depression: randomised controlled trial

BJPsych Open. 2018 Jun 26;4(4):199-207. doi: 10.1192/bjo.2018.18. eCollection 2018 Jul.

Abstract

Background: Depression is a major contributor to the burden of disease in the adolescent population. Internet-based interventions can increase access to treatment.

Aims: To evaluate the efficacy of internet-based cognitive-behavioural therapy (iCBT), including therapist chat communication, in treatment of adolescent depression.

Method: Seventy adolescents, 15-19 years of age and presenting with depressive symptoms, were randomised to iCBT or attention control. The primary outcome was the Beck Depression Inventory II (BDI-II).

Results: Significant reductions in depressive symptoms were found, favouring iCBT over the control condition (F(1,67) = 6.18, P < 0.05). The between-group effect size was Cohen's d = 0.71 (95% CI 0.22-1.19). A significantly higher proportion of iCBT participants (42.4%) than controls (13.5%) showed a 50% decrease in BDI-II score post-treatment (P < 0.01). The improvement for the iCBT group was maintained at 6 months.

Conclusions: The intervention appears to effectively reduce symptoms of depression in adolescents and may be helpful in overcoming barriers to care among young people.

Declaration of interest: N.T. and G.A. designed the programme. N.T. authored the treatment material. The web platform used for treatment is owned by Linköping University and run on a non-for-profit basis. None of the authors receives any income from the programme.

Keywords: Cognitive–behavioural therapy; adolescent; blended treatment; depression; digital; iCBT; internet-based treatment; internet-supported; stigma; treatment gap.