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Internet-based treatment of depression: a randomized controlled trial comparing guided with unguided self-help
University of Bern, Switzerland.
University of Bern, Switzerland.
University of Bern, Switzerland.
Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.ORCID iD: 0000-0003-4753-6745
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2011 (English)In: Cognitive behaviour therapy, ISSN 1651-2316, Vol. 40, no 4, 251-266 p.Article in journal (Refereed) Published
Abstract [en]

Internet-delivered self-help for depression with therapist guidance has shown efficacy in several trials. Results from meta-analyses suggest that guidance is important and that self-help programs without support are less effective. However, there are no direct experimental comparisons between guided and unguided internet-based treatments for depression. The present study compared the benefits of a 10-week web-based unguided self-help treatment with the same intervention complemented with weekly therapist support via e-mail. A waiting-list control group was also included. Seventy-six individuals meeting the diagnostic criteria of major depression or dysthymia were randomly assigned to one of the three conditions. The Beck Depression Inventory (BDI-II) was used as the primary outcome measure. Secondary outcomes included general psychopathology, interpersonal problems, and quality of life. Sixty-nine participants (91%) completed the assessment at posttreatment and 59 (78%) at 6-month follow-up. Results showed significant symptom reductions in both treatment groups compared to the waiting-list control group. At posttreatment, between-group effect sizes on the BDI-II were d = .66 for unguided self-help versus waiting-list and d = 1.14 for guided self-help versus waiting-list controls. In the comparison of the two active treatments, small-to-moderate, but not statistically significant effects in favor of the guided condition were found on all measured dimensions. In both groups, treatment gains were maintained at 6-month follow-up. The findings provide evidence that internet-delivered treatments for depression can be effective whether support is added or not. However, all participants were interviewed in a structured diagnostic telephone interview before inclusion, which prohibits conclusions regarding unguided treatments that are without any human contact.

Place, publisher, year, edition, pages
Routledge, 2011. Vol. 40, no 4, 251-266 p.
National Category
Social Sciences
URN: urn:nbn:se:liu:diva-75498DOI: 10.1080/16506073.2011.616531PubMedID: 22060248OAI: diva2:507468
Available from: 2012-03-05 Created: 2012-03-05 Last updated: 2014-11-28

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Andersson, Gerhard
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ReferencesLink to record
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