Evaluation of an online cognitive behavioural therapy program by patients with traumatic brain injury and depression

Abstract

Primary objective: The most frequently reported psychiatric symptom after traumatic brain injury (TBI) is depression. This study examined whether internet-delivered cognitive behaviour therapy (CBT) could be appropriate and effective for patients with mild or moderate TBI and depression.

Methods and procedures: Patients were recruited for an at-home, 6-week internet-based CBT program (MoodGYM). Participants were assessed during this period by weekly telephone calls and at 12 months post-enrolment. Intervention completion rates, predictors of adherence, user feedback and changes in scores on validated depression scales were assessed.

Main outcomes and results: Twenty-one patients were recruited: 64% and 43% completed the 6-week intervention and the 12-month follow-up, respectively. Adherence rates were not predicted by demographic or injury characteristics in this small sample. Patients identified reading, memory and comprehension requirements as limitations of the program. Scores on the depression scales were significantly decreased upon completion of the intervention and at the 12-month follow-up.

Conclusions: The MoodGYM program may be effective for treating symptoms of depression in patients with TBI. While adherence rates were not predicted by age, education level or injury severity, demands upon memory and concentration which may already be compromised in these patients need to be considered.

• Cognitive behaviour therapy
• depression
• Internet
• outcomes
• traumatic brain injury

Acknowledgements

We thank Helen Christensen and Kathy Griffiths for allowing use of the MoodGYM website and supporting collaboration on this study. We also wish to acknowledge research assistants Sarah Johnston, Mary Ann Pollmann-Mudryj, Tatiana Santini, Amanda White McFarlan and Michelle Williams for their assistance with patient recruitment and data collection, Valerie Gilmore and Martine Andrews for input into the study design and data conduct, Wei Xiong for assistance with data analysis and The Ontario Neurotrauma Foundation for financially supporting this project.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.