A pilot test of Internet-delivered brief interactive training sessions for depression: Evaluating dropout, uptake, adherence, and outcome

Abstract

Objective

Uptake, adherence, and dropout rates for Internet-based programs for depression are in need of improvement. Excessive user burden (eg, heavy content, extended duration) may undermine engagement and precipitate dropout. To address this problem, an alternative format was proposed: Brief Interactive Training Sessions (BITS). BITS target a narrow behavioral health skill and require 3–4 hours to complete. A depression-focused version of BITS that provides training in cognitive distortion/restructuring was tested.

Participants

Fifty-two depressed college students were randomly assigned to BITS or to a wait-list.

Methods

Students competed pre-and post-test (7 week) assessments of depression and cognitive distortions.

Results

Uptake rate was 83%. Among study completers, adherence was 96%. The dropout rate did not improve. Compared to the control group, the experimental group reported a significant reduction in depression and in cognitive distortions.

Conclusions

The BITS format is a promising vehicle for improving uptake and adherence while achieving positive clinical outcomes.

Keywords:

• Counseling
• depression
• Internet treatment
• mental health

Author contributions

Both authors contributed to study conceptualization, design, interpretation of results, and preparation of the manuscript. Dr. Ruehlman conducted the study and analyzed the data.

Compliance with ethical standards

The study is in compliance with the ethical standards of the Institutional and/or National Research Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest disclosure

The authors are the creators of the Think Clearly About Depression Program and the TCD-BITS version. TCD-BITS is not currently commercially available. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of the United States and received approval from the Institutional Review Board of Arizona State University.

Funding

No external funding was provided for the present study.

Informed consent

Informed consent was obtained from all study participants.

Human and animal rights

The study was approved and monitored by the Institutional Review Board (IRB) at the study university. No animals were tested.

Data availability

The data generated and analyzed during the current study are available from the corresponding author on reasonable request.