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. 2012 Sep 25;1(2):e11.
doi: 10.2196/resprot.1925.

Electronic problem-solving treatment: description and pilot study of an interactive media treatment for depression

James Albert Cartreine  1 , Steven E Locke, Jay C Buckey, Luis Sandoval, Mark T Hegel
Affiliations

Electronic problem-solving treatment: description and pilot study of an interactive media treatment for depression

James Albert Cartreine et al. JMIR Res Protoc. .

Abstract

Background: Computer-automated depression interventions rely heavily on users reading text to receive the intervention. However, text-delivered interventions place a burden on persons with depression and convey only verbal content.

Objective: The primary aim of this project was to develop a computer-automated treatment for depression that is delivered via interactive media technology. By using branching video and audio, the program simulates the experience of being in therapy with a master clinician who provides six sessions of problem-solving therapy. A secondary objective was to conduct a pilot study of the program's usability, acceptability, and credibility, and to obtain an initial estimate of its efficacy.

Methods: The program was produced in a professional multimedia production facility and incorporates video, audio, graphics, animation, and text. Failure analyses of patient data are conducted across sessions and across problems to identify ways to help the user improve his or her problem solving. A pilot study was conducted with persons who had minor depression. An experimental group (n = 7) used the program while a waitlist control group (n = 7) was provided with no treatment for 6 weeks.

Results: All of the experimental group participants completed the trial, whereas 1 from the control was lost to follow-up. Experimental group participants rated the program high on usability, acceptability, and credibility. The study was not powered to detect clinical improvement, although these pilot data are encouraging.

Conclusions: Although the study was not powered to detect treatment effects, participants did find the program highly usable, acceptable, and credible. This suggests that the highly interactive and immersive nature of the program is beneficial. Further clinical trials are warranted.

Trial registration: ClinicalTrials.gov NCT00906581; http://clinicaltrials.gov/ct2/show/NCT00906581 (Archived by WebCite at http://www.webcitation.org/6A5Ni5HUp).

Keywords: Depression; Internet intervention; cognitive behavioral therapy; computer-based therapy; interactive media; problem-solving therapy; problem-solving treatment.

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Conflict of interest statement

Conflicts of Interest: Drs Cartreine, Locke, and Hegel are co-owners of Cognitive Behavioral Technologies LLC, which owns the ePST program. However, this entity was created after the study was completed.

Figures

Figure 1
Figure 1
Virtual therapist discusses the Patient Health Questionnaire-9 (PHQ-9) results with the user. Information is provided both graphically and on video.
Figure 2
Figure 2
Consort diagram.
Figure 3
Figure 3
Change in depression.
See this image and copyright information in PMC

References

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    1. Peck DF. The therapist-client relationship, computerized self-help and active therapy ingredients. Clin Psychol Psychother. 2010;17(2):147–53. doi: 10.1002/cpp.669. - DOI - PubMed
    1. Arean P, Hegel M, Vannoy S, Fan MY, Unuzter J. Effectiveness of problem-solving therapy for older, primary care patients with depression: results from the IMPACT project. Gerontologist. 2008 Jun;48(3):311–23. - PubMed
    1. Mynors-Wallis LM, Gath DH, Lloyd-Thomas AR, Tomlinson D. Randomised controlled trial comparing problem solving treatment with amitriptyline and placebo for major depression in primary care. BMJ. 1995 Feb 18;310(6977):441–5. - PMC - PubMed
    1. Mynors-Wallis LM, Gath DH, Day A, Baker F. Randomised controlled trial of problem solving treatment, antidepressant medication, and combined treatment for major depression in primary care. BMJ. 2000 Jan 1;320(7226):26–30. - PMC - PubMed

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