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Randomized Controlled Trial
. 2014 May 29;16(5):e141.
doi: 10.2196/jmir.3261.

Effectiveness of a web-based solution-focused brief chat treatment for depressed adolescents and young adults: randomized controlled trial

Jeannet Kramer  1 , Barbara Conijn, Pien Oijevaar, Heleen Riper
Affiliations
Randomized Controlled Trial

Effectiveness of a web-based solution-focused brief chat treatment for depressed adolescents and young adults: randomized controlled trial

Jeannet Kramer et al. J Med Internet Res. .

Abstract

Background: Up to 9% of young people suffer from depression. Unfortunately, many in need of help remain untreated. The Internet offers anonymous ways to help depressed youth, especially those who are reluctant to search for help because of fear of stigma.

Objective: Our goal was to evaluate the effectiveness of an individual chat treatment based on Solution-Focused Brief Therapy (SFBT) to young individuals aged 12-22 years with depressive symptoms by comparing it to a waiting list control group.

Methods: For this study, 263 young people with depressive symptoms were randomized to the Web-based SFBT intervention, PratenOnline, or to a waiting list control condition. The chat treatment was delivered by trained professionals. Groups were compared on depressive complaints as measured by the Center for Epidemiologic Studies Depression Scale (CES-D) after 9 weeks and 4.5 months. For the chat group only, changes in depressive symptoms at 7.5 months after baseline were explored.

Results: The experimental SFBT condition (n=131) showed significantly greater improvement than the waiting list condition (n=132) in depressive symptoms at 9 weeks and 4.5 months on the CES-D, with a small between group effect size at 9 weeks (d=0.18, 95% CI -0.10 to 0.47) and a large effect size at 4.5 months (d=0.79, 95% CI 0.45-1.08). The percentage of participants showing a reliable and clinically significant change in depression was significantly larger for the SFBT intervention at 4.5 months only (28.2% vs 11.4% for the waiting list, P<.001, number needed to treat=6). At 7.5 months, the SFBT group showed further improvements. However, results have to be considered carefully because of high attrition rates.

Conclusions: The Web-based SFBT chat intervention of PratenOnline was more effective than a waiting list control group in reducing depressive symptoms, and effects were larger at follow-up then at post-treatment. More studies are needed to find out if outcomes will be replicated, especially for those younger than 18 year old.

Trial registration: Netherlands Trial Register: NTR 1696; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1696 (Archived by WebCite at http://www.webcitation.org/6DspeYWrJ).

Keywords: Internet; Solution Focused Brief Therapy; depression; randomized controlled trial; young adults.

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Conflict of interest statement

Conflicts of Interest: Pien Oijevaar was one of the founders of the chat therapy, PratenOnline, in the Netherlands, but she did not derive financial income from the PratenOnline intervention. All other authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow of participants.
Figure 2
Figure 2
Means on CES-D per measurement for Chat (n=131) and WL (n=132) (EM-imputed data).
Figure 3
Figure 3
Number of chat sessions attended by percentages of participants (n=131).
See this image and copyright information in PMC

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