Brief internet-based cognitive behavior therapy program with a supplement drink improved anxiety and somatic symptoms in Japanese workers

Abstract

Background: Self-help cognitive behavior therapy (CBT) is a useful approach for the treatment of psychological problems. Recent research on the effectiveness of self-help internet-based CBT (ICBT) indicates that the paradigm moderately improves psychological problems. Furthermore, previous studies have shown that food and drinks containing supplements improve various health conditions. We investigated the effect of a brief self-help ICBT administered with a supplement drink on psychological well-being and somatic symptoms.

Methods: In total, 101 healthy workers were enrolled in the 4-week ICBT program, which consisted of psychoeducation on stress management, behavior activation, and cognitive restructuring. The supplement soft drink was taken every day during the program. The participants were instructed to watch on-demand video clips and read the self-help guidebook and supporting comic strip weekly on the Internet or smartphone. The Japanese version of the Profile of Mood States (POMS) was administered before and after completion of the program. Scores on the POMS tension-anxiety (POMS-TA), depression (POMS-D), and fatigue (POMS-F) subscales were used to assess the effect of the program. Somatic symptoms were assessed using the Brief Job Stress Questionnaire.

Results: In total, 75 participants continued the program for 4 weeks; however, of those, 27 failed to complete all weekly tasks or meet the post-assessment deadlines. Therefore, the data of 48 participants were included in the analysis. Pre-post intervention comparisons using paired t-tests revealed significant improvement on the POMS-TA, but not the POMS-D or POMS-F subscales. Moreover, participants reported a significant reduction in the severity of low back pain.

Conclusion: Our brief intervention moderately improved anxiety levels and the symptom of low back pain. These findings suggest that the brief ICBT program is effective in non-patient populations. Future directions for brief ICBT are discussed.

Trial registration: This study was registered on February 10, 2016 at UMIN. The registration number is UMIN000020962.

Keywords: Cognitive behavior therapy; Internet; L-carnosine; Self-help; Workplace.

Fig. 1

Participant flow chart. The flow chart shows the progression of participants throughout the study. First, 113 people accessed the registration web page to participate. Before the start of the program, an informed consent session was held in a web forum where the study purpose and procedure were explained. One-hundred and six participants provided web-based informed consent to participate in the study. However, five participants were disqualified because they failed to watch the preparatory psychoeducation video. In total, 75 participants completed the 4-week program, and of those, 48 completed all of the weekly tasks. The data of the 48 completers were included in the analysis. We conducted a supplementary analysis to examine differences between participants who did and did not complete all of the tasks

Fig. 2

Comparison of the Profile of Mood States-tension-anxiety (POMS-TA) scores of participants who did and did not complete the tasks. We found a significant tendency toward an interaction between group and time of assessment for the POMS TA subscale (F(1, 73) = 2.94, p = .091). The Bonferroni post hoc test revealed that the POMS-TA scores improved significantly for the participants who completed the tasks (p < .05)