Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Nov 2;11(11):e046958.
doi: 10.1136/bmjopen-2020-046958.

Protocol for a sequential, multiple assignment, randomised trial to test the effectiveness of message-based psychotherapy for depression compared with telepsychotherapy

Patricia Arean  1 , Derrick Hull  2 , Michael D Pullmann  3 , Patrick J Heagerty  4
Affiliations

Protocol for a sequential, multiple assignment, randomised trial to test the effectiveness of message-based psychotherapy for depression compared with telepsychotherapy

Patricia Arean et al. BMJ Open. .

Abstract

Introduction: Digital mental health tools have become popular alternatives to traditional psychotherapy. One emerging form of digital mental health is message-based care, the use of text messages or asynchronous voice or video messaging to provide psychotherapy. There has been no research into whether this is an effective method of psychotherapy as a stand-alone treatment or in combination with traditional psychotherapy.

Methods and analysis: This is a sequential, multiple assignment randomised trial to compare message-based care, videoconference-psychotherapy and a combination of the two treatments in 1000 depressed adults. Participants will be recruited through Talkspace, a digital mental health company, and randomised to receive 6 weeks of either message-based care only or videoconference-psychotherapy only. At 6 weeks, participants will be evaluated for their response to treatment. Those with a 50% or more response to treatment will continue with their assigned condition. Those who do not respond will be randomised to either monthly videoconference-psychotherapy or weekly videoconference-psychotherapy plus message-based care. Primary outcomes will be depression and social functioning. We will also explore moderators of treatment outcome.

Ethics and dissemination: The study received ethics approval from the University of Washington Institutional Review Board. Results of this study will be presented in peer-reviewed journals and at professional conferences.

Trial registration number: NCT04513080; Pre-results.

Keywords: adult psychiatry; depression & mood disorders; public health.

PubMed Disclaimer

Conflict of interest statement

Competing interests: DH is a contracted employee at Talkspace and Noom.

Figures

Figure 1
Figure 1
Sequential randomisation approach. MBP, message-based psychotherapy; VCP, videoconferencing-based psychotherapy.
Figure 2
Figure 2
Schedule of enrolment, interventions and assessments. ECHO, Experience of Care and Health Outcomes Survey; MDE, Major Depressive Episode; WAISR, Working Alliance Inventory, Short Form.
See this image and copyright information in PMC

References

    1. Auerbach RP, Alonso J, Axinn WG, et al. . Mental disorders among college students in the world Health organization world mental health surveys. Psychol Med 2016;46:2955–70. 10.1017/S0033291716001665 - DOI - PMC - PubMed
    1. Collins PY, Saxena S. Action on mental health needs global cooperation. Nature 2016;532:25–7. 10.1038/532025a - DOI - PubMed
    1. Kuhl EA. Quantifying the cost of depression: American psychiatric association, 2020. Available: http://workplacementalhealth.org/Mental-Health-Topics/Depression/Quantif... [Accessed 11 Sep 2020].
    1. Epping J, Muschik D, Geyer S. Social inequalities in the utilization of outpatient psychotherapy: analyses of registry data from German statutory health insurance. Int J Equity Health 2017;16:147. 10.1186/s12939-017-0644-5 - DOI - PMC - PubMed
    1. Grubbs KM, Fortney JC, Kimbrell T, et al. . Usual care for rural veterans with posttraumatic stress disorder. J Rural Health 2017;33:290–6. 10.1111/jrh.12230 - DOI - PubMed

Publication types

Associated data