Chat- and internet-based cognitive-behavioural therapy in treatment of adolescent depression: Randomised controlled trial

BackgroundDepression is a major contributor to the burden of disease in the adolescent population. Internet-based interventions can increase access to treatment.AimsTo evaluate the efficacy of internet-based cognitive–behavioural therapy (iCBT), including therapist chat communication, in treatment of adolescent depression.MethodSeventy adolescents, 15–19 years of age and presenting with depressive symptoms, were randomised to iCBT or attention control. The primary outcome was the Beck Depression Inventory II (BDI-II).ResultsSignificant reductions in depressive symptoms were found, favouring iCBT over the control condition (F(1,67) = 6.18, P < 0.05). The between-group effect size was Cohen's d = 0.71 (95% CI 0.22–1.19). A significantly higher proportion of iCBT participants (42.4%) than controls (13.5%) showed a 50% decrease in BDI-II score post-treatment (P < 0.01). The improvement for the iCBT group was maintained at 6 months.ConclusionsThe intervention appears to effectively reduce symptoms of depression in adolescents and may be helpful in overcoming barriers to care among young people.Declaration of interestN.T. and G.A. designed the programme. N.T. authored the treatment material. The web platform used for treatment is owned by Linköping University and run on a non-for-profit basis. None of the authors receives any income from the programme.

"This study demonstrates that a combination of clinically meaningful effects, target audience acceptability and real-world feasibility can be achieved with iCBT [internet-based cognitive-behavioural therapy] for the treatment of adolescent depression. The findings on outcome further indicate that therapist support plays a part in improving clinical outcome in treatment of young populations. The findings on treatment completion and alliance indicate that therapist contact in the form of chat communication can produce a stable and positive therapeutic relationship, and provide a meaningful treatment for young individuals." (Authors, 206)