Depression and anxiety are among the most commonly diagnosed mental health conditions in the world. Symptoms can range from mild to severe. Both conditions can be debilitating or chronic for many people. Treatments aimed at reducing symptom severity and improving quality of life vary by method and mode and can be accessed through a variety of avenues.
One of the newest and most accessible methods of treatment is Internet psychotherapy (iPT). This mode of treatment allows clients to gain the benefits of ongoing therapy without having to leave their homes. Additionally, they can participate in treatment when it is convenient for them and as often as they need to. Some iPT programs are delivered under the guidance of a therapist, while others are self-guided. Both methods have been shown to be effective, but unfortunately, the adherence rate is very low.
Strategies to improve adherence have included short text message (SMS) and email reminders. But to date, email reminders have yet to be tested to determine if they have a positive impact on adherence and symptom reduction for self-guided iPT designed to treat both anxiety and depression. To test email reminders in this context, Nickolai Titov of the Centre for Emotional Health at the Department of Psychology of Macquarie University in Australia recently enrolled 257 adults with symptoms of depression and anxiety into an eight-week program of iPT or a wait list control condition. The iPT participants were divided into two groups, one of which received email reminders, the other of which did not.
After eight weeks, Titov assessed the adherence rates and symptom severity of the participants and found that those in the iPT all had decreases in symptoms. However, those who received the email reminders had more significant decreases. This was especially evident in the participants with the most severe symptoms prior to the iPT. Adherence also increased from 35% without reminders to 58% with reminders.
“The overall results indicate that adding automated emails can facilitate adherence and outcomes in self-guided Internet-delivered interventions,” said Titov. In conclusion, the results of this study clearly show that not only is iPT effective, adherence to iPT and other self-guided therapy approaches can be maximized with the implementation of a simple and cost-effective email reminder system.
Titov, N., Dear, B.F., Johnston, L., Lorian, C., Zou, J., et al. (2013). Improving adherence and clinical outcomes in self-guided Internet treatment for anxiety and depression: Randomised controlled trial. PLoS ONE 8(7): e62873. doi:10.1371/journal.pone.0062873
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