When someone meets the threshold for clinical depression, it means that they meet several criteria necessary for a diagnosis. However, many people experience subthreshold symptoms. Although they do not meet the necessary requirements for a clinical diagnosis, their symptoms still impact their quality of life. Despite the fact that a wide range of treatments for depression are readily available, many people with symptoms of depression still do not get help. But the introduction of Internet-based interventions is changing that. There have been a number of studies that have examined how well Internet cognitive behavioral therapies (iCBT) reduce symptoms of depression. But the majority of these studies have been conducted in clinical settings and not in general practice. Because an increasing number of individuals are being treated for depression through their primary care doctors, Alishia D. Williams of the School of Psychiatry at the University of New South Wales in Australia wanted to test how well iCBT worked in practical settings.
Williams conducted a study involving 359 participants who had been referred to the Sadness Program by their primary care doctors. The Sadness Program is a six-module iCBT program delivered over a 10-week period that focuses on education, assertiveness, behavior modification, cognitive transformation, and relapse reduction. The participants consisted of clients with severe/suicidal depression, clinical depression, and nonclinical, subthreshold depression. Williams found that the majority of the participants who completed all of the modules saw significant reductions in symptoms and were categorized as being in remission.
The positive results of the Sadness Program were many, but perhaps most impressive was the way in which this iCBT helped the most extreme and most moderate cases. Those with suicidal thoughts and severe symptoms are usually excluded from iCBT programs. But because this study wanted to capture how internet interventions work in real practice, they were included in this examination and many saw decreases in symptoms. Williams added, “It is interesting to note that nearly 27% of patients prescribed the Sadness Program did not meet threshold criteria for a probable diagnosis of depression.” She believes that these individuals, either in remission or at risk for progression to clinical depression, can prevent symptom exacerbation by having access to this type of treatment. Overall, Williams’ study shows that iCBT can be extremely beneficial to people with varying levels of depression.
Williams, A.D., Andrews, G. (2013). The effectiveness of Internet cognitive behavioral therapy (iCBT) for depression in primary care: A Quality Assurance Study. PLoS ONE 8(2): e57447. doi:10.1371/journal.pone.0057447
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