title: Evaluation of an online cognitive behavioural therapy program by patients with traumatic brain injury and depression.
abstract: OBJECTIVE
  The most frequently reported psychiatric symptom after traumatic brain injury (TBI) is depression. This study examined whether internet-delivered cognitive behaviour therapy (CBT) could be appropriate and effective for patients with mild or moderate TBI and depression.
  
  
  METHODS
  Patients were recruited for an at-home, 6-week internet-based CBT program (MoodGYM). Participants were assessed during this period by weekly telephone calls and at 12 months post-enrolment. Intervention completion rates, predictors of adherence, user feedback and changes in scores on validated depression scales were assessed.
  
  
  RESULTS
  Twenty-one patients were recruited: 64% and 43% completed the 6-week intervention and the 12-month follow-up, respectively. Adherence rates were not predicted by demographic or injury characteristics in this small sample. Patients identified reading, memory and comprehension requirements as limitations of the program. Scores on the depression scales were significantly decreased upon completion of the intervention and at the 12-month follow-up.
  
  
  CONCLUSIONS
  The MoodGYM program may be effective for treating symptoms of depression in patients with TBI. While adherence rates were not predicted by age, education level or injury severity, demands upon memory and concentration which may already be compromised in these patients need to be considered.
authors.affiliation: Trauma and Neurosurgery Program, St. Michael's Hospital, Toronto, ON, Canada. topolovec-vranicj@smh.ca
authors.forename: Jane
authors.initials: J
authors.lastname: Topolovec-Vranic
authors.forename: Nora
authors.initials: N
authors.lastname: Cullen
authors.forename: Alicja
authors.initials: A
authors.lastname: Michalak
authors.forename: Donna
authors.initials: D
authors.lastname: Ouchterlony
authors.forename: Shree
authors.initials: S
authors.lastname: Bhalerao
authors.forename: Cheryl
authors.initials: C
authors.lastname: Masanic
authors.forename: Michael D
authors.initials: MD
authors.lastname: Cusimano
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000523:psychology* / Q000534:rehabilitation; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003866:Depressive Disorder / Q000503:physiopathology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D015397:Program Evaluation; D011795:Surveys and Questionnaires; D013813:Therapy, Computer-Assisted / Q000379:methods*