Evaluation of an online cognitive behavioural therapy program by patients with traumatic brain injury and depression.
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.
Topolovec-Vranic
Jane
J
Trauma and Neurosurgery Program, St. Michael's Hospital, Toronto, ON, Canada. topolovec-vranicj@smh.ca
Cullen
Nora
N
Michalak
Alicja
A
Ouchterlony
Donna
D
Bhalerao
Shree
S
Masanic
Cheryl
C
Cusimano
Michael D
MD
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*