title: Electronic problem-solving treatment: description and pilot study of an interactive media treatment for depression.
abstract: BACKGROUND
  Computer-automated depression interventions rely heavily on users reading text to receive the intervention. However, text-delivered interventions place a burden on persons with depression and convey only verbal content.
  
  
  OBJECTIVE
  The primary aim of this project was to develop a computer-automated treatment for depression that is delivered via interactive media technology. By using branching video and audio, the program simulates the experience of being in therapy with a master clinician who provides six sessions of problem-solving therapy. A secondary objective was to conduct a pilot study of the program's usability, acceptability, and credibility, and to obtain an initial estimate of its efficacy.
  
  
  METHODS
  The program was produced in a professional multimedia production facility and incorporates video, audio, graphics, animation, and text. Failure analyses of patient data are conducted across sessions and across problems to identify ways to help the user improve his or her problem solving. A pilot study was conducted with persons who had minor depression. An experimental group (n = 7) used the program while a waitlist control group (n = 7) was provided with no treatment for 6 weeks.
  
  
  RESULTS
  All of the experimental group participants completed the trial, whereas 1 from the control was lost to follow-up. Experimental group participants rated the program high on usability, acceptability, and credibility. The study was not powered to detect clinical improvement, although these pilot data are encouraging.
  
  
  CONCLUSIONS
  Although the study was not powered to detect treatment effects, participants did find the program highly usable, acceptable, and credible. This suggests that the highly interactive and immersive nature of the program is beneficial. Further clinical trials are warranted.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT00906581; http://clinicaltrials.gov/ct2/show/NCT00906581 (Archived by WebCite at http://www.webcitation.org/6A5Ni5HUp).
authors.affiliation: Program on Behavioral Informatics and eHealth, Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, United States. jcartreine@partners.org.
authors.forename: James Albert
authors.initials: JA
authors.lastname: Cartreine
authors.forename: Steven E
authors.initials: SE
authors.lastname: Locke
authors.forename: Jay C
authors.initials: JC
authors.lastname: Buckey
authors.forename: Luis
authors.initials: L
authors.lastname: Sandoval
authors.forename: Mark T
authors.initials: MT
authors.lastname: Hegel
keywords: Depression; Internet intervention; cognitive behavioral therapy; computer-based therapy; interactive media; problem-solving therapy; problem-solving treatment