title: Feasibility study of an interactive multimedia electronic problem solving treatment program for depression: a preliminary uncontrolled trial.
abstract: Computer-based depression interventions lacking live therapist support have difficulty engaging users. This study evaluated the usability, acceptability, credibility, therapeutic alliance and efficacy of a stand-alone multimedia, interactive, computer-based Problem Solving Treatment program (ePST™) for depression. The program simulated live treatment from an expert PST therapist, and delivered 6 ePST™ sessions over 9weeks. Twenty-nine participants with moderate-severe symptoms received the intervention; 23 completed a minimally adequate dose of ePST™ (at least 4 sessions). Program usability, acceptability, credibility, and therapeutic alliance were assessed at treatment midpoint and endpoint. Depressive symptoms and health-related functioning were assessed at baseline, treatment midpoint (4weeks), and study endpoint (10weeks). Depression outcomes and therapeutic alliance ratings were also compared to previously published research on live PST and computer-based depression therapy. Participants rated the program as highly usable, acceptable, and credible, and reported a therapeutic alliance with the program comparable to that observed in live therapy. Depressive symptoms improved significantly over time. These findings also provide preliminary evidence that ePST™ may be effective as a depression treatment. Larger clinical trials with diverse samples are indicated.
authors.affiliation: Geisel School of Medicine at Dartmouth. Electronic address: Margit.I.Berman@dartmouth.edu.
authors.forename: Margit I
authors.initials: MI
authors.lastname: Berman
authors.affiliation: Geisel School of Medicine at Dartmouth.
authors.forename: Jay C
authors.initials: JC
authors.lastname: Buckey
authors.affiliation: Geisel School of Medicine at Dartmouth.
authors.forename: Jay G
authors.initials: JG
authors.lastname: Hull
authors.affiliation: Geisel School of Medicine at Dartmouth.
authors.forename: Eftihia
authors.initials: E
authors.lastname: Linardatos
authors.affiliation: Geisel School of Medicine at Dartmouth.
authors.forename: Sueyoung L
authors.initials: SL
authors.lastname: Song
authors.affiliation: Geisel School of Medicine at Dartmouth.
authors.forename: Robert K
authors.initials: RK
authors.lastname: McLellan
authors.affiliation: Center for Technology and Behavioral Health; Geisel School of Medicine at Dartmouth.
authors.forename: Mark T
authors.initials: MT
authors.lastname: Hegel
mesh_terms: D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000523:psychology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019212:Multimedia; D010349:Patient Compliance; D011340:Problem Solving / Q000502:physiology*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013813:Therapy, Computer-Assisted / Q000379:methods*
keywords: Electronic Problem Solving Treatment; computer-based therapy; depression treatment; therapeutic alliance