title: Effectiveness of a web-based solution-focused brief chat treatment for depressed adolescents and young adults: randomized controlled trial.
abstract: BACKGROUND
  Up to 9% of young people suffer from depression. Unfortunately, many in need of help remain untreated. The Internet offers anonymous ways to help depressed youth, especially those who are reluctant to search for help because of fear of stigma.
  
  
  OBJECTIVE
  Our goal was to evaluate the effectiveness of an individual chat treatment based on Solution-Focused Brief Therapy (SFBT) to young individuals aged 12-22 years with depressive symptoms by comparing it to a waiting list control group.
  
  
  METHODS
  For this study, 263 young people with depressive symptoms were randomized to the Web-based SFBT intervention, PratenOnline, or to a waiting list control condition. The chat treatment was delivered by trained professionals. Groups were compared on depressive complaints as measured by the Center for Epidemiologic Studies Depression Scale (CES-D) after 9 weeks and 4.5 months. For the chat group only, changes in depressive symptoms at 7.5 months after baseline were explored.
  
  
  RESULTS
  The experimental SFBT condition (n=131) showed significantly greater improvement than the waiting list condition (n=132) in depressive symptoms at 9 weeks and 4.5 months on the CES-D, with a small between group effect size at 9 weeks (d=0.18, 95% CI -0.10 to 0.47) and a large effect size at 4.5 months (d=0.79, 95% CI 0.45-1.08). The percentage of participants showing a reliable and clinically significant change in depression was significantly larger for the SFBT intervention at 4.5 months only (28.2% vs 11.4% for the waiting list, P<.001, number needed to treat=6). At 7.5 months, the SFBT group showed further improvements. However, results have to be considered carefully because of high attrition rates.
  
  
  CONCLUSIONS
  The Web-based SFBT chat intervention of PratenOnline was more effective than a waiting list control group in reducing depressive symptoms, and effects were larger at follow-up then at post-treatment. More studies are needed to find out if outcomes will be replicated, especially for those younger than 18 year old.
  
  
  BACKGROUND
  Netherlands Trial Register: NTR 1696; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1696 (Archived by WebCite at http://www.webcitation.org/6DspeYWrJ).
authors.affiliation: Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, Netherlands. jkramer@trimbos.nl.
authors.forename: Jeannet
authors.initials: J
authors.lastname: Kramer
authors.forename: Barbara
authors.initials: B
authors.lastname: Conijn
authors.forename: Pien
authors.initials: P
authors.lastname: Oijevaar
authors.forename: Heleen
authors.initials: H
authors.lastname: Riper
mesh_terms: D000293:Adolescent; D003863:Depression / Q000628:therapy*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D011614:Psychotherapy, Brief / Q000379:methods*; D017216:Telemedicine; D014850:Waiting Lists; D055815:Young Adult
keywords: Internet; Solution Focused Brief Therapy; depression; randomized controlled trial; young adults