title: Internet-delivered treatment: its potential as a low-intensity community intervention for adults with symptoms of depression: protocol for a randomized controlled trial.
abstract: BACKGROUND
  Depression is a high prevalence disorder, displaying high rates of lifetime incidence, early age onset, high chronicity, and role impairment. In Ireland 12-month prevalence of depression has been reported to be 10.3%. A large percentage of affected individuals have no medical diagnosis nor seek treatment. Cognitive Behavior Therapy (CBT) has established itself as an option for the treatment of depression. Many Irish adults with depression find it difficult to access evidence-based CBT, this is due to several factors, like stigma and costs. However, systematic factors including the shortage of trained professionals and the relative underdevelopment of services also make access difficult.Stepped-care can increase access to evidence-based CBT. One option is tailored internet-delivered treatment programs. Preliminary research from Ireland needs now to include large-scale studies on effectiveness. Thus the current study seeks to examine the potential of an internet-delivered low-intensity treatment for symptoms of depression in an Irish adult community sample.
  
  
  METHODS
  The study is a randomized controlled trial of an online CBT (iCBT) program for the treatment of adults with depressive symptoms. The trial will include an active treatment group and a waiting-list control group. The active condition will consist of 8 weekly modules of iCBT, with post-session feedback support. Participants in the waiting list will receive access to the treatment at week 8. Participants will complete the Beck Depression Inventory (BDI-II) and eligibility criteria will also apply. Primary outcomes are depressive symptoms. Secondary outcomes include quality of life indicators, significant events and satisfaction with online treatment. Data will be collected at baseline and at post-treatment, week 8, and at follow-up week 20 (3-months) and week 32 (6-months). Analysis will be conducted on the intention-to-treat basis.
  
  
  CONCLUSIONS
  The study seeks to evaluate the effectiveness of an online delivered treatment for depression in a community sample of Irish adults with symptoms of depression. The study will be a first contribution and depending on the sample recruited the results may be generalizable to people with similar difficulties in Ireland and may therefore give insight into the potential of low-intensity interventions for Irish people with depressive symptoms.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN03704676. DOI: 10.1186/ISRCTN03704676.
authors.affiliation: SilverCloud Health Ltd, Dublin, Ireland. derek.richards@silvercloudhealth.com.
authors.forename: Derek
authors.initials: D
authors.lastname: Richards
authors.forename: Ladislav
authors.initials: L
authors.lastname: Timulak
authors.forename: Gavin
authors.initials: G
authors.lastname: Doherty
authors.forename: John
authors.initials: J
authors.lastname: Sharry
authors.forename: Amy
authors.initials: A
authors.lastname: Colla
authors.forename: Ciara
authors.initials: C
authors.lastname: Joyce
authors.forename: Claire
authors.initials: C
authors.lastname: Hayes
mesh_terms: D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003866:Depressive Disorder / Q000628:therapy*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D016896:Treatment Outcome; D014850:Waiting Lists