title: An Internet-based self-help intervention for people with HIV and depressive symptoms: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Many people living with HIV suffer from depressive symptoms. In a previous pilot study, self-help cognitive behavioral therapy (in booklet format) was found to be effective in treating depressive symptoms in people with HIV. We developed an online self-help program in Dutch and English (based on the booklet) for people with HIV and depressive symptoms. Besides the main question regarding the effectiveness of the program aimed at lowering depressive symptoms, sub-questions will focus on the moderators of treatment success (for which patients is the program especially beneficial?) and the mechanisms of change underlying the treatment outcome (which mediators affect the outcome of treatment?). In this paper, the protocol of the study will be described.
  
  
  METHODS
  The effectiveness of the program will be investigated by comparing the intervention group with a waiting list-control group in a randomized controlled design, by including a pretest and three post-tests. The self-help program contains four main components: activation, relaxation, changing maladaptive cognitions, and goal attainment. Participants with mild to moderate depressive symptoms will work on the program for 6 to 10 weeks, during which a coach will provide motivational support by telephone once a week. Participants in the control condition will receive weekly minimal support from a coach for 8 weeks, and after the second post-test, they can gain access to the self-help program. Depressive symptoms and possible mediators (e.g., activation, cognitive coping, self-efficacy, and goal adjustment) will be assessed by self-report three times during the intervention/waiting period and at the pretest and first post-test.
  
  
  CONCLUSIONS
  The proposed study aims to evaluate the effectiveness of an online self-help intervention for people with HIV and depressive symptoms. If the intervention is shown to be effective, the program will be implemented. Consequently, many patients with HIV could be reached, and their psychological care may be improved.
  
  
  BACKGROUND
  Netherlands Trial Register: NTR5407.
authors.affiliation: Institute of Psychology, Section of Clinical Psychology, Leiden University, Faculty of Social and Behavioral Sciences, P.O. Box 9555, 2300, RB, Leiden, The Netherlands. s.van.luenen@fsw.leidenuniv.nl.
authors.forename: Sanne
authors.initials: S
authors.lastname: van Luenen
authors.affiliation: Institute of Psychology, Section of Clinical Psychology, Leiden University, Faculty of Social and Behavioral Sciences, P.O. Box 9555, 2300, RB, Leiden, The Netherlands.
authors.forename: Vivian
authors.initials: V
authors.lastname: Kraaij
authors.affiliation: Institute of Psychology, Section of Clinical Psychology, Leiden University, Faculty of Social and Behavioral Sciences, P.O. Box 9555, 2300, RB, Leiden, The Netherlands.
authors.forename: Philip
authors.initials: P
authors.lastname: Spinhoven
authors.affiliation: Institute of Psychology, Section of Clinical Psychology, Leiden University, Faculty of Social and Behavioral Sciences, P.O. Box 9555, 2300, RB, Leiden, The Netherlands.
authors.forename: Nadia
authors.initials: N
authors.lastname: Garnefski
mesh_terms: D000223:Adaptation, Psychological; D002985:Clinical Protocols; D003071:Cognition; D015928:Cognitive Behavioral Therapy; D003376:Counseling; D003863:Depression / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000523:psychology; D006801:Humans; D020407:Internet; D009042:Motivation; D009426:Netherlands; D011569:Psychiatric Status Rating Scales; D012107:Research Design; D012648:Self Care; D020377:Self Efficacy; D012720:Severity of Illness Index; D013689:Telephone; D013813:Therapy, Computer-Assisted / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Coaching; Cognitive behavioral therapy; Depression; HIV; Internet; Randomized controlled trial; Self-help