Currently accepted at: JMIR mHealth and uHealth
Date Submitted: May 2, 2018
Open Peer Review Period: May 7, 2018 - Jun 7, 2018
Date Accepted: Oct 26, 2018
(closed for review but you can still tweet)
Effectiveness of a Multimodal Digital Psychotherapy Platform for Adult Depression: A Naturalistic Feasibility Study
Although psychotherapy is one of the most efficacious treatments for depression, limited accessibility to trained providers significantly limits access to care. Many digital platforms seeking to provide these services using digital modalities (e.g. video, text, chat) have been developed in an attempt to overcome this obstacle. However, use of these modalities individually poses barriers to intervention access and acceptability. Multi-modal platforms, comprising those that allow users to select from a number of available modalities, may provide a solution to these concerns.
We investigated the efficacy and feasibility of a multi-modal digital psychotherapy platform, also examining differential responses to intervention by gender, physical status, and health status, plus the ways in which prior exposure to traditional face-to-face psychotherapy affected response to multi-modal digital psychotherapy. Finally, we examined the dose-effect relations.
Data was collected from a total of 318 active users of BetterHelp, a multi-modal digital psychotherapy platform. Information on physical status, health status, and prior exposure to psychotherapy was obtained using self-report measures. Symptom change was measured using the PHQ-9 at Time 1 (time of enrollment) and Time 2 (3 months after enrollment). Intervention dosage was measured as the sum of individual therapist-user interactions across modalities.
Depression symptom severity significantly reduced after use of the multi-modal digital psychotherapy intervention (P < .001). Individuals without prior traditional psychotherapy experience revealed increased improvement after intervention (P = .006). We found no significant dose-response of therapy, nor significant differences in outcomes across gender, financial status, or physical health status.
Users of BetterHelp experienced significantly reduced depression symptom severity after engaging with the platform. Findings suggest that this intervention is equally effective across gender, financial status, and physical health status, and particularly effective for individuals without a history of psychotherapy. Taken together results of the study suggest that multi-modal digital psychotherapy is a potentially efficacious treatment for adult depression; experimental trials are needed. Implications for treatment delivery are discussed.
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