Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Feb 14, 2020
Date Accepted: Apr 8, 2020
Effectiveness of a transdiagnostic guided Internet-delivered protocol for emotional disorders versus treatment as usual in specialized care: A randomized controlled trial
ABSTRACT
Background:
Anxiety disorders and depression (emotional disorders) are highly prevalent mental disorders. There is extensive empirical evidence supporting the efficacy of cognitive-behavioral therapy (CBT) for the treatment of these disorders. However, there are still some barriers related to their dissemination and implementation that make it difficult for patients to receive these treatments, especially in public health care settings where resources are limited. Recent advances in improving CBT dissemination encompass different perspectives. One is the transdiagnostic approach, which offers treatment protocols that can be used for a range of emotional disorders. Another approach is the use of the Internet to reach a larger number of people who could benefit from CBT.
Objective:
To analyze the effectiveness and acceptability of a transdiagnostic Internet-delivered protocol (EmotionRegulation) with human and automated guidance in patients from public specialized mental health care settings.
Methods:
A two-armed randomized controlled trial (RCT) was conducted to compare the effectiveness of EmotionRegulation to treatment as usual (TAU) in public specialized mental health care. In all, 214 participants were randomly assigned to receive either EmotionRegulation (n= 106) or TAU (n= 108). Measurement assessments were conducted at pre- and post-intervention and 3-month follow-up.
Results:
The results revealed the superiority of EmotionRegulation versus TAU on measures of depression (d = 0.41), anxiety (d = 0.35), and health-related quality of life (d = -0.45) at post-treatment, and these gains were maintained at 3-month follow-up. Furthermore, results for expectations and opinions showed that EmotionRegulation was well-accepted by participants.
Conclusions:
EmotionRegulation was more effective than TAU for the treatment of emotional disorders in the Spanish public mental health system. Implications of this RCT, limitations, and suggestions for future research are discussed. Clinical Trial: ClinicalTrials.gov NCT02345668, 27 July 2015; https://clinicaltrials.gov/ct2/show/NCT02345668
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