Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Sep 26, 2022
Date Accepted: May 3, 2023
The evaluation of the GET.ON nationwide online-only treatment service for depression and stress-related symptoms – A naturalistic trial
ABSTRACT
Background:
GET.ON (HelloBetter) treatment interventions have been shown to be efficacious in multiple randomized controlled trials.
Objective:
This study evaluates the effectiveness of a national digital mental health service based on two GET.ON interventions, implemented nationwide in Germany.
Methods:
Following an initial web-based questionnaire, participants were allocated either to GET.ON Mood Enhancer or GET.ON Stress. Participants received either a semi-standardized guided, feedback-on-demand guided or self-guided version of the treatment, depending on baseline symptom severity and personal choice.
Results:
Uncontrolled routine-care data of 851 participants were analyzed within a pre-post design. Half of the participants were allocated to the stress intervention (41% semi-standardized, 52% feedback-on-demand and 7% self-guided version) and almost all participants in the mood intervention received semi-standardized guidance. Results on depression-related symptom severity indicate the reduction of reported symptoms with a large effect size of d = -0.92 (95%-CI = -1.21 - -0.63). 51.9% of the participants displayed a treatment response, i.e. reliable change on the PHQ-8. A similar symptom reduction was observed on perceived stress and insomnia severity. Symptom deterioration was observed in 3.8% of participants. Furthermore, 47.6% of the participants completed all modules of the intervention provided. Guidance significantly moderated both, effectiveness, and adherence of the interventions in reducing depressive symptom severity. Participant satisfaction was high across all patient groups and both interventions, 89% of participants would recommend it to a friend in need of similar help.
Conclusions:
Results suggest that the tailored digital mental health service for depression and stress-related symptoms are effective in German routine mental health care. The present study also indicates the importance of guidance when iCBT interventions are delivered in routine care. This study provides further evidence for the potential of iCBT delivered as online-only solutions for increasing access to and utilization of psychological treatments. Clinical Trial: This is a report on routinely collected data.
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