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Improving adherence and clinical outcomes in self-guided internet treatment for anxiety and depression: randomised controlled trial


Titov, N and Dear, BF and Johnston, L and Lorian, C and Zou, J and Wootton, B and Spence, J and McEvoy, PM and Rapee, RM, Improving adherence and clinical outcomes in self-guided internet treatment for anxiety and depression: randomised controlled trial, PLOS ONE, 2013, (July) pp. 11. ISSN 1932-6203 (2013) [Refereed Article]


Copyright Statement

Copyright 2013 Titov et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

DOI: doi:10.1371/journal.pone.0062873


Background: Depression and anxiety are common, disabling and chronic. Self-guided internet-delivered treatments are popular, but few people complete them. New strategies are required to realise their potential.

Aims: To evaluate the effect of automated emails on the effectiveness, safety, and acceptability of a new automated transdiagnostic self-guided internet-delivered treatment, the Wellbeing Course, for people with depression and anxiety.

Method: A randomised controlled trial was conducted through the website: Two hundred and fifty seven people with elevated symptoms were randomly allocated to the 8 week course either with or without automated emails, or to a waitlist control group. Primary outcome measures were the Patient Health Questionnaire 9-Item (PHQ-9) and the Generalized Anxiety Disorder 7-Item (GAD-7).

Results: Participants in the treatment groups had lower PHQ-9 and GAD-7 scores at post-treatment than controls. Automated emails increased rates of course completion (58% vs. 35%), and improved outcomes in a subsample with elevated symptoms.

Conclusions: The new self-guided course was beneficial, and automated emails facilitated outcomes. Further attention to strategies that facilitate adherence, learning, and safety will help realise the potential of self-guided interventions.

Item Details

Item Type:Refereed Article
Keywords:internet, treatment, anxiety, depression
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Mental health services
Objective Division:Health
Objective Group:Provision of health and support services
Objective Field:Mental health services
UTAS Author:Wootton, B (Dr Bethany Wootton)
ID Code:90824
Year Published:2013
Web of Science® Times Cited:151
Deposited By:Psychology
Deposited On:2014-04-25
Last Modified:2014-11-27
Downloads:433 View Download Statistics

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