Feasibility study of an interactive multimedia electronic problem solving treatment program for depression: a preliminary uncontrolled trial

Abstract

Computer-based depression interventions lacking live therapist support have difficulty engaging users. This study evaluated the usability, acceptability, credibility, therapeutic alliance and efficacy of a stand-alone multimedia, interactive, computer-based Problem Solving Treatment program (ePST™) for depression. The program simulated live treatment from an expert PST therapist, and delivered 6 ePST™ sessions over 9weeks. Twenty-nine participants with moderate-severe symptoms received the intervention; 23 completed a minimally adequate dose of ePST™ (at least 4 sessions). Program usability, acceptability, credibility, and therapeutic alliance were assessed at treatment midpoint and endpoint. Depressive symptoms and health-related functioning were assessed at baseline, treatment midpoint (4weeks), and study endpoint (10weeks). Depression outcomes and therapeutic alliance ratings were also compared to previously published research on live PST and computer-based depression therapy. Participants rated the program as highly usable, acceptable, and credible, and reported a therapeutic alliance with the program comparable to that observed in live therapy. Depressive symptoms improved significantly over time. These findings also provide preliminary evidence that ePST™ may be effective as a depression treatment. Larger clinical trials with diverse samples are indicated.

Keywords: Electronic Problem Solving Treatment; computer-based therapy; depression treatment; therapeutic alliance.

Copyright © 2014. Published by Elsevier Ltd.

Figures

FIGURE 1

ePST™ Participant Flow Through the Study.

FIGURE 2

A: HSCL as a Function of Treatment. B: MARDS as a Fuction of Treatment.

FIGURE 3

PHQ-9 Scores over Time.