Getting Help for Depression Online

As promised, this is one in a series of posts I’ll write about online interventions that help treat specific mental health concerns. In this post, I’ll talk about some of the depression programs available online.

The Australian National University’s Centre for Mental Health Research is one of the unsung heroes in the development and research of programs to treat depression online, for both adults and teens. What they have done over the past decade is not exactly rocket science, and yet, surprisingly, most people have never heard of one of their free online programs. They’ve taken cognitive behavioral theories and techniques and translated them into online tutorials and programs. Then they did something a lot of organizations (and virtually all companies) fail to do — they did solid, randomized controlled trials to show their designed interventions work.

Their simplest intervention is an educational website about depression called BluePages. Yes, it offers the usual array of information about depression symptoms and treatments, but they’ve gone a step further and provided an evaluation of what treatments work for depression by evaluating the clinical research. Most interesting is that the BluePages website itself has clinical evidence backing its usefulness.

A more involved intervention offered by the same researchers from the CMHR is the MoodGYM training program. This is a web-based, self-guided program based upon cognitive-behavioral and interpersonal therapy techniques that is intended to help people with depression. MoodGYM is comprised of 6 modules.

We’ve mentioned MoodGYM previously in relationship to another online depression program and reported on the previous research about MoodGYM. MoodGYM has eight published research citations (some of which are noted in the references to this entry), and a few of them are randomized controlled trials.

MoodGYM is not for the faint of heart, however. In many ways, it is just as in-depth as a face-to-face clinical intervention and therefore takes nearly as much time and effort. And that’s one of its drawbacks — few people stick with the program to fully benefit from its positive effects. Despite this challenge, over 34,000 people visit MoodGYM every month and they have over 200,000 registered users. MoodGYM is reaching a lot of depressed people who want help for their depression, but can’t (or won’t) see a professional for it.

Another self-help program presented at the e-Mental Health Summit 2009 was Beating the Blues, a UK-based program composed of 8, 50-minute weekly sessions conducted on a computer or online. This program is available for free to most people living in the UK; it’s meant to be “prescribed” by a general practitioner. In the early research data presented at the conference, for those who completed the program, researchers saw a decrease of approximately 50 percent in patients’ outcome measure scores — they got significantly, clinically better after completing the program.

The Beating the Blues program suffered from the same problem that seems to plague all self-help programs — poor followup and completion by participants. Out of the people referred to the program in the research discussed by Kate Cavanagh of Newcastle University, only about 37 percent actually completed it. This leaves a lot of room for improvement for non-completers.

As Helen Christensen, the Director of the Australian National University’s Centre for Mental Health Research noted in her presentation to the conference, web-based interventions are attractive for many reasons. Their costs actually decline the more we can get people to use them, which is one of the few treatment interventions that can be said for. They are easy to make available and administer to the entire population, and they don’t require a professional’s oversight in a one-on-one environment.

She also mentioned a few ways of combating the drop-out problem in these programs. One is to start designing online interventions that are tailored for the individual. For instance, a teen might see a more entertainment-oriented, video-based program while an older adult might be more comfortable with text-based images and information. Voluntary reminders administered via your mobile phone, Twitter, Facebook or email might also be helpful. Incentives for completing major steps in the program — for instance, each module in the MoodGYM — might also help drive a person to finish the intervention.

I’ve touched upon only a few of the online depression interventions now available presented at the conference (another self-help program for the Netherlands was called Colour Your Life). The key point is that there are many of these kinds of online interventions available that directly treat mild to moderate depression — the most common form of depression that affects the greatest amount of people. If you’re suffering from depression, I encourage you to try out one of these free online depression programs. Help may be, literally, just a click away.

References:

Cavanagh, K.; Shapiro, D. A.; Van Den Berg, S.; Swain, S.; Barkham, M. & Proudfoot, J. (2006). The effectiveness of computerized cognitive behavioural therapy in routine care. British Journal of Clinical Psychology, 45(4), 499-514.

Griffiths, K.M. & Christensen, H. (2007). Internet-based mental health programs: A powerful tool in the rural medical kit. The Australian Journal of Rural Health, 15(2), 81-87.

Griffiths, K.M. Christensen, H. Jorm, A.F., Evans, K. & Groves, C. (2004). Effect of web-based depression literacy and cognitive-behavioural therapy interventions on stigmatising attitudes to depression: Randomised controlled trial. British Journal of Psychiatry, 185(4), 342-349.

O’Kearney, R., Kang, K., Christensen, H. & Griffiths, K. (2009). A controlled trial of a school-based Internet program for reducing depressive symptoms in adolescent girls. Depression and Anxiety, 26(1), 65-72.