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Keywords:

  • Computerized CBT;
  • Internet-delivered therapy;
  • moodGYM;
  • stepped care

Objectives

To evaluate the effectiveness of the computerized CBT (cCBT) programme, MoodGYM, for the reduction in symptoms of general psychological distress (the primary outcome), depression, anxiety, stress, and impaired daily functioning.

Design

A randomized controlled trial, with a waiting list control condition, in a routine clinical setting.

Methods

Participants were 149 public mental health service users (aged 18–61 [= 35.3 years; SD = 10.3]) waiting for interventions. Self-report outcome measures were administered online at baseline and post-intervention (i.e., after 32 days).

Results

After high dropout rates, a post-intervention completers analysis examined 28 MoodGYM participants and 38 waiting list control participants. MoodGYM was significantly more effective than the waiting list control for the reduction of symptoms of general psychological distress (F[1, 64] = 4.45; < .05) and stress (F[1, 64] = 5.35; < .05) but not depression, anxiety, or impaired daily functioning.

Conclusions

Due to their high associated dropout rates, self-help cCBT programmes such as MoodGYM should not be provided as front-line treatments. However, as it is likely to be agreeable and beneficial to some service users, perhaps self-help cCBT should be provided as an additional treatment option.

Practitioner points

  • Computerized CBT has predominantly been evaluated in ‘efficacy’ trials which often include motivated, self-referred participants unrepresentative of clinical populations. Multi-site recruitment in the present trial allowed participants with characteristics typical of public mental health service users across Ireland to be included.
  • MoodGYM's effectiveness was demonstrated for the primary outcome, general psychological distress symptoms, and one of four secondary outcomes (i.e., stress symptoms). However, 56.3% of MoodGYM participants (and 85% of males) dropped out of the study, limiting the validity of findings.
  • Feedback to MoodGYM (for those who engaged with it) was generally positive (e.g., 68% of respondents would recommend MoodGYM to a friend if they needed some help). However, 73% of MoodGYM participants did not complete all five sessions.
  • Due to their limited effectiveness and high associated dropout rates, self-help cCBT programmes such as MoodGYM should not be provided as front-line treatments, in place of higher intensity interventions such as one-to-one psychotherapy. However, as it is likely to be agreeable and beneficial to some service users, self-help cCBT is perhaps best offered as an additional treatment option.