Web-based cognitive behavior therapy for depression with and without telephone tracking in a national helpline: Secondary outcomes from a randomized controlled trial

Abstract

Background: An earlier report indicated that callers to a telephone counseling service benefited from the addition of an evidence-based Web intervention for depression. It is not known whether the Web intervention would also lower alcohol use and stigma, or improve quality of life and knowledge of depression and its treatments. Objective: To report the secondary outcomes of a trial of a Web-based cognitive behavior therapy (CBT) intervention for depression, including hazardous alcohol use, quality of life, stigma, depression literacy, and CBT literacy. Methods: We recruited a sample of 155 callers to Lifeline, a national telephone counseling service in Australia, who met the criteria for moderate to high psychological distress. Participants were randomly assigned to 1 of 4 conditions: (1) Web CBT plus weekly telephone tracking, (2) Web CBT only, (3) weekly telephone tracking only, and (4) neither Web CBT nor telephone tracking. Participants were assessed at preintervention, postintervention, and 6 and 12 months postintervention. Results: At postintervention, participants who completed the Web intervention either with or without telephone support had lower levels of hazardous alcohol use (without tracking: P =.008, effect size = 0.23; with tracking: P =.003, effect size = 0.26), improved quality of life (without tracking: P =.001, effect size = 0.81; with tracking: P =.009, effect size = 0.63), and improved CBT literacy (without tracking: P =.01, effect size = 0.71; with tracking: P