Internet-delivered Cognitive Behaviour Therapy (ICBT) for Post-secondary Students

University of Regina

Status: Completed

Conditions: Depression; Anxiety

Treatments: Behavioral: Internet-delivered cognitive behaviour therapy; Behavioral: Booster Session; Behavioral: Motivational Interviewing

Study type: Interventional

Funder types: Other

Identifiers

NCT04264585

2019-205

Details and patient eligibility

About

Post-secondary students are at an elevated risk for anxiety and depression, with approximately one in three students experiencing clinical levels of symptoms at some point during their academic career. Despite the high prevalence of these mental health concerns, many students do not receive adequate treatment. Internet-delivered cognitive behaviour therapy (ICBT) is an alternative to face-to-face service that is effective for improving symptoms of anxiety and depression in general adult populations. Recently, there has been increasing interest in the use of ICBT in post-secondary populations, however high drop-out rates and small effect sizes suggest that current ICBT programs are not fully meeting students' specific needs. Additional research is necessary to ensure that ICBT is delivered to students in a manner that is both acceptable and effective.

The proposed study will be an implementation trial to examine whether the efficacy of an ICBT course for post-secondary students is improved by offering a motivational interviewing component at pre-treatment and a booster session 1-month after completing treatment. Follow-up assessment will be conducted as 3-month post-treatment. Primary outcomes are anxiety, depression, and academic functioning. Implementation outcomes will include measures of the acceptability, adoption, and fidelity (assessed by number of modules completed) of the ICBT course.

Full description

The aims of the study will be to: assess the efficacy of the UniWellbeing Course in reducing symptoms of anxiety and depression and increasing adjustment to academic and social responsibilities; to assess the impact of a pre-treatment motivational interviewing component on attrition, engagement, and outcomes (depression, anxiety, and academic functioning); to assess the impact of a booster session on anxiety, depression, and academic and social adjustment at three-month follow-up; and to assess the combined effect of including both a motivational interviewing component and booster session on outcomes.

Enrollment: 308 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• registered as a student at a post-secondary institution in Saskatchewan; over the age of 18;endorse symptoms of depression and/or anxiety; be able to access computers and the Internet and be comfortable using them; and willing to provide a physician as an emergency contact

Exclusion criteria

• high risk of suicide or hospitalization for mental health in previous 12 months
• unmanaged alcohol or drug use problems
• severe psychiatric illness that is not managed (e.g. psychosis or mania)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: None (Open label)

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308 participants in 4 patient groups

Standard ICBT

Experimental group

Description:

Clients assigned to the Standard ICBT condition will receive the standard version of the ICBT course, which consists of four lessons spread across the span of five weeks. Clients will receive five weeks of therapist support.

Treatment:

Behavioral: Internet-delivered cognitive behaviour therapy

ICBT with Motivational Interviewing

Experimental group

Description:

Clients assigned to the ICBT with Motivational Interviewing condition will receive the Planning for Change lesson before Lesson 1 of the UniWellbeing Course.

Treatment:

Behavioral: Internet-delivered cognitive behaviour therapy

Behavioral: Motivational Interviewing

ICBT with Booster

Experimental group

Description:

Clients assigned to the ICBT with Booster condition will receive access to a booster session one month after the end of the ICBT course.

Treatment:

Behavioral: Internet-delivered cognitive behaviour therapy

Behavioral: Booster Session

ICBT with Motivational Interviewing and Booster

Experimental group

Description:

Clients assigned to the ICBT with Motivational Interviewing and Booster condition will receive access to both the Motivational Interviewing content (before Lesson 1 of the UniWellbeing Course) and the booster session (one month after ICBT course).

Treatment:

Behavioral: Internet-delivered cognitive behaviour therapy

Behavioral: Booster Session

Behavioral: Motivational Interviewing