Text Messaging and Cognitive Behavioral Therapy for Depression (HealthySMS)

University of California San Francisco (UCSF)

Status: Completed

Conditions: Depression

Treatments: Behavioral: Group CBT for Depression; Behavioral: Group CBT for Depression with MoodText

Study type: Interventional

Funder types: Other

Identifiers

NCT01083628

68556-35551-01

Details and patient eligibility

About

This study aims to asses whether adding automated text messaging to group cognitive behavioral therapy for depression increases engagement which may lead to improved outcomes.

Full description

Background: Cognitive Behavioral Therapy (CBT) for depression is efficacious, but effectiveness is limited when implemented in low-income settings due to engagement difficulties including nonadherence with skill-building homework and early discontinuation of treatment. Automated messaging can be used in clinical settings to increase dosage of depression treatment and encourage sustained engagement with psychotherapy.

Objectives: The aim of this study was to test whether a text messaging adjunct (mood monitoring text messages, treatment-related text messages, and a clinician dashboard to display patient data) increases engagement and improves clinical outcomes in a group CBT treatment for depression. Specifically, the investigators aim to assess whether the text messaging adjunct led to an increase in group therapy sessions attended, an increase in duration of therapy attended, and reductions in Patient Health Questionnaire-9 item (PHQ-9) symptoms compared with the control condition of standard group CBT in a sample of low-income Spanish speaking Latino patients.

Methods: Patients in an outpatient behavioral health clinic were assigned to standard group CBT for depression (control condition; n=40) or the same treatment with the addition of a text messaging adjunct (n=45). The adjunct consisted of a daily mood monitoring message, a daily message reiterating the theme of that week's content, and medication and appointment reminders. Mood data and qualitative responses were sent to a Web-based platform (HealthySMS) for review by the therapist and displayed in session as a tool for teaching CBT skills.

Enrollment: 85 patients

Sex: All

Ages: 18 to 100 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Participation in CBT group at San Francisco General Hospital

Exclusion criteria

• Active suicidality
• Active and severe psychosis

Trial design

Primary purpose: Health Services Research

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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85 participants in 2 patient groups

Group CBT for Depression with MoodText'

Experimental group

Description:

Group cognitive behavioral therapy utilizing the BRIGHT manual for depression along with automated text messaging for mood monitoring and reminder of session content

Treatment:

Behavioral: Group CBT for Depression with MoodText

Group CBT for Depression

Active Comparator group

Description:

Standard group cognitive behavioral therapy utilizing the BRIGHT manual for depression

Treatment:

Behavioral: Group CBT for Depression