Interactive Media Treatment for Depression: Description and Feasibility Evaluation
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Abstract
Background
Advances have been made in the field of computer automated treatments of depression. One commonality among treatments to date is that the interventions have been delivered primarily via text that users must read. This places a burden on persons seeking treatment for depression and may prevent some from using the program due to literacy requirements.
Objective
The primary aim of this project was to develop a computer automated treatment for depression that is delivered via interactive media technology. The program is electronic problem-solving therapy (ePST). By utilizing branching video and audio, the ePST simulates the experience of being in therapy with a master clinician, who provides six sessions of problem-solving therapy. A secondary objective was to conduct an initial feasibility evaluation to measure the program’s usability, acceptability, and credibility, and to refine study procedures in preparation for a larger clinical trial.
Methods
ePST was produced in a professional multimedia production facility and incorporates video, audio, graphics, animation, and text. ePST uses multiple failure analyses of patient data across sessions and across problems to identify ways to help the user improve his or her problem solving. The feasibility study was conducted with fourteen persons who met DSM-IV-TR criteria for minor depression. An experimental group (n=7) used the program while a waitlist control group (n=7) was provided with no treatment for six weeks. Participants used the program on site at a research clinic in private exam rooms.
Results
All of the experimental group participants completed the trial, whereas one from the control was lost to follow-up. Experimental group participants rated the program high on usability, acceptability, and credibility. Two experimental group participants had more than a two-week lapse between sessions, which was longer than the study design permitted. Percent change in depression was compared between the two groups. Completers in the control group (n=6) experienced an 11% reduction in depression, compared to experimental group participants, who completed ePST as intended (n=5) and experienced a 52% reduction (P=.052). The intent to treat analysis detected a decrease in depression of 35% (P=.253 compared to the control group).
Conclusions
Although the study was not powered to detect treatment effects, participants did find ePST highly usable, acceptable, and credible. This suggests that the highly interactive and immersive nature of the program is a benefit. A larger clinical trial is under way. A brief demonstration of ePST will be provided.
Advances have been made in the field of computer automated treatments of depression. One commonality among treatments to date is that the interventions have been delivered primarily via text that users must read. This places a burden on persons seeking treatment for depression and may prevent some from using the program due to literacy requirements.
Objective
The primary aim of this project was to develop a computer automated treatment for depression that is delivered via interactive media technology. The program is electronic problem-solving therapy (ePST). By utilizing branching video and audio, the ePST simulates the experience of being in therapy with a master clinician, who provides six sessions of problem-solving therapy. A secondary objective was to conduct an initial feasibility evaluation to measure the program’s usability, acceptability, and credibility, and to refine study procedures in preparation for a larger clinical trial.
Methods
ePST was produced in a professional multimedia production facility and incorporates video, audio, graphics, animation, and text. ePST uses multiple failure analyses of patient data across sessions and across problems to identify ways to help the user improve his or her problem solving. The feasibility study was conducted with fourteen persons who met DSM-IV-TR criteria for minor depression. An experimental group (n=7) used the program while a waitlist control group (n=7) was provided with no treatment for six weeks. Participants used the program on site at a research clinic in private exam rooms.
Results
All of the experimental group participants completed the trial, whereas one from the control was lost to follow-up. Experimental group participants rated the program high on usability, acceptability, and credibility. Two experimental group participants had more than a two-week lapse between sessions, which was longer than the study design permitted. Percent change in depression was compared between the two groups. Completers in the control group (n=6) experienced an 11% reduction in depression, compared to experimental group participants, who completed ePST as intended (n=5) and experienced a 52% reduction (P=.052). The intent to treat analysis detected a decrease in depression of 35% (P=.253 compared to the control group).
Conclusions
Although the study was not powered to detect treatment effects, participants did find ePST highly usable, acceptable, and credible. This suggests that the highly interactive and immersive nature of the program is a benefit. A larger clinical trial is under way. A brief demonstration of ePST will be provided.
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