A Randomized Controlled Trial of In-Home Tele-Behavioral Health Care Utilizing Behavioral Activation for Depression

Not Applicable

Completed

Brief Summary: This study will evaluate the effectiveness of a web-based behavioral activation(BA) treatment for depression by comparing it to in-person BA treatment in Soldiers and Veterans with Major and Minor Depressive Disorder. We will test the hypothesis that 8 sessions of in-home BA delivered via a webcam will be as safe and effective in reducing symptoms of hopelessness and depression as in-person BA treatment for depression.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Currently undergoing psychotherapy for depression
less than 18 or greater than 65 year of age
Active psychotic symptoms/disorders as determined by the SCID for DSM-IV
Dysthymic Disorder
Current suicidal ideation with intent or recent (within six months) history of a suicide attempt
History of Organic Mental Disorder
Current substance dependence as determined by the SCID (lifetime substance dependence or substance abuse will not be excluded)
History of violence or poor impulse control causing potential risk to staff or others
Significant ongoing stressors that require urgent crisis intervention
Having a living arrangement that will not permit the use of a private space to participate in the study

Arm && Interventions

Group	Intervention	Description
In Home	Behavioral Activation	Participants in this condition will receive 8 sessions of BA treatment over the course of approximately 8 weeks (one session per week). The sessions will be conducted in their homes using an Army approved secure web-based video conferencing system. BA has been successfully delivered in this time frame, and it has been delivered via in-home video conferencing technology.
In-Person	Behavioral Activation	Participants in this condition will receive 8 sessions of BA treatment over the course of approximately 8 weeks (one session per week with allowance for rescheduled sessions). The sessions will be conducted in a clinic setting at The National Center for Telehealth \& Technology.

Primary Outcome Measures

Name	Time	Method
Beck Hopelessness Scale (BHS)	Post treatment - Week 8	The BHS is a 20-item scale for measuring negative attitudes about the future. Each item is scored with a true/false response. Total scores range from 0-20 with higher scores indicating a greater degree of hopelessness.

Secondary Outcome Measures

Name	Time	Method
Beck Depression Inventory -II (BDI-II)	3 month follow up	The BDI-II is the most commonly used self-report measure of clinical depression severity. It consists of 21 items that are rated on a 4-point scale which yield a range of scores from 0 - 63. The BDI-II has sound psychometric properties. The higher the score the worse the outcome.
Beck Hopelessness Scale (BHS)	3 month follow up	The BHS is a 20-item scale for measuring negative attitudes about the future. Each item is scored with a true/false response. Total scores range from 0-20 with higher scores indicating a greater degree of hopelessness.
Adverse Events	3 month follow up	Safety data will be collected on adverse events, psychiatric hospitalizations, suicides and non-fatal suicide-related behaviors, number of times the treatment collateral was utilized during treatment, treatment adherence, participant drop-out rate, and frequency of requests for patient or therapist technical support. Safety related data will be recorded after each treatment session on the Treatment Session Checklist.

Locations (2): National Center for Telehealth and Technology
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Tacoma, Washington, United States
Portland VA Medical Center
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Portland, Oregon, United States