MedPath

Message-Based Psychotherapy and Digital Treatment Sequences for Depression

Not Applicable
Completed
Conditions
Study Adherence
Depressive Disorder
Registration Number
NCT04513080
Lead Sponsor
Talkspace
Brief Summary

This partnership between Talkspace and the UW ALACRITY Center will determine how effective unlimited text-based psychotherapy for depression is when compared to once-a-week psychotherapy. This study will also determine what the best treatment options are for people who are not responding well to either unlimited texting or weekly psychotherapy. The results of this study will be a new product version of message-based care that can tailor psychotherapy intensity based on the needs of future consumers with depression.

Detailed Description

This is a fast track SBIR proposal that will (1) test the effectiveness of daily, message-based psychotherapy (MBP) for depression, compared to traditionally delivered, video-chat psychotherapy (VCP) and (2) develop an evidence-based treatment sequence for those who do not respond to either daily MBP or VCP.

Phase 1 consists of a pilot study to determine the best incentive model to retain a sample of people 18 years old and older with depression into a SMART trial. Information from this pilot will inform the retention strategy for Phase 2.

Phase 2 is a 12-week, randomized clinical trial using a SMART design to test the following aims: 1. Determine the relative effectiveness of daily MBP compared to weekly VCP in treating symptoms of depression and improving social functioning; 2. For those who fail to respond to 6 weeks of weekly VCP only, determine whether the addition of daily messaging, or a switch to monthly video-chat plus daily messaging improves depression and functional outcomes; and 3. For those who fail to respond to 6 weeks of daily MBP, whether the addition of monthly video-chat or weekly video-chat improves outcomes. Participants will provide data on mood, activity, and functioning, and we will collect data on use of treatment (texts and sessions), and working alliance.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
973
Inclusion Criteria
  • 18 years old or older
  • English or Spanish speaking
  • Live in the United States
  • Score of 10 or greater on the PHQ-9 screening
  • Receive a diagnosis of depression from a Talkspace intake clinician
Exclusion Criteria
  • Under the age of 18
  • Non-English or Spanish speaking
  • Do not meet criteria for a depressive disorder
  • Participants with active suicidal ideation or with a primary diagnosis of psychosis will also be excluded and referred to intensive care.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Primary Outcome Measures
NameTimeMethod
Change in Patient Health Questionnaire (PHQ-9)Change from Baseline PHQ-9 at 6 weeks and 12 weeks after treatment starts

Phase 2: The PHQ-9 consists of 9 depression items and one disability item. Each time is associated with a DMS symptom of depression, which the participant rates whether or not they have experienced the symptom over the last two weeks, with severity rating of 0-3. It is one of the few measures that is brief (it takes less than one minute to give) and has been found to have excellent sensitivity to change over time.

Change in Neuro-QoL - Ability to Participate in Social Roles and ActivitiesChange from Baseline Neuro-QoL at 6 weeks and 12 weeks after treatment starts

Phase 2: The Neuro-QoL is used to assess ability to participate in social roles and activities and will be used to assess functioning and disability.

Secondary Outcome Measures
NameTimeMethod
Change in Generalized Anxiety Disorder (GAD-7)Change from Baseline GAD-7 at 6 weeks and 12 weeks after treatment starts

Phase 2: To assess for co-occurring anxiety, we will use the GAD-7, a 7- item screener for generalized anxiety. It consists of items related to GAD. Participants rate on a scale of 0-3 how much they have experienced in the last two weeks. The scale is a valid screener for GAD.

Trial Locations

Locations (1)

Talkspace

🇺🇸

New York, New York, United States

Talkspace
🇺🇸New York, New York, United States

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