Improving Access to Treatment of Anxiety and Depression in Young Adults Using Transdignostic iCBT: Feasibility of a Translated Version of an Empirically Supported Program
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 25
- 试验地点
- 2
- 主要终点
- Changes in depression as assessed with the Patient Health Questionnaire-9 items
研究概览
简要总结
Anxiety and depression represent the most common mental health problems. Unfortunately, only a minority of people in need will seek or access traditional mental health services. Access to traditional psychological care is even more challenging for linguistic minorities as well as for people living in rural areas and for young adults - a group that has the highest rate of anxiety and depression but the lowest rate of consulting traditional services.Telepsychotherapy can facilitate access to effective psychological care as done in Australia where the government has been offering an evidence-based 8-week online therapy program called the Wellbeing Course. This online course helps people manage worry, stress, anxiety and depression. It has been evaluated in several clinical trials and successfully implemented as an Australian national treatment service. Its transdiagnostic nature, and the fact that the guidance of a clinician is not required for an efficient and safe administration and maintenance of therapeutic gains make it not only a viable option, but also an easily accessible fist line intervention. More recently, findings from a feasibility study conducted by our research laboratory have supported the efficacy of a French-Canadian translation among French-speaking minorities in New-Brunswick. A version of the Wellbeing Course for young adults has been developed called the Mood Mechanic Course. Empirical support has been obtained.
This study is a feasibility open trial, the first phase of a 3-phase research program designed to implement a French-Canadian translation of the Mood Mechanic Course in New Brunswick targeting groups for which access to traditional services has been most problematic: youth (18 to 25 years old), people living in rural areas and linguistic minorities. The course is an 8-week week program based on principles of cognitive behaviour therapy. It includes five online lessons, do-it-yourself exercises, case stories, and additional resources on different topic such as sleep hygiene. Twenty young adults will be recruited across New Brunswick among French-Canadian minority communities. Self-report measures assessing anxiety and depression will be administered pre/post treatment and at a 3-month follow-up. It is expected that the course will help overcome barriers in help seeking to improve the mental health of our communities.
详细描述
BACKGROUND. Anxiety and depression are highly prevalent mental health problems and chronic conditions accounting for the highest proportion of mental disorders in Canada. Young adults aged 15 to 24 are particularly vulnerable, this age group having the highest prevalence rates reported during a 12-month period of anxiety (11.6%) and depression (7%) in Canada. Access to evidence-based psychological treatments for anxiety and depression has been limited and particularly problematic for linguistic minorities.
RATIONALE FOR PERFORMING THE STUDY. Self-administered internet-based cognitive-behavioural therapy (iCBT) is a first-line therapy that could better meet the needs of young adults. Not only could its delivery format provide increased access to French services in both urban and rural areas, but it could also help young adults to overcome many of the barriers reported by Canadians with unmet or partially met needs for counselling.
An established iCBT shown to be effective for the treatment of anxiety and depression is the Wellbeing program developed by Titov and colleagues. The Wellbeing Course presents a number of advantages. It is a transdiagnostic program that allows the treatment of both anxiety and depression, which makes it a cost-efficient treatment. More recent evidence suggests that no direct clinical contact is required for gains to be significant and maintained over a 12-month follow-up. A version of the Wellbeing Course for young adults has been developed called the Mood Mechanic Course. Data gathered so far support its efficacy.
The majority of iCBT programs are only available in English, despite the fact that their translation can be a highly cost-effective strategy. More recently, findings from a feasibility study have supported the efficacy of a French-Canadian translation of the Wellbeing Course among French-speaking minorities in New-Brunswick.
PRIMARY OBJECTIVES. To examine the feasibility and acceptability of a French-Canadian and self-guided version of the Mood Mechanic Course on anxiety and depression among young adults.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 25 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Resident of New Brunswick;
- •18 to 25 years of age;
- •French as their native language;
- •Good comprehension of written French;
- •Reliable access to the Internet;
- •Clinical levels of depression, generalized anxiety disorder, panic disorder or social anxiety disorder, as indicated by the total score of at least one of the following measures: QSP-9 ≥ 5; GAD-7 ≥ 5, PAS ≥ 19, SPIN ≥ 19;
- •Not currently following another cognitive-behavioral therapy (CBT);
- •No change of medication at least one month prior to the study and no change expected over the next two months;
- •In agreement to share relevant personal information.
排除标准
- •Severe depression or suicide intent or plan (score ≥ 23 or a score > 2 on item 9 (suicidal ideation) of PHQ-9;
- •Currently experiencing psychotic symptoms.
结局指标
主要结局
Changes in depression as assessed with the Patient Health Questionnaire-9 items
时间窗: Pre-test (Week 1), Post-test (Week 8) and 3-month follow-up
French version: 9 items assessing symptoms of major depressive disorder on a scale from 0 (Not at all) to 3 (Nearly every day).
Changes in anxiety as assessed with the Generalized Anxiety Disorder Scale 7-Item Scale
时间窗: Pre-test (Week 1), Post-test (Week 8) and 3 month follow-up
French version: 7 items assessing symptoms of generalized anxiety disorder on a scale from 0 (Not at all) to 3 (Nearly every day).
次要结局
- Changes in anxiety as assessed with the Panic and Agoraphobia Scale (PAS)(Pre-test (Week 1), Post-test (Week 8) and 3 month follow-up)
- Changes in anxiety as assessed with the Social Phobia Inventory (SPIN)(Pre-test (Week 1), Post-test (Week 8) and 3 month follow-up)
- Changes in resilience as assessed with the Connor-Davidson Resilience Scale(Pre-test (Week 1), Post-test (Week 8) and 3 month follow-up)
- Changes in life satisfaction as assessed with the Life Satisfaction Questionnaire(Pre-test (Week 1), Post-test (Week 8) and 3 month follow-up)
- Treatment acceptability(Post-test (Week 8))
研究者
France Talbot
Associate professor
Universite de Moncton