Table 2.
Description of the interventions found in the non–internet-based cognitive behavioral therapy studies.
| Study designs and author (year) | Treatment paradigm | Intervention technology | Description | |
| RCTsa | ||||
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|
Aardoom et al [40] (2016) | Psychoeducation | Website | Featback was a website that offered psychoeducation and general information on eating disorders, along with monitoring and tailored feedback (automatically by the program) on progress. Examined 4 dimensions: (1) body dissatisfaction, (2) concern with body weight or shape, (3) unbalanced nutrition and dieting, and (4) binge eating and compensatory behaviors. Therapist support was by email, teleconferencing, or chat. |
|
|
Bernstein et al [41] (2016) | CBTb | Automated text messages (and phone) | All participants received a brochure on the benefits of quitting smoking and a phone number for a smokers’ quitline. Intervention participants also received 4 weeks of nicotine patches and gum, a referral faxed to a quitline, and enrollment in SmokefreeTXT, an automatic texting library of 128 texts. Five random messages were sent per day. The evaluation used EMA,c allowing users to send feedback to the automated system about mood, craving, use, or health care contact. |
|
|
Constant et al [42] (2014) | Informational only | Automated text messages | Intervention involved automated text messages starting on the first day. 13 timed text messages were sent with reminders to take medication and to provide information on bleeding, cramping, and side effects. This was compared with SOC,d which was abortion counseling (eg, information on mifepristone side effects), administration of mifepristone on site, self-administration at home (1-2 days), and follow-up clinical assessment (2-3 weeks). Intervention group received both the intervention and the SOC. |
|
|
Kannisto et al [43] (2017) | Informational only | Automated text messages | Intervention was Mobile.Net, a tailored SMS text message system designed for medication adherence and outpatient care in adult patients with psychosis. Participants received semiautomatic texts for 12 months (approximately 10/month, 2-25 text messages) based on preferences. They could decide the amount, timing, frequency, and the content of the messages. |
|
|
Kleiboer et al [44] (2015) | Problem-solving therapy | Website | Five-part study that looked at varying levels of support with an internet-based, PSTe for depression and anxiety called Allesondercontrole, which had 5 weekly lessons with exercises guiding on problem-solving in a structured format. Condition 1 received no support, condition 2 received support upon request and condition 3 received weekly support from a coach. Condition 4 did not receive the internet-based treatment but did receive nonspecific support via chat or email. Condition 5 was a waitlist condition with access to a website containing psychoeducation about depression and anxiety. |
|
|
Mason et al [45] (2012) | Social cognitive theory | Website | Tailored advice consisted of an advice report based on several variables (eg, sex, previous quit attempts, current health, etc). Participants reported a quit date (past or future) and received a progress report 4 weeks later, which included baseline variables, quit date reminders, slip-ups, and changes in variables. Standard reports were generated using similar algorithms but with default content and modal responses and were all identical. Advice reports could be accessed and filled out at the iQUIT website. |
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|
Pictet et al [46] (2016) | CBMf | Website | Three-part study that compared 2 types of cognitive bias modification programs, as well as comparing them to a waitlist condition. Both intervention groups received access to a website that introduced photographic illustrations and audio recordings depicting everyday situations, and then the patients were instructed to imagine the situations. In the Imagery CBM group, the situations always ended positively. In the Control CBM group, the situations ended positively half the time and negatively in the other half. |
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|
Sherman et al [47] (2012) | Psychoeducation, crisis intervention model | Videos; Phone support | 4-part RCT receiving either: usual care, usual care and videos, telephone counseling, or telephone counseling and videos. Usual care involved office or inpatient visits, offering education, support group access and options for referral. Psychoeducational videos were offered in the institution or in the home, with 4 phase-specific videos on coping with breast cancer diagnoses. Telephone counseling consisted of 4 phase-specific telephone calls conducted by a nurse interventionist trained in telephone counseling approaches. These were also on coping with breast cancer. |
| Non-RCT quantitative studies | ||||
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|
Ahmedani et al [48] (2015) | Motivational interviewing and CBT | Computer tablet with app | Intervention was a handheld tablet in which an animated narrator interacts with the participants by user input. Responses by the participants on the tablet would lead to varying responses by the program, allowing for branching down unique pathways and feedback tailored specifically to the user. This system combined motivational interviewing and CBT models. Intervention was delivered via a handheld computer tablet with headphones. |
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|
Kipping et al [49] (2016) | Informational only | Website | HealthCheck was a patient portal that allowed access of patients to their health care. It included access to EMR,g the ability to request medication renewals on the web, view upcoming appointments and educational materials, and access to communication with the providers. |
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|
Piette et al [50] (2013) | Informational only (medication adherence) | IVRh | CarePartner program (Depression Version) was an IVR system that monitored the patients’ depression symptoms using PHQi-9 and provided advice to improve medication adherence and prompt clinical follow-up. Suicidal ideation led to an alert to the clinical team, instructions to call 911 or the provider, or a suicide hotline. Faxes were sent to the providers when there was a sharp rise in PHQ-9 or medication adherence problems. |
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|
Pratap et al [51] (2018) | Cognitive control, problem-solving therapy, informational | App | Three-part study that compared 3 different self-guided phone apps for the treatment of depression. The first group used a video-game inspired app called Project EVO, a cognitive-based program designed to modulate cognitive control abilities. The second app was an iPSTj program. The third was daily health tips (HTips), a program designed to provide information control to overcome depressed mood through self-care and physical activity. Each app had daily reminders. All programs were self-guided |
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Stein et al [52] (2012) | Informational only (medication adherence) | Computer software | CommonGround was a computerized support system that the participants could use before a medication visit. It included an introductory video about recovery from mental illness and brief videos of patients discussing their recovery. It was followed by a customized survey of the patient’s concerns, decisional balance, and trade-off exercises. |
| Qualitative study | ||||
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|
Bauer et al [53] (2018) | Informational only | App | Ginger.io was a smartphone app with a web-based dashboard with notifications to complete regular clinical surveys, occasional satisfaction surveys, and with health tips (eg, self-care activities) related to depression and anxiety 3-4 times a week. The dashboard allowed for the monitoring of patient app use. Participants used this app while continuing collaborative care treatment, which was care with a general practitioner, a care manager, and a psychiatric consultant. |
aRCT: randomized controlled trial.
bCBT: cognitive behavioral therapy.
cEMA: ecological momentary assessment.
dSOC: standard of care.
ePST: problem-solving treatment.
fCBM: cognitive bias modification.
gEMR: electronic medical record.
hIVR: integrated voice response.
iPHQ: patient health questionnaire.
jiPST: internet-based problem-solving therapy.