%0 Journal Article
%@ 1438-8871
%I JMIR Publications
%V 25
%N 
%P e46052
%T Comparing Message-Based Psychotherapy to Once-Weekly, Video-Based Psychotherapy for Moderate Depression: Randomized Controlled Trial
%A Song,Jiyoung
%A Litvin,Boris
%A Allred,Ryan
%A Chen,Shiyu
%A Hull,Thomas D
%A Areán,Patricia A
%+ Department of Psychology, University of California, Berkeley, 2121 Berkeley Way, Berkeley, CA, 94720, United States, 1 9493794232, jiyoungsong@berkeley.edu
%K randomized controlled trial
%K message-based psychotherapy
%K video-based psychotherapy
%K telemedicine
%K depression
%K anxiety
%K functional impairment, credibility, alliance, engagement
%K mental health
%K text mining
%K message therapy
%K Burden of Disease
%K telehealth
%K intervention
%D 2023
%7 29.6.2023
%9 Original Paper
%J J Med Internet Res
%G English
%X Background: Despite the high prevalence of major depressive disorder and the related societal burden, access to effective traditional face-to-face or video-based psychotherapy is a challenge. An alternative that offers mental health care in a flexible setting is asynchronous messaging therapy. To date, no study has evaluated its efficacy and acceptability in a randomized controlled trial for depression. Objective: The aim of this study was to compare the efficacy and acceptability of message-based psychotherapy for depression to once-weekly video-based psychotherapy. Methods: In this 2-armed randomized controlled trial, individuals (N=83) with depressive symptomatology (Patient Health Questionnaire-9 ≥10) were recruited on the internet and randomly assigned to either a message-based intervention group (n=46) or a once-weekly video-based intervention group (n=37). Patients in the message-based treatment condition exchanged asynchronous messages with their therapist following an agreed-upon schedule. Patients in the video-based treatment condition met with their therapist once each week for a 45-minute video teletherapy session. Self-report data for depression, anxiety, and functional impairment were collected at pretreatment, weekly during treatment, at posttreatment, and at a 6-month follow-up. Self-reported treatment expectancy and credibility for the assigned intervention were assessed at pretreatment and therapeutic alliance at posttreatment. Results: Findings from multilevel modeling indicated significant, medium-to-large improvements in depression (d=1.04; 95% CI 0.60-1.46), anxiety (d=0.61; 95% CI 0.22-0.99), and functional impairment (d=0.66; 95% CI 0.27-1.05) for patients in the message-based treatment condition. Changes in depression (d=0.11; 95% CI –0.43 to 0.66), anxiety (d=–0.01; 95% CI –0.56 to 0.53), and functional impairment (d=0.25; 95% CI –0.30 to 0.80) in the message-based treatment condition were noninferior to those in the video-based treatment condition. There were no significant differences in treatment credibility (d=–0.09; 95% CI –0.64 to 0.45), therapeutic alliance (d=–0.15; 95% CI –0.75 to 0.44), or engagement (d=0.24; 95% CI –0.20 to 0.67) between the 2 treatment conditions. Conclusions: Message-based psychotherapy could present an effective and accessible alternative treatment modality for patients who might not be able to engage in traditional scheduled services such as face-to-face or video-based psychotherapy. Trial Registration: ClinicalTrials.gov NCT05467787; https://www.clinicaltrials.gov/ct2/show/NCT05467787 
%M 37384392
%R 10.2196/46052
%U https://www.jmir.org/2023/1/e46052
%U https://doi.org/10.2196/46052
%U http://www.ncbi.nlm.nih.gov/pubmed/37384392