MindSpot clinic: An accessible, efficient, and effective online treatment service for anxiety and depression

Nickolai Titov, Blake F. Dear, Lauren G. Staples, James Bennett-Levy, Britt Klein, Ronald M. Rapee, Clare Shann, David Richards, Gerhard Andersson, Lee Ritterband, Carol Purtell, Greg Bezuidenhout, Luke Johnston, Olav B. Nielssen

    Research output: Contribution to journalArticlepeer-review

    139 Citations (Scopus)

    Abstract

    OBJECTIVE: The main objective of this study was to report the feasibility of delivering online cognitive-behavioral therapy (iCBT) treatments for anxiety and depression in a national public mental health service.

    METHODS: A prospective noncontrolled cohort study was conducted of all patients who began assessment or treatment at the MindSpot Clinic from January through December 2013. Clinic services were used by a representative cross-section of the Australian population. Mean age at assessment was 36.4±13.0 years, and age range was 18-86 years. Patients completed one of four online courses over eight weeks, during which they received weekly support from a therapist via telephone or secure e-mail. Primary outcome measures were the nine-item Patient Health Questionnaire (PHQ-9) and the seven-item Generalized Anxiety Disorder scale (GAD-7) administered at posttreatment and three months posttreatment.

    RESULTS: A total of 10,293 adults who self-identified as having problems with anxiety or depression commenced assessment, and 7,172 completed the assessment and were eligible for analysis. Of these, 2,049 enrolled in a course and 1,471 completed the course, for a course completion rate of 71.8%. Moderate to large noncontrolled effect sizes (Cohen's d=.67-1.66, 95% confidence interval=.08-2.07) were found from assessment to three-month follow-up. At posttreatment and follow-up, reliable recovery ranged from 46.7% to 51.1%, and deterioration ranged from 1.9% to 3.8%. Mean total therapist time per patient was 111.8±61.6 minutes.

    CONCLUSIONS: The MindSpot Clinic produced treatment outcomes that were comparable to results from published clinical trials of iCBT. This model of service delivery represents an innovative method of providing accessible, low-cost, effective, and acceptable mental health services to many people who currently are not receiving care.

    Original languageEnglish
    Pages (from-to)1043-1050
    Number of pages8
    JournalPsychiatric Services
    Volume66
    Issue number10
    DOIs
    Publication statusPublished - 1 Oct 2015

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