A Closer Look at Negative Effects in a Guided Web-Based Intervention for Mild to Moderate Depression

• Published in: Clinical psychology (New York, N.Y.) N.Y.), 2021-06, Vol.28 (2), p.131-141
• Main Authors: Oehler, Caroline, Görges, Frauke, Hegerl, Ulrich, Rummel-Kluge, Christine
• Format: Article
• Language: English
• Subjects: Cognitive Behavior Therapy; Digital Interventions; Female; Human; Major Depression; Male; Online Therapy; Psychotherapy; Side Effects (Treatment); Symptoms
• ISSN: 0969-5893; 1468-2850
• DOI: 10.1037/cps0000004

Although evidence on the efficacy of web-based interventions for depression seems promising, possible negative effects (NE), especially those beyond symptom deterioration, are largely understudied. Alongside a randomized, controlled trial with an active control condition, data on NEs were collected from 347 participants. An adapted version of the Inventory of Negative Effects of Psychotherapy yielded higher rates of participants experiencing at least one NE (30% intervention, 30.7% control) than the more common analysis of reliable deterioration rates (3.7% intervention, 6.2% control). Although patients reported to feel "not taken seriously," pressured by the intervention's schedule, or frustrated about the occurrence of technical problems, our results indicate that NEs in a web-based intervention were not more common than those reported for face-to-face psychotherapy. Public Health Significance StatementWhile the effectiveness of Internet-based interventions for people with depression has been demonstrated many times, side effects and adverse events have received little scientific attention so far. These can be of different kinds: deterioration of symptoms, frustration about technical problems or effects on social life are only examples, therefore the current article integrates multiple approaches to shed light on negative effects. Overall, Internet-based interventions seem to lead to a comparable or even lower number of negative effects as face-to-face psychotherapy even if the content differed. No serious adverse events caused by the intervention were observed.