Integration of peer support and computer-based CBT for veterans with depression

• Published in: Computers in human behavior 2014-02, Vol.31, p.57-64
• Main Authors: Nelson, C. Beau, Abraham, Kristen M., Walters, Heather, Pfeiffer, Paul N., Valenstein, Marcia
• Format: Article
• Language: English
• Subjects: Cognitive behavioral therapy; Computer-based Cognitive Behavioral Therapy; Depression; Disorders; Human behavior; Major depressive disorder; Mental health; Patients; Peer support; Pilots; Public health; Reduction; Self-help approaches
• ISSN: 0747-5632; 1873-7692
• DOI: 10.1016/j.chb.2013.10.012

•Completion rates for the computer-based Cognitive Behavioral Therapy program were high.•Veteran-peers provided support and helped prompt completion of the cCBT program.•Significant decreases in depressive symptoms and increases in hope were observed in post ratings.•Marginal decreases in anxiety symptoms were also observed.•The feasibility of a Veteran-peer assisted cCBT program was supported. Depressive disorders are a serious public health concern and treatment priority for the Veterans Health Administration. Computer-based Cognitive Behavioral Therapy (cCBT) is an effective intervention for patients with major depressive disorders; however, rates of program completion are an area of concern, which may be improved through the assistance of peers. This pilot study investigated the feasibility of a Veteran-peer assisted cCBT intervention. Participants were patients diagnosed with depression at an Outpatient Mental Health (OMH) or Primary Care Mental Health (PCMH) clinic at a single VHA facility. Participants were paired with a Veteran-peer and given access to a widely used cCBT program via the Internet. Measures of depressive symptoms were obtained at baseline, 4-, and 8-weeks follow-up. Completion rates and program satisfaction were also assessed. At 8weeks, symptom reductions and completion rates were comparable to study results of brief individual, group CBT, and staff assisted computerized CBT interventions. Significant reductions in depressive symptoms were observed in patients from both clinics, although ratings of program usefulness, relevance, and ease of use were higher for individuals recruited from the PCMH clinic. Peer-assisted cCBT for depression is feasible but further research is needed to determine the clinical efficacy of this approach.