Stearns-Yoder Kelly A, Ryan Arthur T, Smith Alexandra A, Forster Jeri E, Barnes Sean M, Brenner Lisa A
Veterans Affairs Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, United States.
Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz School of Medicine, Aurora, CO, United States.
JMIR Form Res. 2022 Apr 25;6(4):e31835. doi: 10.2196/31835.
Computerized cognitive behavioral therapies (cCBTs) have been developed to deliver efficient, evidence-based treatment for depression and other mental health conditions. Beating the Blues (BtB) is one of the most empirically supported cCBTs for depression. The previous trial of BtB with veterans included regular guidance by health care personnel, which increased the complexity and cost of the intervention.
This study, conducted by researchers at a Veterans Affairs Medical Center, aims to test the acceptability and feasibility of unguided cCBT for depression among US military veterans.
To examine the acceptability of BtB delivered without additional peer or other mental health care provider support, a before-and-after trial was conducted among United States (US) military veterans experiencing mild to moderate depressive symptoms. The feasibility of the study design for a future efficacy trial was also evaluated.
In total, 49 veterans completed preintervention assessments and received access to BtB, and 29 participants completed all postintervention assessments. The predetermined acceptability criterion for the intervention was met. Although the predetermined feasibility criteria regarding screening eligibility rate, number of BtB modules completed, and completion of a posttreatment assessment were not met, the results were comparable with those of other cCBT studies.
This is the first study among US military veterans to demonstrate support for the implementation of cCBT for depression without the assistance of a mental health professional or a peer support specialist, suggesting that stand-alone computer-aided interventions may be viable. Ideas for improving feasibility in future trials based on this study are discussed.
计算机化认知行为疗法（cCBTs）已被开发用于为抑郁症和其他心理健康状况提供高效、循证治疗。“战胜忧郁”（BtB）是治疗抑郁症最具实证支持的cCBTs之一。此前针对退伍军人的BtB试验包括医护人员的定期指导，这增加了干预的复杂性和成本。
这项由退伍军人事务医疗中心的研究人员开展的研究，旨在测试无指导的cCBT对美国退伍军人抑郁症的可接受性和可行性。
为检验在没有额外同伴或其他心理健康护理提供者支持的情况下提供BtB的可接受性，对有轻度至中度抑郁症状的美国退伍军人进行了一项前后对照试验。还评估了该研究设计用于未来疗效试验的可行性。
共有49名退伍军人完成了干预前评估并获得了BtB，29名参与者完成了所有干预后评估。达到了干预的预定可接受性标准。尽管在筛查合格比率、完成的BtB模块数量以及完成治疗后评估方面未达到预定的可行性标准，但结果与其他cCBT研究的结果相当。
这是美国退伍军人中第一项证明在没有心理健康专业人员或同伴支持专家协助的情况下实施cCBT治疗抑郁症的研究，表明独立的计算机辅助干预可能是可行的。讨论了基于本研究在未来试验中提高可行性的想法。
