Depression Clinical Trial
Official title:
Automated Text Messaging to Increase Engagement in Cognitive Behavioral Therapy (CBT) for Depression
This study aims to asses whether adding automated text messaging to group cognitive behavioral therapy for depression increases engagement which may lead to improved outcomes.
Background: Cognitive Behavioral Therapy (CBT) for depression is efficacious, but
effectiveness is limited when implemented in low-income settings due to engagement
difficulties including nonadherence with skill-building homework and early discontinuation of
treatment. Automated messaging can be used in clinical settings to increase dosage of
depression treatment and encourage sustained engagement with psychotherapy.
Objectives: The aim of this study was to test whether a text messaging adjunct (mood
monitoring text messages, treatment-related text messages, and a clinician dashboard to
display patient data) increases engagement and improves clinical outcomes in a group CBT
treatment for depression. Specifically, the investigators aim to assess whether the text
messaging adjunct led to an increase in group therapy sessions attended, an increase in
duration of therapy attended, and reductions in Patient Health Questionnaire-9 item (PHQ-9)
symptoms compared with the control condition of standard group CBT in a sample of low-income
Spanish speaking Latino patients.
Methods: Patients in an outpatient behavioral health clinic were assigned to standard group
CBT for depression (control condition; n=40) or the same treatment with the addition of a
text messaging adjunct (n=45). The adjunct consisted of a daily mood monitoring message, a
daily message reiterating the theme of that week's content, and medication and appointment
reminders. Mood data and qualitative responses were sent to a Web-based platform (HealthySMS)
for review by the therapist and displayed in session as a tool for teaching CBT skills.
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