Effectiveness of a Transdiagnostic Guided Internet-Delivered Protocol for Emotional Disorders Versus Treatment as Usual in Specialized Care: Randomized Controlled Trial

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Abstract

Background

Anxiety disorders and depression (emotional disorders) are highly prevalent mental disorders. Extensive empirical evidence supports the efficacy of cognitive behavioral therapy (CBT) for the treatment of these disorders. However, there are still some barriers related to their dissemination and implementation, which make it difficult for patients to receive these treatments, especially in public health care settings where resources are limited. Recent advances in improving CBT dissemination encompass different perspectives. One is the transdiagnostic approach, which offers treatment protocols that can be used for a range of emotional disorders. Another approach is the use of the internet to reach a larger number of people who could benefit from CBT.

Objective

This study aimed to analyze the effectiveness and acceptability of a transdiagnostic internet-delivered protocol (EmotionRegulation) with human and automated guidance in patients from public specialized mental health care settings.

Methods

A 2-armed randomized controlled trial (RCT) was conducted to compare the effectiveness of EmotionRegulation with treatment as usual (TAU) in specialized mental health care. In all, 214 participants were randomly assigned to receive either EmotionRegulation (n=106) or TAU (n=108). Measurement assessments were conducted at pre- and postintervention and at a 3-month follow-up.

Results

The results revealed the superiority of EmotionRegulation over TAU on measures of depression ( d=0.41), anxiety ( d=0.35), and health-related quality of life ( d=−0.45) at posttreatment, and these gains were maintained at the 3-month follow-up. Furthermore, the results for expectations and opinions showed that EmotionRegulation was well accepted by participants.

Conclusions

EmotionRegulation was more effective than TAU for the treatment of emotional disorders in the Spanish public mental health system. The implications of this RCT, limitations, and suggestions for future research are discussed.

Trial Registration

ClinicalTrials.gov NCT02345668; https://clinicaltrials.gov/ct2/show/NCT02345668

Related collections

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Author and article information

Contributors

Alberto González-Robles:

ORCID: https://orcid.org/0000-0002-3749-3756

Department of Basic and Clinical Psychology, and PsychobiologyUniversitat Jaume ISos Baynat Avenue, Campus del Riu SecResearch II Building, LabpsitecCastellón de la Plana, 12071Spain34 964387646 ext 7646vrobles@uji.es

Journal

Journal ID (nlm-ta): J Med Internet Res

Journal ID (iso-abbrev): J. Med. Internet Res

Journal ID (publisher-id): JMIR

Title: Journal of Medical Internet Research

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Print): 1439-4456

ISSN (Electronic): 1438-8871

Publication date Collection: July 2020

Publication date (Electronic): 7 July 2020

Volume: 22

Issue: 7

Electronic Location Identifier: e18220

Affiliations

[1 ] Department of Basic and Clinical Psychology, and Psychobiology Universitat Jaume I Castellón de la Plana Spain

[2 ] CIBER Fisiopatología Obesidad y Nutrición (CIBERObn) Instituto Carlos III Madrid Spain

[3 ] Department of Personality, Assessment, and Clinical Psychology Universidad Complutense de Madrid Madrid Spain

[4 ] Department of Psychiatry Hospital Universitari Vall d'Hebron Barcelona Spain

[5 ] Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR) Barcelona Spain

[6 ] Biomedical Network Research Centre on Mental Health (CIBERSAM) Barcelona Spain

[7 ] Department of Psychiatry and Forensic Medicine Universitat Autònoma de Barcelona Barcelona Spain

Author notes

Corresponding Author: Alberto González-Robles vrobles@ 123456uji.es

Author information

Alberto González-Robles https://orcid.org/0000-0002-3749-3756

Amanda Díaz-García https://orcid.org/0000-0003-4398-4014

Azucena García-Palacios https://orcid.org/0000-0001-9250-8714

Pablo Roca https://orcid.org/0000-0001-9815-4902

Josep Antoni Ramos-Quiroga https://orcid.org/0000-0003-1622-0350

Cristina Botella https://orcid.org/0000-0001-8783-6959

Article

Publisher ID: v22i7e18220

DOI: 10.2196/18220

PMC ID: 7381075

PubMed ID: 32673226

SO-VID: 32a3d539-b388-47a5-a5bf-9c0ba43edca0

Copyright © ©Alberto González-Robles, Amanda Díaz-García, Azucena García-Palacios, Pablo Roca, Josep Antoni Ramos-Quiroga, Cristina Botella. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 07.07.2020.

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

History

Date received : 14 February 2020

Date revision requested : 24 March 2020

Date revision received : 8 April 2020

Date accepted : 8 April 2020

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