NCT04264585

Brief Summary

Post-secondary students are at an elevated risk for anxiety and depression, with approximately one in three students experiencing clinical levels of symptoms at some point during their academic career. Despite the high prevalence of these mental health concerns, many students do not receive adequate treatment. Internet-delivered cognitive behaviour therapy (ICBT) is an alternative to face-to-face service that is effective for improving symptoms of anxiety and depression in general adult populations. Recently, there has been increasing interest in the use of ICBT in post-secondary populations, however high drop-out rates and small effect sizes suggest that current ICBT programs are not fully meeting students' specific needs. Additional research is necessary to ensure that ICBT is delivered to students in a manner that is both acceptable and effective. The proposed study will be an implementation trial to examine whether the efficacy of an ICBT course for post-secondary students is improved by offering a motivational interviewing component at pre-treatment and a booster session 1-month after completing treatment. Follow-up assessment will be conducted as 3-month post-treatment. Primary outcomes are anxiety, depression, and academic functioning. Implementation outcomes will include measures of the acceptability, adoption, and fidelity (assessed by number of modules completed) of the ICBT course.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
308

participants targeted

Target at P75+ for not_applicable anxiety

Timeline
Completed

Started Feb 2020

Typical duration for not_applicable anxiety

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

February 7, 2020

Completed
4 days until next milestone

First Posted

Study publicly available on registry

February 11, 2020

Completed
17 days until next milestone

Study Start

First participant enrolled

February 28, 2020

Completed
1.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 26, 2021

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 26, 2021

Completed
Last Updated

November 18, 2021

Status Verified

November 1, 2021

Enrollment Period

1.3 years

First QC Date

February 7, 2020

Last Update Submit

November 17, 2021

Conditions

Keywords

anxietydepressionpost-secondary studentsinternet-delivered cognitive behaviour therapyrandomized controlled trialpatient-centredtherapist-assistance

Outcome Measures

Primary Outcomes (2)

  • Patient Health Questionnaire 9-item (PHQ-9)

    Change in depression symptoms. 9 items are summed into a total score, with scores ranging from 0 to 27. Higher scores are associated with higher depression severity.

    Baseline (screening), weeks 1-6, 9, and 17

  • Generalized Anxiety Disorder 7-item (GAD-7)

    Change in anxiety symptoms. 7 items are summed into a total score ranging from 0 to 21, with higher scores indicating more severe self-reported levels of anxiety.

    Baseline (screening), weeks 1-6, 9, and 17

Secondary Outcomes (7)

  • Sheehan Disability Scale (SDS)

    Baseline (screening), week 6, 9, and 17

  • Alcohol Use Disorders Identification Test (AUDIT)

    Baseline (screening), week 6, and week 9

  • Drug Use Disorders Identification Test (DUDIT)

    Baseline (screening), week 6, and week 9

  • Academic functioning

    Baseline (screening), weeks 1-6, 9, and 17

  • Treatment credibility.

    Baseline (screening), week 6

  • +2 more secondary outcomes

Study Arms (4)

Standard ICBT

EXPERIMENTAL

Clients assigned to the Standard ICBT condition will receive the standard version of the ICBT course, which consists of four lessons spread across the span of five weeks. Clients will receive five weeks of therapist support.

Behavioral: Internet-delivered cognitive behaviour therapy

ICBT with Motivational Interviewing

EXPERIMENTAL

Clients assigned to the ICBT with Motivational Interviewing condition will receive the Planning for Change lesson before Lesson 1 of the UniWellbeing Course.

Behavioral: Internet-delivered cognitive behaviour therapyBehavioral: Motivational Interviewing

ICBT with Booster

EXPERIMENTAL

Clients assigned to the ICBT with Booster condition will receive access to a booster session one month after the end of the ICBT course.

Behavioral: Internet-delivered cognitive behaviour therapyBehavioral: Booster Session

ICBT with Motivational Interviewing and Booster

EXPERIMENTAL

Clients assigned to the ICBT with Motivational Interviewing and Booster condition will receive access to both the Motivational Interviewing content (before Lesson 1 of the UniWellbeing Course) and the booster session (one month after ICBT course).

Behavioral: Internet-delivered cognitive behaviour therapyBehavioral: Motivational InterviewingBehavioral: Booster Session

Interventions

All clients will receive the same materials, namely the UniWellbeing Course, which was developed at Macquarie University, Australia. The UniWellbeing Course is a transdiagnostic intervention targeting symptoms of depression and anxiety, that has been tailored for use in post-secondary students. It comprises 4 online lessons that provide psychoeducation about: symptom identification and the cognitive behavioural model; thought monitoring and challenging; de-arousal strategies and pleasant activity scheduling; graduated exposure; and relapse prevention. Seven supplementary lessons can also be accessed at any time (e.g., sleep, communication). Materials are presented in a didactic (i.e., text-based with visual images) and case-enhanced learning format (i.e., educational stories demonstrate the application of skills) with 4 lesson summaries and homework assignments that facilitate skill acquisition. Therapists will spend \~15 mins. per week/per client.

ICBT with BoosterICBT with Motivational InterviewingICBT with Motivational Interviewing and BoosterStandard ICBT

Clients assigned to the ICBT with Motivational Interviewing condition will receive access to the Planning for Change lesson before accessing Lesson 1. They will be presented with five interactive online exercises based on motivational interviewing principles (i.e. values clarification, importance ruler, looking back, confidence ruler, and looking forward). As clients complete the exercises, they are prompted to answer open-ended questions and are provided with written feedback.

ICBT with Motivational InterviewingICBT with Motivational Interviewing and Booster
Booster SessionBEHAVIORAL

Clients assigned to the ICBT with Booster condition will receive access to a booster session one month after the end of the ICBT course. The booster session will include information about maintaining motivation, a review of the ICBT course content and skills, and information about structured problem solving. Clients will also have access to a Do-It-Yourself guide that summarizes the information in the booster session and includes worksheets for clients to practice the problem-solving skills described in the booster. This booster session will be self-guided (ie. no therapist support is offered).

ICBT with BoosterICBT with Motivational Interviewing and Booster

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • registered as a student at a post-secondary institution in Saskatchewan; over the age of 18;endorse symptoms of depression and/or anxiety; be able to access computers and the Internet and be comfortable using them; and willing to provide a physician as an emergency contact

You may not qualify if:

  • high risk of suicide or hospitalization for mental health in previous 12 months
  • unmanaged alcohol or drug use problems
  • severe psychiatric illness that is not managed (e.g. psychosis or mania)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Online Therapy Unit University of Regina

Regina, Saskatchewan, S4S 0A2, Canada

Location

Related Publications (1)

  • Peynenburg V, Hadjistavropoulos H, Thiessen D, Titov N, Dear B. Internet-Delivered Cognitive Behavioral Therapy for Postsecondary Students: Randomized Factorial Trial for Examining Motivational Interviewing and Booster Lessons. J Med Internet Res. 2022 Sep 7;24(9):e40637. doi: 10.2196/40637.

MeSH Terms

Conditions

Anxiety DisordersDepression

Interventions

Motivational Interviewing

Condition Hierarchy (Ancestors)

Mental DisordersBehavioral SymptomsBehavior

Intervention Hierarchy (Ancestors)

Directive CounselingCounselingMental Health ServicesBehavioral Disciplines and ActivitiesHealth ServicesHealth Care Facilities Workforce and Services

Study Officials

  • Vanessa Peynenburg, MA

    University of Regina

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
FACTORIAL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 7, 2020

First Posted

February 11, 2020

Study Start

February 28, 2020

Primary Completion

June 26, 2021

Study Completion

June 26, 2021

Last Updated

November 18, 2021

Record last verified: 2021-11

Locations