The Climate Sadness program: an open trial of Internet-based treatment for depression
Sarah Perini, Nickolai Titov, Gavin Andrews

This paper reports the results of an open trial of an Internet based clinician-assisted computerized cognitive behavioural treatment (CaCCBT) program for depression. Thirteen participants meeting Diagnostic and Statistical Manual of the American Psychiatric Disorder – 4th Edition (DSM-IV) criteria for Major Depression were recruited. Participants completed 6 on-line lessons and weekly homework assignments, received frequent email contact from a clinical psychologist, and participated in a moderated online discussion forum with other participants. Paired sample t-tests and effect sizes (Cohen’s d) were calculated using an intention-to-treat design. Seventy seven percent of participants completed the 6 lessons during the 9 week program. The pre to post-treatment effect size on the Patient Health Questionnaire – 9 Item (PHQ-9) was 1.0. Participants found the Internet treatment program acceptable and satisfactory. Mean therapist time spent per patient during the program was 208 minutes. These encouraging results are consistent with previous literature indicating that Internet-based programs for depression combined with clinical guidance can result in clinically significant improvements in outcomes for patients. These data provide further support for the development of Internet-based treatment for common mental disorders.


Clinician assisted computerized cognitive behavioural therapy; depression; treatment; Internet

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