Telephone-supported computerised cognitive–behavioural therapy: REEACT-2 - A large scale pragmatic randomised trial of telephone-supported computerised Cognitive Behaviour Therapy

Background Computerised cognitive behaviour therapy (cCBT) for depression has the potential to be efficient therapy but engagement is poor in primary care trials. Aim We tested the benefits of adding telephone-support to cCBT. Methods We compared telephone-facilitated cCBT (MoodGYM) (n=187) to minimally-supported cCBT (MoodGYM) (n=182) in a pragmatic randomised trial (RCT). Outcomes were depression severity (PHQ9), anxiety (GAD7), and somatoform complaints (PHQ15) at 4 & 12 months. Results cCBT use increased by a factor of between 1.5 and with telephone-facilitation. At four months PHQ-9 scores were 1.9 points lower (95% CI 0.5 to 3.3) for telephone supported cCBT. At 12 months the results were no longer statistically significant (0.9 PHQ9 points; 95%CI -0.5 to 2.3). There was improvement in anxiety scores and for somatic complaints. Discussion Telephone facilitation of cCBT improves engagement and expedites depression improvement. The effect was small to moderate and comparable with other low intensity psychological interventions.