This application proposes to develop and pilot several variants of Internet WWW mental health """"""""self help"""""""" skills training sites for children, adolescents and parents. The two main interventions will address adolescent depression and child behavior problems, as representatives of internalizing and externalizing disorders. The development process will involve piloting these skills-training Web interventions in several representative settings--a large non-profit HMO, a public health clinic, and in public schools--while integrating them with more traditional health care delivery. Users will be permitted to log onto the interventions Web sites from the home or work settings as well. Using both qualitative and quantitative data, we will evaluate the acceptability and satisfaction with these interventions from the perspective of users (patients themselves), providers, and other pertinent stakeholders in each of the settings listed above. We will also conduct effect-size and effect-size variability estimates of the impact of these interventions on both clinical outcomes as well as health care utilization and costs, as a preliminary to conducting full randomized controlled trials. The research team will build on their experiences developing and evaluating several in-person psychotherapy treatments, an Internet depression intervention for adults, and an interactive multimedia software for assessing and intervening with disruptive behavior disorders. This proposed Internet-based intervention development application is significant because (1) Web-based interventions may help address unmet need, and overcome barriers to mental health service; (2) The intervention takes a public health perspective that is unusual in mental health. There will likely be low intensity intervention effects, but because the program will be available to a much larger percentage of the population than typically receives person-to-person services, the overall population effect is likely to be of significant magnitude; (3) The low intensity nature and low incremental cost of delivery of the Web-based interventions suggest that they may be cost-effective; (4) The proposed web interventions address a gap in the existing pool of mental health resources on the Internet at the present time, because they will provide access to Internet-appropriate versions of rigorously tested, research based interventions.
| Clarke, Greg; Kelleher, Chris; Hornbrook, Matt et al. (2009) Randomized effectiveness trial of an Internet, pure self-help, cognitive behavioral intervention for depressive symptoms in young adults. Cogn Behav Ther 38:222-34 |
