Trial reportBehaviour research and therapy2019
A randomized noninferiority trial evaluating remotely-delivered stepped care for depression using internet cognitive behavioral therapy (CBT) and telephone CBT.
Trial report in Behaviour research and therapy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 36 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Stepped Telemental Health Care Intervention for Depression
SUPERA: Supporting Peer Interactions to Expand Access to Digital Cognitive Behavioral Therapy for Spanish-speaking Safety-Net Patients in Primary Care
Who cites it
36 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Next-Generation Cognitive-Behavioral Therapy for Depression: Integrating Digital Tools, Teletherapy, and Personalization for Enhanced Mental Health Outcomes.Medicina (Kaunas, Lithuania) · 2025Pooled it
- Effectiveness and Acceptance of Technology-Based Psychological Interventions for the Acute Treatment of Unipolar Depression: Systematic Review and Meta-analysis.Journal of medical Internet research · 2021Pooled it
- Personalized Transdiagnostic Cognitive Behavior Therapy With Midtreatment Stepped Care to Improve Mental Health Among University Students in Sweden: Feasibility Study for a Randomized Controlled Trial.JMIR formative research · 2026Trial
- Incorporating a Stepped Care Approach Into Internet-Based Cognitive Behavioral Therapy for Depression: Randomized Controlled Trial.JMIR mental health · 2024Trial
- User Engagement Clusters of an 8-Week Digital Mental Health Intervention Guided by a Relational Agent (Woebot): Exploratory Study.Journal of medical Internet research · 2023Trial
- Improving Cost-effectiveness and Access to Cognitive Behavior Therapy for Depression: Providing Remote-Ready, Computer-Assisted Psychotherapy in Times of Crisis and Beyond.Psychotherapy and psychosomatics · 2020Trial
- Stepping Up: Predictors of 'Stepping' within an iCBT Stepped-Care Intervention for Depression.International journal of environmental research and public health · 2019Trial
- Therapists' time allocation in guided digital mental health interventions - A scoping review and case study.Internet interventions · 2026Review
- Investigating the Role of Situational Disruptors in Engagement with Digital Mental Health Tools.CSCW : proceedings of the Conference on Computer-Supported Cooperative Work. Conference on Computer-Supported Cooperative Work · 2025Article
- Insights from fifteen years of real-world development, testing and implementation of youth digital mental health interventions.Internet interventions · 2025Review
- A framework for designing hybrid effectiveness-implementation trials for digital health interventions.Annals of epidemiology · 2025Article
- Long-term outcomes of smartphone-delivered cognitive behavior therapy for body dysmorphic disorder: A one-year naturalistic follow-up.Internet interventions · 2025Article
- The Use of Text Messaging as an Adjunct to Internet-Based Cognitive Behavioral Therapy for Major Depressive Disorder in Youth: Secondary Analysis.JMIR formative research · 2024Article
- Predicting recurrent chat contact in a psychological intervention for the youth using natural language processing.NPJ digital medicine · 2024Article
- Internet- and mobile-based aftercare and relapse prevention interventions for anxiety and depressive disorders: a systematic review.Frontiers in psychology · 2024Review
- Peer-supported mobile mental health for veterans in primary care: A pilot study.Psychological services · 2023Article
- A Qualitative Exploration of General Practitioners' Treatment Decision-Making for Depressive Symptoms.Medical decision making : an international journal of the Society for Medical Decision Making · 2023Article
- User experiences of an online therapist-guided psychotherapy platform, OPTT: A cross-sectional study.Internet interventions · 2023Article
- Effectiveness and implementation of an electronic health record-integrated digital health intervention for managing depressive symptoms in ambulatory oncology: The My Well-Being Guide study rationale and protocol.Contemporary clinical trials · 2023Article
- A Bayesian Reanalysis of a Trial of Psilocybin versus Escitalopram for Depression.Psychedelic medicine (New Rochelle, N.Y.) · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
This trial examined whether a stepped care program for depression, which initiated treatment with internet cognitive behavioral therapy, including telephone and messaging support, and stepped up non-responders to telephone-administered cognitive behavioral therapy (tCBT), was noninferior, less costly to deliver, and as acceptable to patients compared to tCBT alone. Adults with a diagnosis of major depressive episode (MDE) were randomized to receive up to 20 weeks of stepped care or tCBT. Stepped care (n = 134) was noninferior to tCBT (n = 136) with an end-of-treatment effect size of d = 0.03 and a 6-month post-treatment effect size of d = -0.07 [90% CI 0.29 to 0.14]. Therapist time in stepped care was 5.26 (SD = 3.08) hours versus 10.16 (SD 4.01) for tCBT (p < 0.0001), with a delivery cost difference of $-364.32 [95% CI $-423.68 to $-304.96]. There was no significant difference in pre-treatment preferences (p = 0.10) or treatment dropout (39 in stepped care; 27 in tCBT; p = 0.14). tCBT patients were significantly more satisfied than stepped care patients with the treatment they received (p < 0.0001). These findings indicate that stepped care was less costly to deliver, but no less effective than tCBT. There was no significant difference in treatment preference or completion, however satisfaction with treatment was higher in tCBT than stepped care.
trial registrationclinicaltrials.gov Identifier: NCT01906476.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.