Computerized Cognitive Behavioral Therapy: Engaging and Maintaining Community Mental Health Center Patients

Kaitlin Boger, School of Educational Leadership for Change

The Substance Abuse and Mental Health Services Administration (SAMHSA) National Registry of Evidence-based Programs and Practices (NREPP) (SAMHSA NREPP, 2014a) listed Beating the Blues (BTB) as an effective treatment for mild to moderate depression and anxiety. In this study I examined how BTB works with a sample of U.S. patients, some of whom had severe depression and/or anxiety symptoms. The purpose of this study was to determine what additional aspects could improve the BTB program as used in a Community Mental Health Center (CMHC). I used a mixed method approach to answer these research questions:

1. What aspects of BTB work effectively and efficiently for participants?

2. What aspects of BTB do not work effectively or efficiently and how would participants recommend they be improved?

3. How effective is BTB for people who experience severe depression and/or anxiety?

I gathered data from:

(a) The reports that the software generated which included the participants’ Patient Health Questionnaire-9 item (PHQ-9) score and their Generalized Anxiety Disorder-7 item (GAD-7) score.

(b) The Beating the Blues feedback forms, which used 12 questions to gauge how participants felt the program could be improved.

(c) Individual narratives from participants.

I found that, overall, BTB participants at the CMHC benefited from using the BTB program. Participants noted enjoying the coaching aspects of the program as well as the technology aspects of the program. Participants with severe symptoms were not significantly more likely to complete the program than participants with non-severe symptoms. Males were more likely to complete the program than females. Referral sources appeared to impact results; those who were referred by their primary care physicians completed more sessions than those referred by other sources. Implications of the study included considering BTB as a first step when patients have mild to moderate or severe anxiety and/or depression since BTB appears to allow severe participants to decrease into a moderate range.

Keywords: Beating the Blues, computerized cognitive behavioral therapy, patient experience, mixed methods, effective, efficient, depression, anxiety, severe, mental health, community mental health center