Blended Care Versus Face-to-Face Therapy for Depression (BLENDED)
Major Depressive Disorder
About this trial
This is an interventional treatment trial for Major Depressive Disorder focused on measuring depression, psychotherapy, blended, cognitive behavioral, psychodynamic
Eligibility Criteria
Inclusion Criteria:
- Age 18-65
- Current diagnosis of major depressive disorder with or without dysthymic disorder according to DSM 5 criteria.
- PHQ score ≥ 10.
Note: Use of pharmacotherapy for depression and other psychiatric disorders during the intervention is allowed (with the exception of antipsychotic medication for psychotic disorder), as this reflects routine clinical care. Of note, in routine clinical care, it is not uncommon that antipsychotic medication is prescribed for symptoms in the depressive-anxious cluster rather than for primary psychotic symptoms.
Exclusion Criteria:
- Current psychotic symptoms or bipolar disorder.
- Current use of antipsychotic medication specifically for the treatment of primary psychotic disorder.
- Severe Personality Disorder (e.g., borderline personality disorder).
- Historic or current self-injury/parasuicide of such extent and/or severity that may substantially interfere with the ability to engage in brief psychotherapy.
- Current excessive use of drugs/alcohol.
- Not fluent in Dutch.
- Clinical contra-indication to brief psychotherapy (e.g., attachment history - multiple separations, serious ongoing trauma in childhood, multiple caregivers - suggesting the need for longer-term psychotherapy).
- Evidence of pervasive use of help.
- Highly unstable or insecure life arrangements.
- No access to computer/internet or computer illiteracy.
- Participation in another depression clinical trial within the last year where the participant has received CBT or PDT.
Sites / Locations
- CGG AndanteRecruiting
- CGG VaggaRecruiting
- CGG Mandel & LeieRecruiting
- CGG VBORecruiting
- CGG De PontRecruiting
- CGG KempenRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Experimental
Active Comparator
Active Comparator
Blended Dynamic Interpersonal Therapy (B-DIT)
Blended Cognitive Behavioral Therapy (B-CBT)
Dynamic Interpersonal Therapy (DIT)
Cognitive Behavioral Therapy (CBT)
B-DIT is based on the same treatment principles as face-to-face Dynamic Interpersonal Therapy (DIT) and has the same structure of treatment consisting of three phases: (a) an exploration and engagement phase, (b) a middle or working through phase, and (c) an ending phase. B-DIT consists of 8 online modules that are alternated with up to 8 fortnightly face-to-face sessions.
B-CBT is based on the same treatment principles as face-to-face Cognitive Behavioral Therapy (CBT). These include (a) psycho-education about depression, (b) cognitive restructuring (i.e., identifying and challenging maladaptive thoughts and beliefs, fostering problem solving capacities), (c) mindfulness and acceptance based approaches, and (d) relapse prevention. B-CBT in this trial consists of 8 online modules that are alternated with up to 8 fortnightly face-to-face sessions.
DIT is a short-term, integrative psychodynamic, 16 weekly sessions individual therapy for depression. DIT formulates the presenting symptoms of depression as responses to interpersonal difficulties or perceived threats to attachments (loss/separation) and hence also as threats to the self.
CBT is a brief talking therapy that consists of a maximum of 16 sessions, offered over 4 to 6 months. CBT is based on the assumption that depression is directly related to patterns of thinking. Specifically, dysfunctional and often automatic patterns of thinking are assumed to be related to the onset and maintenance of depression.