MindSpot Clinic: An Accessible, Efficient, and Effective Online Treatment Service for Anxiety and Depression

Psychiatr Serv. 2015 Oct;66(10):1043-50. doi: 10.1176/appi.ps.201400477. Epub 2015 Jul 1.

Abstract

Objective: The main objective of this study was to report the feasibility of delivering online cognitive-behavioral therapy (iCBT) treatments for anxiety and depression in a national public mental health service.

Methods: A prospective noncontrolled cohort study was conducted of all patients who began assessment or treatment at the MindSpot Clinic from January through December 2013. Clinic services were used by a representative cross-section of the Australian population. Mean age at assessment was 36.4±13.0 years, and age range was 18-86 years. Patients completed one of four online courses over eight weeks, during which they received weekly support from a therapist via telephone or secure e-mail. Primary outcome measures were the nine-item Patient Health Questionnaire (PHQ-9) and the seven-item Generalized Anxiety Disorder scale (GAD-7) administered at posttreatment and three months posttreatment.

Results: A total of 10,293 adults who self-identified as having problems with anxiety or depression commenced assessment, and 7,172 completed the assessment and were eligible for analysis. Of these, 2,049 enrolled in a course and 1,471 completed the course, for a course completion rate of 71.8%. Moderate to large noncontrolled effect sizes (Cohen's d=.67-1.66, 95% confidence interval=.08-2.07) were found from assessment to three-month follow-up. At posttreatment and follow-up, reliable recovery ranged from 46.7% to 51.1%, and deterioration ranged from 1.9% to 3.8%. Mean total therapist time per patient was 111.8±61.6 minutes.

Conclusions: The MindSpot Clinic produced treatment outcomes that were comparable to results from published clinical trials of iCBT. This model of service delivery represents an innovative method of providing accessible, low-cost, effective, and acceptable mental health services to many people who currently are not receiving care.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Ambulatory Care Facilities
  • Anxiety Disorders / therapy*
  • Australia
  • Cognitive Behavioral Therapy / methods*
  • Depressive Disorder / therapy*
  • Electronic Mail
  • Female
  • Humans
  • Internet*
  • Male
  • Mental Health Services / economics*
  • Middle Aged
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Surveys and Questionnaires
  • Telemedicine
  • Treatment Outcome
  • Young Adult