Depression is one of the most common disorders with an intense burden of disease associated with high health care costs. Currently there are 4 Million people in Germany affected by depression. However, only few are being treated effectively.

One option to supplement classical therapy concepts are provided by internet-based treatments, due to shortened waiting times, location- and time-independent help as well as lowered inhibition threshold. Ample evidence exists for the effectiveness of internet-based treatments for depression, however, not everyone is interested in only internet-based treatments. Blended treatments, including face-to-face therapy and internet-based elements, are able to add to classical treatment options.

At the beginning of 2014, E-Compared started with the European-wide task, to evaluate the effectiveness of a blended treatment of face-to-face therapy with internet- and mobile-based elements for depressive patients.

Internet-based blended treatment with Moodbuster – How does it work?
Patients are assigned to an E-COMPARED therapist (professional psychologists focusing on cognitive behavioral therapy) who is responsible for their treatment, including face-to-face sessions and the internet lessons. The first meeting is the so called “technical instruction”. In this session the therapist explains all components of the combined treatment: psychotherapy sessions, the smartphone app (mood ratings, communication with the therapist) and most important the “Moodbuster” website. Therapist and patient get to know each other during this appointment and the therapist can also help to overcome potential inhibition relating to technical requirements.

During the 10-week intervention patients work on one module per week (e.g. Psychoeducation, Behavioral Activation or Cognitive Restructuring) and receive written feedback from their therapist. Fortnightly psychotherapy sessions take place. In these sessions, online modules’ contents as well as patients’ personal topics are discussed. At the end of treatment a phone interview as well as an online assessment takes place to assess the patients’ current condition and their impressions on the treatment.

As therapists in E-COMPARED, our primary job is to do the psychotherapy sessions including documentation and coaching the patients with the Moodbuster website. It can be an advantage for us that the patients are able to educate themselves about depression information, so that these information can be used and expanded in the face-to-face sessions. Emphasis is also laid on homework assignments, which are reliably done – thanks to the internet-based modules and prompts (reminders, feedbacks). The mood evaluation through the App enables us to identify specific patterns and exceptions with the patients. Furthermore, the content and time structured treatment concept provides helpful orientation for the therapists and also creates transparency for the patients. Also, this treatment can easily be adapted to individual needs, e. g. repetition of modules as well as adding optional modules. Patients of all ages, varying disease burden, with or without previous therapy experience can be included, so that we have a diverse daily routine as therapists. First impressions of our patients show that they like to have 24/7 access to information about their disorder as well as recap exercises. The appealing and user-friendly design of our Moodbuster website is experienced as a contributing motivational factor. The content on our website is easily comprehensible, which can lead to redundant information in therapy experienced patients. Participation in this study means immediate treatment – far from routine care. Treatment starts two weeks after study application (in case of randomization). This is an interesting point from our perspective, because patients with recently developed symptoms can be helped. Overall, most of our patients are profiting from the combined treatment.

Please contact for further information.

Ingrid Titzler, M.Sc.
Lehrstuhl für Klinische Psychologie und Psychotherapie
Friedrich-Alexander-Universität Erlangen-Nürnberg