Online cognitive behavioural therapy as an initial treatment for psychological distress in patients waiting for therapy: Study protocol

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Abstract
Background: Wait times for mental health treatment are long. This protocol describes a trial to test whether engaging in a self-directed online cognitive behavioural therapy tool (called ‘Just a Thought’) while waiting for psychological therapy is an acceptable and effective intervention for help-seeking patients. The trial will be conducted within the context of a large psychological service in Auckland, New Zealand. Methods: In this parallel group, pragmatic randomised controlled trial, consenting patients with at least five weeks to wait for their first therapy appointment will be randomly assigned to receive Just a Thought (intervention) or waitlist-as-usual conditions plus generic wellbeing information (control) while they wait. Mental health, general health and wellbeing, and treatment satisfaction will be measured across the first ten weeks of the trial, and at 8 months. Outcomes: The primary outcomes are the acceptability and effectiveness of Just a Thought as an initial treatment. Acceptability will be assessed as participants’ satisfaction, and effectiveness as change in psychological distress over time (relative to control). We hypothesise that participants will be more satisfied with Just a Thought than generic wellbeing information and that those who engage in Just a Thought will show greater reductions in psychological distress than those in the waiting-as-usual group. Conclusions: Online cognitive behavioural therapy is efficacious and has the potential to provide people experiencing psychological distress with fast access to evidence-based psychological treatment. This study will provide insight into its potential as an acceptable and effective pre-treatment for people seeking psychological help.

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