We go online to access many of the everyday services we need. But when it comes to something as personal as therapy for behavioral health conditions like depression and anxiety, can the internet offer a solution?
An innovative program from Partners HealthCare suggests it can. Internet-based CBT (Cognitive Behavioral Therapy), or iCBT, teaches patients skills commonly learned from in-person CBT sessions from the comfort and privacy of their own homes. Originally developed at a care center in Australia, the iCBT method was adopted by Partners in a 2015 McLean Hospital pilot, leading to a randomized controlled McLean study demonstrating significant reduction in depression symptoms with the method.
The online program is offered through primary care practices on Epic across the Partners network, with modules to treat three separate conditions: depression, Generalized Anxiety Disorder (GAD), and mixed anxiety and depression. The treatment is composed of six lessons, framed in a comics-like format using relatable character personas. Users log onto the system to view a lesson, complete homework, and report on their activities, thoughts, and symptoms. Exercises throughout the lessons teach users how to identify, challenge, and change negative or distorted thinking patterns and maladaptive behaviors. New lessons become available each week until the patient completes the module.
Since adding both the Generalized Anxiety Disorder (GAD) and mixed anxiety and depression modules in December 2018, Partners has seen average monthly enrollment rates increase from 47 to 93 new patients a month, across the practices that offer the program. The system is now considering both Spanish-based modules as well as additional modules addressing other behavioral health concerns. The team is also exploring the functionality of an iCBT mobile app, so patients could access the program directly on their phones.
“I find it extremely helpful to many patients who are willing to put in the effort to do the work,” says Jenn Doyle, a Behavioral Health Support Specialist embedded at Charles River Medical Associates (a group of Partners HealthCare-affiliated primary care practices). “People who complete the program have significantly lowered their anxiety and depression symptom scores.”
Read more about the innovation and how it’s helping Partners patients here.