Guided self-help course on the Internet for Turkish migrants with depression: a randomised controlled trial

The Turkish population living in the Netherlands has a high prevalence of
psychological complaints and experiences a high threshold for seeking
professional help for these problems. Seeking help through the Internet can
bridge these barriers. This project aims to evaluate the effectiveness of
"Alles Onder Controle TR" (in Dutch and Turkish), a web-based guided self-help
intervention for depressed Turkish migrants.

This study will investigate the effectiveness of a culturally adapted and
internet-based guided self-help intervention among Turkish migrants, in terms
of reduction of depressive symptoms (CES-D). As a secondary objective, the
underlying mechanisms of change will be measured in terms of somatic symptoms,
anxiety, acculturation, satisfaction and the quality of life.

This study is a randomized controlled trial with two conditions 1) web-based
guided self-help intervention (experimental group) and 2) the wait-list control
group (access to the intervention after 4 months).

The intervention we will evaluate is the adapted version of the original
website Alles Onder Controle (AOC; Allesondercontrole.nu), a brief problem
solving intervention based on *self-examination* therapy (Bowman et al, 1995):
Alles Onder Controle TR (in Dutch) and Her *ey Kontrol Alt*nda (in Turkish).

The course is available in two languages and both are adapted by a Turkish
psychologist in collaboration with the VU University, by:
- cultural sensitivity in the languages and presentation concerning
psychological problems
- use of cultural specific cases and problems that are recognizable for the
target group concerned
- cultural specific examples of persons with similar problems

The intervention consists of 5 sessions and takes 5 weeks in total. During that
period the respondents indicate what they think is important in their lives,
they make a list of their *problems and worries* and they categorize their
problems into three groups: unimportant (not related to what they think is
important in their lives), important and solvable (these problems are solved by
a systematic problem-solving approach consisting of 6 steps), or important but
unsolvable (for example having lost someone by death, having a chronic general
medical disease; for these problems they make a plan how to live with it). At
the end of the course, the participant will receive a certificate for
successfully completing the course.

For the study, participants will be asked to complete 3 questionnaires during 4
months. One questionnaire takes 30 minutes. The total amount for following the
intervention varies per participant. Ideally, it will take on average 20
minutes each day. By participating to the study, participants don*t run any
known or notable risks. Participants have always the opportunity to withdraw
from this study without obligation to state their reasons and can decide by
their own the amount of spent time during the study. We expect that
participants with depressive complaints will benefit from the intervention if
it works as expected. Overall, all participants are free to take medicine,
therapy by a professional or seek for help for their complaints.