Beating the Blues.

This study compares computerized cognitive behavioural therapy with limited therapist support to face-to-face therapy based on cognitive behavioural techniques in a (non-inferiority) randomized trial. The study will focus will be on clinical and cost effectiveness.

On the basis of the available literature, we hypothesize that the clinical and cost effectiveness of computerized cognitive-behavioural therapy with limited therapist support is not inferior (by an amount of delta = 0.2) to face-to-face therapy based on cognitive behavioural techniques.

1. Baseline;

2. Mid-treatment;

3. Post-treatment;

4. Six-month follow-up;

5. Twelve-month follow-up.

The CCBT program that is going to be used in this study is Beating the Blues (BtB). BtB is based on cognitive-behavioural techniques and consists of an introductory video and eight computerized sessions, lasting around fifty minutes. The sessions are (inter)active and based on cognitive behavioural techniques, clarified with the help of animations and case-studies. Each session ends with a summary and several homework assignments. Furthermore, both the therapist and the client receive a progress report after each session. The complete program minimally takes eight weeks. The client is encouraged to go through one session each week, and to schedule all of the sessions in his or her diary beforehand. During the BtB program, the therapists meet their client three times in face-to-face sessions of 45 minutes each:

1. Before the program - for an intake;

2. After the fourth session - for motivation and support;

3. After the program - for an evaluation.



The alternative to CCBT in this study is face-to-face therapy based on cognitive-behavioural techniques. The face-to-face therapy lasts minimally eight and maximally sixteen weeks, with eight to nine sessions of 45 minutes each. The client is supposed to do home work assignments after each session. In order to ensure that the therapists indeed do apply cognitive-behavioural techniques, a random selection of five percent of the sessions will be video-taped. These videos will be analyzed for their cognitive-behavioural content by independent therapists.