Principal Results
depression, anxiety
LITTLE
This is one of the first studies to compare message-based care to the standard of care for the treatment of depression in a randomized clinical trial. We found that message-based care results in similar, positive outcomes to standard psychotherapy practice delivered over videoconferencing. Importantly, the magnitudes of change between pretreatment and posttreatment and between pretreatment and 6-month follow-up, as well as the rates of change over the course of treatment, were not smaller than those experienced by participants in the video-based treatment condition. Between pretreatment and 6-month follow-up, the effect sizes for message-based care were medium to large.Importantly, not only did we find positive effects of message-based care on depression, anxiety, and functioning, but participants also found this method of care delivery to be credible and acceptable. There is considerable discussion in the field of digital mental health about the sporadic use of technology, where most people will use technology and quickly abandon it. Little is known as to the cause of this pattern of use, as assessments of credibility, acceptability, and utility are rarely collected. Our data find that, compared to what is evident in the use of digital mental health in research studies and the general community, these participants completed most sessions available to them and reported high levels of working alliance and engagement in the message-based treatment condition, comparable to those in the video-based treatment condition.