Skip to main content
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 4
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Twomey, C. O'Reilly, G. and Byrne, M. 2015. Effectiveness of cognitive behavioural therapy for anxiety and depression in primary care: a meta-analysis. Family Practice, Vol. 32, Issue. 1, p. 3.

    Stacey, Dawn Légaré, France Col, Nananda F Bennett, Carol L Barry, Michael J Eden, Karen B Holmes-Rovner, Margaret Llewellyn-Thomas, Hilary Lyddiatt, Anne Thomson, Richard Trevena, Lyndal Wu, Julie HC and Stacey, Dawn 2014. Cochrane Database of Systematic Reviews.

    Vittengl, Jeffrey R. and Jarrett, Robin B. 2013. The Wiley Handbook of Cognitive Behavioral Therapy.

    Brown, Richard L. 2011. Configuring Health Care for Systematic Behavioral Screening and Intervention. Population Health Management, Vol. 14, Issue. 6, p. 299.


A computer-assisted depression intervention in primary care

  • W. Levin (a1), D. R. Campbell (a1), K. B. McGovern (a1), J. M. Gau (a2), D. B. Kosty (a3), J. R. Seeley (a3) and P. M. Lewinsohn (a3)
  • DOI:
  • Published online: 20 October 2010

The clinical benefit for depression of an interactive computer-assisted cognitive-behavioral program on CD-ROM, the Wellness Workshop (WW), was evaluated in a randomized controlled trial.


A total of 191 individuals referred by primary-care physicians were randomly assigned to a control group, where physician-directed treatment as usual (TAU) was provided, or to a treatment group, where TAU was supplemented with the WW CD-ROM, delivered by mail (WW+TAU). Data were collected at baseline, at 6 weeks' post-intervention, and at a 6-month follow-up assessment. Participants were given a strong incentive by a reimbursement of $75 for completion of each assessment. Measures included symptom ratings obtained via structured clinical diagnostic interviews, as well as a battery of self-report questionnaires on symptoms specifically targeted by the intervention.


Analysis of results demonstrated evidence for skill acquisition for improving dysfunctional thinking and reducing anxiety. Among those who met diagnostic criteria for depression, WW+TAU participants were three times more likely to remit at 6 weeks' post-test than TAU participants.


The evidence supports the conclusion that the WW intervention added benefit to traditional care for depression. No placebo comparison group was included and the WW+TAU participants received slightly more attention (a supportive telephone contact, ⩽5 min from a psychologist 2 weeks after receiving the program). Overall, the findings add support to the accumulating evidence for the potential clinical benefit of computer-assisted behavioral health interventions.

Corresponding author
*Address for correspondence: W. Levin, Ph.D., mPower, LLC, 2039 Harris Street, Eugene, OR 97405, USA. (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

G Andersson (2009). Using the Internet to provide cognitive behaviour therapy. Behaviour Research and Therapy 47, 175180.

G Andersson , P Cuijpers (2009). Internet-based and other computerized psychological treatments for adult depression: a meta-analysis. Cognitive Behaviour Therapy 38, 196205.

G Andrews , C Issakidis , G Carter (2001). Shortfall in mental health service utilisation. British Journal of Psychiatry 179, 417425.

RA Brown , DM Evans , IW Miller , ES Burgess , TI Mueller (1997). Cognitive-behavioral treatment for depression in alcoholism. Journal of Consulting and Clinical Psychology 65, 715726.

H Christensen , KM Griffiths , AF Jorm (2004). Delivering interventions for depression by using the internet: randomised controlled trial. British Medical Journal 328, 265.

P Cuijpers , G Andersson (2009). Special issue on computerized treatments of depression. Cognitive Behaviour Therapy 38, 193195.

P Cuijpers , RF Muñoz , GN Clarke , PM Lewinsohn (2009). Psychoeducational treatment and prevention of depression: the ‘Coping with Depression’ course thirty years later. Clinical Psychology Review 29, 449458.

P Cuijpers , F Smit , J Oostenbrink , R de Graaf , M Ten Have , A Beekman (2007). Economic costs of minor depression: a population-based study. Acta Psychiatrica Scandinavica 115, 229236.

LE de Graaf , MJH Huibers , H Riper , SAH Gerhards , A Arntz (2009). Use and acceptability of unsupported online computerized cognitive behavioral therapy for depression and associations with clinical outcome. Journal of Affective Disorders 116, 227231.

BG Danaher , HG McKay , JR Seeley (2005). The information architecture of behavior change websites. Journal of Medical Internet Research 7(2): e12.

I Elkin , MB Parloff , SW Hadley , JH Autry (1985). NIMH treatment of depression collaborative research program. Archives of General Psychiatry 42, 305316.

MD Evans , SD Hollon , RJ DeRubeis , JM Piasecki , WM Grove , MJ Garvey , VB Tuason (1992). Differential relapse following cognitive therapy and pharmacotherapy for depression. Archives of General Psychiatry 49, 802808.

E Frank , AJ Rush , M Blehar , S Essock , W Hargreaves , M Hogan , R Jarrett , RL Johnson , WJ Katon , P Lavori , JP McNulty , G Niederehe , N Ryan , G Stuart , SB Thomas , GD Tollefson , B Vitiello (2002). Skating to where the puck is going to be: a plan for clinical trials and translation research in mood disorders. Biological Psychiatry 52, 631654.

KE Green , KM Iverson (2009). Computerized cognitive-behavioral therapy in a stepped care model of treatment. Professional Psychology: Research and Practice , 96–103.

PR Grime (2004). Computerized cognitive behavioural therapy at work: a randomized controlled trial in employees with recent stress-related absenteeism. Occupational Medicine 54, 353359.

RD Hays , KB Wells , CD Sherbourne , W Rogers , K Spritzer (1995). Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses. Archives of General Psychiatry 52, 1119.

RMA Hirschfeld , JBW Williams , RL Spitzer , JR Calabrese , L Flynn , PE Keck Jr., L Lewis , SL McElroy , RM Post , DJ Rapport , JM Russell , GS Sachs , J Zajecka (2000). Development and validation of a screening instrument for bipolar spectrum disorder: the mood disorder questionnaire. American Journal of Psychiatry 157, 18731875.

SD Hollon , MO Stewart , D Strunk (2006). Enduring effects for cognitive behavior therapy in the treatment of depression and anxiety. Annual Review of Psychology 57, 285315.

E Kaltenthaler , J Brazier , E de Nigris , I Tumur , M Ferriter , C Beverley , G Parry , G Rooney , P Sutcliffe (2006). Computerised cognitive behaviour therapy for depression and anxiety update: a systematic review and economic evaluation. Health Technology Assessment 10, 1168.

E Kaltenthaler , G Parry , C Beverley , M Ferriter (2008). Computerised cognitive-behavioural therapy for depression: systematic review. British Journal of Psychiatry 193, 181184.

W Katon , H Schulberg (1992). Epidemiology of depression in primary care. General Hospital Psychiatry 14, 237247.

MB Keller , PW Lavori , B Friedman , E Nielsen , J Endicott , PA McDonald-Scott (1987). The Longitudinal Interval Follow-up Evaluation: a comprehensive method for assessing outcome in prospective longitudinal studies. Archives of General Psychiatry 44, 540548.

RC Kessler , P Berglund , O Demler , R Jin , D Koretz , KR Merikangas , AJ Rush , EE Walters , PS Wang (2003). The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). Journal of the American Medical Association 289, 30953105.

RC Kessler , KA McGonagle , S Zhao , CB Nelson , M Hughes , S Eshleman , HU Wittchen , KS Kendler (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Archives of General Psychiatry 51, 8–19.

DJ MacPhillamy , PM Lewinsohn (1982). The Pleasant Events Schedule: studies on reliability, validity, and scale intercorrelations. Journal of Consulting and Clinical Psychology 50, 363380.

J Mintz , LI Mintz , MJ Arruda , SS Hwang (1992). Treatments of depression and the functional capacity to work. Archives of General Psychiatry 49, 761768.

LS Radloff (1977). The CES-D Scale: a self-report depression scale for research in the general population. Applied Psychological Measurement 1, 385401.

MT Shea , I Elkin , SD Imber , SM Sotsky , JT Watkins , JF Collins , PA Pilkonis , E Beckham , DR Glass , RT Dolan , MB Parloff (1992). Course of depressive symptoms over follow-up: findings from the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Archives of General Psychiatry 49, 782787.

CR Snyder , SC Sympson , FC Ybasco , T Borders , MA Babyak , RL Higgins (1996). Development and validation of the State Hope Scale. Journal of Personality and Social Psychology 70, 321335.

RL Spitzer , K Kroenke , M Linzer , SR Hahn , JBW Williams , FV deGruy , D Brody , M Davies (1995). Health-related quality of life in primary care patients with mental disorders: results from the Prime-MD 1000 study. Journal of the American Medical Association 274, 15111517.

K Strosahl (1994). Entering the new frontier of managed mental health care: gold mines and land mines. Cognitive and Behavioral Practice 1, 5–23.

KB Wells , CD Sherbourne (1999). Functioning and utility for current health of patients with depression or chronic medical conditions in managed, primary care practices. Archives of General Psychiatry 56, 897904.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *