asynchronous techniques for the delivery of empirically supported psychotherapies

Conditions: Depressive Symptoms; Anxiety; Stress; Impairment

Summary: the aim of this study is to test the feasibility, acceptability and efficacy of methods for delivering mental health support when real-time communication is not possible (e.g. on long duration space flights where communication lags of up to 45 minutes are anticipated). the investigators hypothesize that the two enhanced treatment conditions (i.e., those with therapist support) will outperform the online self-management program without support. the investigators also predict that outcomes for the two enhanced conditions will be comparable to those reported in the literature for in-person psychotherapy programs.

the aim of this study is to test the feasibility, acceptability and efficacy of methods for delivering mental health support when real-time communication is not possible (e.g. on long duration space flights where communication lags of up to 45 minutes are anticipated). participants will be healthy, high functioning adults (e.g., medical residents, postdoctoral fellows in the sciences, math, and engineering) who report elevated psychological distress, mood or anxiety symptoms. participants will complete a self-guided online therapy program (mycompass) and will be randomized to receive one of the following: (1) online therapy without therapist support, 2) online therapy plus therapist support via electronic text-based messaging (i.e., secure email), or 3) online therapy plus therapist support via video messaging. outcomes will be evaluated weekly via online self-report measures of psychological distress, mood, anxiety, number of hours and quality of sleep, fatigue, and resiliency indicators (i.e., coping and mindfulness). the investigators will examine changes over time in outcomes across all three groups. the investigators hypothesize that the two enhanced treatment conditions (i.e., those with therapist support) will outperform the online self-management program without support. the investigators also predict that outcomes for the two enhanced conditions will be comparable to those reported in the literature for in-person psychotherapy programs.

Eligibility criteria:
inclusion criteria: 1. 18+years old; 2. masters of art degree or higher in social/biomedical(medicine)/physical science, engineering or mathematics 3. current elevated distress as measured by the depression anxiety and stress scale, 21 item version(≥ 5 on dass depression subscale or ≥ 4 on dass anxiety subscale or ≥ 8 on dass stress subscale) (dass, lovibond \& lovibond, 1995); and, (5) ≥ 5 on any subscale of the sheehan disability scale (sds, sheehan 1983). exclusion criteria: 1. any current or recent (i.e. past month) suicide ideation 2. any history of suicide attempt (within past 5 years) 3. serious mental illness (i.e., psychosis, mania) 4. alcohol or substance dependency during the past 6 months 5. serious medical problems (e.g., seizures, cancer) 6. current participation in psychotherapy 7. new use of psychoactive medications (i.e., benzodiazepines for less than 1 month or selective serotonin reuptake inhibitors \[ssris\], tricyclics, or serotonin-norepinephrine reuptake inhibitors \[snris\] for less than 3 months).