exploring use of internet-delivered cognitive behaviour therapy (icbt) by diverse ethnocultural people of saskatchewan

Conditions: Anxiety; Depression

Summary: in an attempt to increase timely and accessible psychological treatment for depression and anxiety, internet-delivered cognitive behaviour therapy (icbt) has emerged. in icbt, patients review treatment materials online and complete relevant exercises to learn cognitive behavioural strategies. they also commonly access brief therapist support through weekly emails or phone calls. data analysis of icbt offered via the online therapy unit in saskatchewan has found lower participation in icbt among individuals from diverse (non-white/ caucasian) ethnocultural backgrounds. furthermore, feedback from participants has identified opportunities to improve icbt by: 1) simplifying language to improve clarity; 2) adding audiovisual content to aid with learning icbt strategies; and 3) adding in diverse examples/stories to show applicability of icbt to individuals with diverse backgrounds. the purpose of this study is to evaluate an icbt program that has been improved in this way, called the culturally enhanced wellbeing course. specifically, the observational pilot study with 30 clients from diverse ethnocultural backgrounds aims to examine improvements in depression and anxiety from pre to post treatment as well as patient experiences with the culturally enhanced wellbeing course.

in the last 10 years, the online therapy unit has successfully provided icbt to more than 10000 people experiencing mental health problems and there has been a growing demand and utilization of icbt in saskatchewan. however, a recent analysis of service utilization trends over six years shows that there has been a consistently low (11%) participation from the people of diverse (non-white/ caucasian) ethnocultural groups in the icbt program, called the wellbeing course. furthermore, the number of icbt lessons completed by the participants of diverse ethnocultural backgrounds was significantly lower compared to white/caucasian participants. review of feedback from participants from diverse ethnocultural backgrounds indicated a need to simplify the language of the course, and diversify the narratives in the stories which accompany the lessons to illustrate how the exercises can be used and how past participants have found the course. participants also suggested the addition of audiovisual elements in conjunction with text throughout the lessons to improve understanding of materials. in this study, we will aim to evaluate the culturally enhanced wellbeing course among 30 treatment-seeking adults in saskatchewan from diverse cultural backgrounds. the culturally enhanced wellbeing course will be evaluated through pre-post-treatment assessments using self-report questionnaires and individual semi-structured telephone interviews conducted toward the end of treatment.

Eligibility criteria:
inclusion criteria: * 18 years or older * endorse symptoms of anxiety or depression * resident of saskatchewan * access to a computer and the internet * self-identifying as having a diverse ethnocultural background exclusion criteria: * have a severe unmanaged psychiatric illness (e.g. psychosis) * assessed as being at high risk of suicide * report severe problems with alcohol or drugs * report severe cognitive impairment

Keywords: anxiety depression therapist-assistance internet-delivered cognitive behaviour therapy patient-centred therapy knowledge implementation mental health system