Study: NCT05648175

Intervention type: BEHAVIORAL
Group type: EXPERIMENTAL
Intervention: e-CBT
Description: The participant will submit their weekly homework and receive personalized feedback from their assigned therapist on OPTT. The feedback adds customization by acknowledging the participant's experiences in the past week and ensures the participant has understood the CBT concepts.

Intervention type: BEHAVIORAL
Group type: ACTIVE_COMPARATOR
Intervention: e-CBT
Description: The participant will submit their weekly homework and receive personalized feedback from their assigned therapist on OPTT. The feedback adds customization by acknowledging the participant's experiences in the past week and ensures the participant has understood the CBT concepts.

Intervention type: BEHAVIORAL
Group type: EXPERIMENTAL
Intervention: e-CBT + Phone Call
Description: In addition to the e-CBT program (see 1 above), the participant will receive a weekly phone/video call from their assigned therapist. The goal is to build on the therapeutic relationship and to add personalization with direct verbal encouragement. This phone/video call is limited to a one-time, 15-20 minutes call each intervention week.44 The purpose is to check with the patient on their treatment progress. The secure call will either be a phone or video (via Microsoft Teams) call, depending on the preference of the patient.

Intervention type: BEHAVIORAL
Group type: ACTIVE_COMPARATOR
Intervention: e-CBT + Phone Call
Description: In addition to the e-CBT program (see 1 above), the participant will receive a weekly phone/video call from their assigned therapist. The goal is to build on the therapeutic relationship and to add personalization with direct verbal encouragement. This phone/video call is limited to a one-time, 15-20 minutes call each intervention week.44 The purpose is to check with the patient on their treatment progress. The secure call will either be a phone or video (via Microsoft Teams) call, depending on the preference of the patient.

Intervention type: BEHAVIORAL
Group type: EXPERIMENTAL
Intervention: e-CBT + Phone Call + Pharmacotherapy
Description: In addition to the e-CBT program (see 1 above), the participant will receive standard pharmacotherapy following DSM-5 guidelines. A pharmacotherapy allocation system has been developed (Figure 1; Figure 2) that follows clinical guidelines. All medications will be prescribed by a psychiatrist on the research team. All medications are a part of the clinical standard of care. The medications will be provided to the participant through the normal process of receiving medication (i.e., pharmacy). Participants allocated to the e-CBT + Phone Call + Pharmacotherapy arm will begin the pharmacotherapy optimization process at the same time as they begin the e-CBT program. Oversight of medication in the e-CBT + Pharmacotherapy arm will be conducted by a psychiatrist on the team who will make a judgement regarding whether to alter the medications. This will not require any additional study visits/time commitment for the participants in this arm.

Intervention type: BEHAVIORAL
Group type: ACTIVE_COMPARATOR
Intervention: e-CBT + Phone Call + Pharmacotherapy
Description: In addition to the e-CBT program (see 1 above), the participant will receive standard pharmacotherapy following DSM-5 guidelines. A pharmacotherapy allocation system has been developed (Figure 1; Figure 2) that follows clinical guidelines. All medications will be prescribed by a psychiatrist on the research team. All medications are a part of the clinical standard of care. The medications will be provided to the participant through the normal process of receiving medication (i.e., pharmacy). Participants allocated to the e-CBT + Phone Call + Pharmacotherapy arm will begin the pharmacotherapy optimization process at the same time as they begin the e-CBT program. Oversight of medication in the e-CBT + Pharmacotherapy arm will be conducted by a psychiatrist on the team who will make a judgement regarding whether to alter the medications. This will not require any additional study visits/time commitment for the participants in this arm.