Supplementary Material for: Online Self-Help as an Add-On to Inpatient Psychotherapy: Efficacy of a New Blended Treatment Approach

Background: Depression is one of the most frequent and
costly mental disorders. While there is increasing evidence for the
efficacy of online self-help to improve depression or prevent relapse,
there is little evidence in blended care settings, especially combined
with inpatient face-to-face psychotherapy. Therefore, we evaluated
whether an evidence-based online self-help program improves the efficacy
of inpatient psychotherapy. Methods: A total of 229
depressed patients were randomly allocated either to an online self-help
program (intervention group [IG]; Deprexis) or an active control group
(CG; weekly online information on depression) in addition to inpatient
psychodynamic psychotherapy. Both groups had access to their respective
experimental intervention for 12 weeks, regardless of inpatient
treatment duration. Reduction of depressive symptoms, as measured with
the Beck Depression Inventory-II, was the primary outcome at the end of
the intervention (T2). Results: Depressive symptoms were
statistically significantly lower in the IG compared to the active CG at
T2 with a moderate between-group effect size of d = 0.44. The same applied to anxiety (d = 0.33), quality of life (d = 0.34), and self-esteem (d
= 0.38) at discharge from inpatient treatment (T1). No statistically
significant differences were found regarding dysfunctional attitudes (d = 0.14) and work ability (d = 0.08) at T1. Conclusions:
This is the first evidence for blended treatment combining online
self-help with inpatient psychotherapy. The study opens new and
promising avenues for increasing the efficacy of inpatient
psychotherapy. Future studies should determine how integration of online
self-help into the therapeutic process can be developed further.