Message-based psychotherapy and digital treatment sequences for depression

PROJECT SUMMARY. This is a fast track SBIR proposal that will (1) test the effectiveness of daily, message- based psychotherapy (MBP) for depression, compared to traditionally delivered, video-chat psychotherapy (VCP) and (2) develop an evidence-based treatment sequence for those who do not respond to either daily MBP or VCP. Phase 1 consists of a pilot study to determine the best incentive model to retain a sample of people 18 years old and older with depression into a SMART trial. Information from this pilot will inform the retention strategy for Phase 2. Phase 2 is a 12-week, randomized clinical trial using a SMART design to test the following aims: 1. Determine the relative effectiveness of daily MBP compared to weekly VCP in treating symptoms of depression and improving social functioning; 2. For those who fail to respond to 6 weeks of weekly VCP only, determine whether the addition of daily messaging, or a switch to monthly video-chat plus daily messaging improves depression and functional outcomes; and 3. For those who fail to respond to 6 weeks of daily MBP, whether the addition of monthly video-chat or weekly video-chat improves outcomes. Participants will provide data on mood, activity, and functioning, and we will collect data on use of treatment (texts and sessions), and working alliance. Information from this study has the following impact on science: We will have information on the effectiveness of psychotherapy delivered via messaging-based platforms, and the relative effectiveness of this model of care compared to traditional, one-hour-a-week care. This is important to the field because there is considerable concern that care delivered in this manner may be less effective than the typical delivery model of one-hour-a- week care. We will be able to determine the best method of enhancing care for those who do not respond to either daily messaging only or traditional, once a week video-based sessions. This study is innovative in that it will provide useful information as to who responds to different types of psychotherapy delivery, a question that has been one of importance to health care organizations who plan to integrate remote psychotherapy into their system of care, as well as to patients seeking to inform themselves of mental health resources appropriate to their situation. The data from this study will result in the following commercialization plan: Talkspace is well established in direct to consumer markets and is growing important relationships and partnerships within mental healthcare. Future initiatives include continuing to expand business partnerships with leading payers, employers and healthcare organizations, as well as expanding globally to other countries that are struggling to build a mental healthcare infrastructure that can meet the needs of their citizens, especially low- and middle- income countries where phones are widely available, but mental health resources are not. The acquisition of data comparing MBP to traditionally delivered VCP will put Talkspace’s product above the others in the market. Further, the creation of a treatment sequence for people who do not respond to either type of psychotherapy will result in a novel feature of the product that has the potential to tailor treatment intensity.