Effectiveness of Internet-Based Cognitive Behavioral Therapy for Treating Mothers With Depression
Effectiveness of Internet-Based Cognitive Behavioral Therapy for Treating Mothers With Depression
This study will evaluate the effectiveness of an Internet-based cognitive behavioral therapy
 program in treating mothers with depression who have young children.
Being a mother of a young child can be very stressful. Many women find that being a parent
 may not be as enjoyable as expected and that they feel persistently tired or sad. Because of
 the possible "lows" of recent motherhood, new mothers are particularly prone to depression.
 The impact of depression on recent mothers is significant, including emotional distress for
 the woman as well as possible disturbances in the child's development. If left untreated, the
 mother's depression may cause strain on family life and her relationship with her child.
 Cognitive behavioral therapy (CBT), a form of psychotherapy that can be used to treat people
 with depression, aims to modify thoughts and behaviors. Despite the availability of helpful
 CBT programs, most depressed people do not receive treatment. To make these treatments more
 accessible to mothers who may lack the means to seek help, this study will adapt CBT for
 depression to an at-home computer-based program. This study will evaluate the effectiveness
 of the computer-based CBT program in improving the moods of depressed mothers and their
 children and enhancing the quality of time shared between mother and child.

 Participation in this single-blind study will last at least 8 weeks. A computer, modem,
 monitor, and Internet connection will be installed in the homes of all participants.
 Participants will then be randomly assigned to receive either immediate treatment or delayed
 treatment, which will begin after a wait-list period. Treatment will be delivered on a
 computer, which will allow the participants to chat online with other parents and their
 program coach. There will be 11 CBT-related lessons over 8 weeks, taking between 8 and 11
 hours total to complete. The lessons will promote self-learning and will include content of
 particular relevance to mothers of young children, including how to handle stress and improve
 mood. Participants will be required to contact their coach at least every 2 weeks to review
 the lessons learned. There will be three assessments, occurring at pretreatment, immediately
 post-treatment, and 3 months post-treatment. Participants assigned to delayed treatment will
 complete one additional assessment prior to beginning the wait-list period. Each assessment
 will involve both parent and child and will include play interactions, questionnaires, and
 interviews about parenting, feelings, child behavior, moods, and self-esteem. Another
 caretaker of the child and the child's teacher will also be asked to complete questionnaires
 about the child's and/or parent's behavior.
Inclusion Criteria:

 -  Evidence of elevated self-reported depressive symptomatology, confirmed by a CES-D
 score of greater than 21

 -  Understands spoken English

 -  Either the biological/adoptive mother, permanent legal guardian, or long-term relative
 caretaker for the child

 -  Resides in a stable residence with the infrastructure for phone service that can
 support Internet access