This study involved the initial development and testing of a video self-help intervention called LifeStories, which features real patients describing their use of coping strategies for depression based on Acceptance and Commitment Therapy. We conducted a baseline-controlled open trial (AB design) of 11 individuals diagnosed with major depressive disorder. Participants reported high levels of satisfaction and transportation (i.e., engagement) after watching LifeStories. No significant changes were observed during the 4-week baseline period in terms of interviewer-rated depression severity (primary outcome), but a significant and large effect size improvement was observed at Week 8 postintervention. The majority of participants (54.5%) showed a reliable and clinically significant posttreatment response. Significant improvements also were observed during the intervention period only for self-reported depressive symptoms and aspects of mindfulness (nonreactivity). Qualitative data analysis of participant interviews identified additional areas for improvement and refinement. Future testing in a randomized trial is warranted based on these encouraging results.
American Psychiatric Association. (2010). Practice guideline for the treatment of patients with major depressive disorder (3rd ed., Vol. 3). Washington, DC: Author.
2.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
AndrewsG.CuijpersP.CraskeM. G.McEvoyP.TitovN. (2010). Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: A meta-analysis. PLoS ONE, 5(10), e13196. doi:10.1371/journal.pone.0013196
5.
A-TjakJ. G.DavisM. L.MorinaN.PowersM. B.SmitsJ. A.EmmelkampP. M. (2015). A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems. Psychotherapy and Psychosomatics, 84, 30-36. doi:10.1159/000365764
6.
BaborT. F.Higgins-BiddleJ. C.SaundersJ. B.MonteiroM. G. (2001). AUDIT: The Alcohol Use Disorders Identification Test. Guidelines for use in primary care (2nd ed.). Geneva, Switzerland: World Health Organization.
7.
BaerR. A.SmithG. T.HopkinsJ.KrietemeyerJ.ToneyL. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13, 27-45. doi:10.1177/1073191105283504
8.
BanduraA. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice Hall.
9.
BermanA. H.BergmanH.PalmstiernaT.SchlyterF. (2003). DUDIT manual: The Drug Use Disorders Identification Test. Stockholm, Sweden: Department of Clinical Neuroscience, Karolinska Institutet.
10.
BondF. W.HayesS. C.BaerR. A.CarpenterK. M.GuenoleN.OrcuttH. K.. . . ZettleR. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: A revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy, 42, 676-688. doi:10.1016/j.beth.2011.03.007
11.
BuhrmanM.SkoglundA.HusellJ.BergstromK.GordhT.HurstiT.. . . AnderssonG. (2013). Guided internet-delivered acceptance and commitment therapy for chronic pain patients: A randomized controlled trial. Behaviour Research and Therapy, 51, 307-315. doi:10.1016/j.brat.2013.02.010
12.
CarmodyJ.BaerR. A. (2008). Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. Journal of Behavioral Medicine, 31, 23-33. doi:10.1007/s10865-007-9130-7
13.
CarvalhoA. F.CavalcanteJ. L.CasteloM. S.LimaM. C. (2007). Augmentation strategies for treatment-resistant depression: A literature review. Journal of Clinical Pharmacy and Therapeutics, 32, 415-428. doi:10.1111/j.1365-2710.2007.00846.x
14.
ChristensenH.GriffithsK. M.FarrerL. (2009). Adherence in Internet interventions for anxiety and depression. Journal of Medical Internet Research, 11(2), e13. doi:10.2196/jmir.1194
15.
CuijpersP.DonkerT.JohanssonR.MohrD. C.van StratenA.AnderssonG. (2011). Self-guided psychological treatment for depressive symptoms: A meta-analysis. PLoS ONE, 6(6), e21274. doi:10.1371/journal.pone.0021274
16.
DavidsonJ. R. (2010). Major depressive disorder treatment guidelines in America and Europe. Journal of Clinical Psychiatry, 71(Suppl. E1), e04.
17.
DevillyG.J.BorkovecT.D. (2000). Psychometric properties of the credibility/expectancy questionnaire. Journal of Behavior Therapy and Experimental Psychiatry, 31, 73-86.
18.
FirstM. B.WilliamsJ. B. W.KargR. S.SpitzerR. S. (2015). Structured Clinical Interview for DSM-5—Research Version (SCID-5 for DSM-5, Research Version; SCID-5-RV). Arlington, VA: American Psychiatric Association.
19.
FledderusM.BohlmeijerE. T.PieterseM. E.SchreursK. M. (2012). Acceptance and commitment therapy as guided self-help for psychological distress and positive mental health: A randomized controlled trial. Psychological Medicine, 42, 485-495.
20.
FleuryM. J.ImbouaA.AubeD.FarandL.LambertY. (2012). General practitioners’ management of mental disorders: A rewarding practice with considerable obstacles. BMC Family Practice, 13, Article 19. doi:10.1186/1471-2296-13-19
21.
FrieseS.RingmayrT. (2011). ATLAS.ti 6 user manual. Berlin, Germany: ATLAS.ti Scientific Software Development GmbH.
22.
GreenM. C. (2004). Transportation into narrative worlds: The role of prior knowledge and perceived realism. Discourse Processes, 38, 247-266.
23.
GreenM. C.BrockT. C. (2000). The role of transportation in the persuasiveness of public narratives. Journal of Personality and Social Psychology, 79, 701-721. doi:10.1037/0022-3514.79.5.701
24.
HayesS. C.StrosahlK. D.WilsonK. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change (2nd ed.). New York, NY: Guilford Press.
25.
HingE.UddinS. (2010). Visits to primary care delivery sites: United States, 2008 (NCHS Data Brief No. 47). Hyattsville, MD: National Center for Health Statistics.
26.
HinyardL. J.KreuterM. W. (2007). Using narrative communication as a tool for health behavior change: A conceptual, theoretical, and empirical overview. Health Education & Behavior, 34, 777-792. doi:10.1177/1090198106291963
27.
HoustonT. K.AllisonJ. J.SussmanM.HornW.HoltC. L.TrobaughJ.. . . HullettS. (2011). Culturally appropriate storytelling to improve blood pressure: A randomized trial. Annals of Internal Medicine, 154, 77-84. doi:10.7326/0003-4819-154-2-201101180-00004
28.
JacobsonN. S.TruaxP. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12.
29.
JonesM. E.CockrumP. C. (2000). A critical review of published economic modelling studies in depression. Pharmacoeconomics, 17, 555-583.
30.
KanterJ. W.MulickP. S.BuschA. M.BerlinK. S.MartellC. R. (2006). The Behavioral Activation for Depression Scale (BADS): Psychometric properties and factor structure. Journal of Psychopathology and Behavioral Assessment, 29(3), Article 191. doi:10.1007/s10862-006-9038-5
31.
KatonW.UnutzerJ.WellsK.JonesL. (2010). Collaborative depression care: History, evolution and ways to enhance dissemination and sustainability. General Hospital Psychiatry, 32, 456-464. doi:10.1016/j.genhosppsych.2010.04.001
32.
KazdinA. E. (1998). Research design in clinical psychology (Vol. 3). Boston, MA: Allyn & Bacon.
33.
KesslerR. C.BerglundP.DemlerO.JinR.KoretzD.MerikangasK. R.. . . WangP. S. (2003). The epidemiology of major depressive disorder: Results from the National Comorbity Survey Replication (NCS-R). The Journal of American Medical Association, 289, 3095-3105.
34.
KraemerH.MintzJ.NodaA.TinklenbergJ.YesavageJ. A. (2006). Caution regarding the use of pilot studies to guide power calculations for study proposals. Archives of General Psychiatry, 63, 484-489. doi:10.1001/archpsyc.63.5.484
35.
KreuterM. W.GreenM. C.CappellaJ. N.SlaterM. D.WiseM. E.StoreyD.. . . WoolleyS. (2007). Narrative communication in cancer prevention and control: A framework to guide research and application. Annals of Behavior Medicine, 33, 221-235.
36.
KroenkeK.SpitzerR. L.WilliamsJ. B. W. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606-613. doi:10.1046/j.1525-1497.2001.016009606.x
37.
LarkeyL. K.LopezA. M.MinnalA.GonzalezJ. (2009). Storytelling for promoting colorectal cancer screening among underserved Latina women: A randomized pilot study. Cancer Control, 16, 79-87.
38.
LarsenD. L.AttkissonC. C.HargreavesW. A.NguyenT. D. (1979). Assessment of client/patient satisfaction: development of a general scale. Evaluation and program planning, 2, 197-207.
39.
ManosR. C.KanterJ. W.BuschA. M. (2010). A critical review of assessment strategies to measure the behavioral activation model of depression. Clinical Psychology Review, 30, 547-561. doi:10.1016/j.cpr.2010.03.008
40.
MohrD. C.HartS. L.HowardI.JulianL.VellaL.CatledgeC.FeldmenM. D. (2006). Barriers to psychotherapy among depressed and nondepressed primary care patients. Annals of Behavior Medicine, 32, 254-258.
41.
MurphyS. T.FrankL. B.ChatterjeeJ. S.Baezconde-GarbanatiL. (2013). Narrative versus nonnarrative: The role of identification, transportation, and emotion in reducing health disparities. The Journal of Communication, 63, 116-137. doi:10.1111/jcom.12007
42.
OndersmaS. J.ChaseS. K.SvikisD. S.SchusterC. R. (2005). Computer-based brief motivational intervention for perinatal drug use. Journal of Substance Abuse Treatment, 28, 305-312. doi:10.1016/j.jsat.2005.02.004
43.
PilkonisP. A.ChoiS. W.ReiseS. P.StoverA. M.RileyW. T.CellaD. (2011). Item banks for measuring emotional distress from the Patient-Reported Outcomes Measurement Information System (PROMIS®): Depression, anxiety, and anger. Assessment, 18, 263-283. doi:10.1177/1073191111411667
44.
PowersM. B.Zum Vörde Sive VördingM. B.EmmelkampP. M. (2009). Acceptance and commitment therapy: A meta-analytic review. Psychotherapy and Psychosomatics, 78, 73-80.
45.
RushA. J.TrivediM. H.IbrahimH. M.CarmodyT. J.ArnowB.KleinD. N.. . . KellerM. (2003). The 16-item Quick Inventory of Depressive Symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): A psychometric evaluation in patients with chronic major depression. Biological Psychiatry, 54, 573-583.
46.
SantucciL. C.McHughR. K.BarlowD. H. (2012). Direct-to-consumer marketing of evidence-based psychological interventions: Introduction. Behavior Therapy, 43, 231-235.
47.
SteketeeG.ChamblessD. L. (1992). Methodological issues in prediction of treatment outcome. Clinical Psychology Review, 12, 387-400.
48.
UebelackerL. A.WangP. S.BerglundP.KesslerR. C. (2006). Clinical differences among patients treated for mental health problems in general medical and specialty mental health settings in the National Comorbidity Survey Replication. General Hospital Psychiatry, 28, 387-395.
49.
van SchaikD. J.KlijnA. F.van HoutH. P.van MarwijkH. W.BeekmanA. T.de HaanM.van DyckR. (2004). Patients’ preferences in the treatment of depressive disorder in primary care. General Hospital Psychiatry, 26, 184-189.
50.
WallerR.GilbodyS. (2009). Barriers to the uptake of computerized cognitive behavioural therapy: A systematic review of the quantitative and qualitative evidence. Psychological Medicine, 39, 705-712. doi:10.1017/S0033291708004224
51.
WenzeS. J.GaudianoB. A.WeinstockL. M.TezanosK. M.MillerI. W. (2015). Adjunctive psychosocial intervention following hospital discharge for patients with bipolar disorder and comorbid substance use: A pilot randomized controlled trial. Psychiatry Research, 228, 516-525.
52.
WilesN.ThomasL.AbelA.RidgwayN.TurnerN.CampbellJ.. . . LewisG. (2013). Cognitive behavioural therapy as an adjunct to pharmacotherapy for primary care based patients with treatment resistant depression: Results of the CoBalT randomised controlled trial. The Lancet, 381(9864), 375-384. doi:10.1016/S0140-6736(12)61552-9
53.
WilsonK. G.SandozE. K.KitchensJ.RobertsM. E. (2010). The Valued Living Questionnaire: Defining and measuring valued action within a behavioral framework. The Psychological Record, 60, 249-272.
