AI-based chatbot micro-intervention for parents: Meaningful engagement, learning, and efficacy.

Introduction: Mental health issues have been on the rise among children and adolescents, and digital parenting programs have shown promising outcomes. However, there is limited research on the potential efficacy of utilizing chatbots to promote parental skills. This study aimed to understand whether parents learn from a parenting chatbot micro intervention, to assess the overall efficacy of the intervention, and to explore the user characteristics of the participants, including parental busyness, assumptions about parenting, and qualitative engagement with the chatbot. Methods: A sample of 170 parents with at least one child between 2-11 years old were recruited. A randomized control trial was conducted. Participants in the experimental group accessed a 15-min intervention that taught how to utilize positive attention and praise to promote positive behaviors in their children, while the control group remained on a waiting list. Results: Results showed that participants engaged with a brief AI-based chatbot intervention and were able to learn effective praising skills. Although scores moved in the expected direction, there were no significant differences by condition in the praising knowledge reported by parents, perceived changes in disruptive behaviors, or parenting self-efficacy, from pre-intervention to 24-hour follow-up. Discussion: The results provided insight to understand how parents engaged with the chatbot and suggests that, in general, brief, self-guided, digital interventions can promote learning in parents. It is possible that a higher dose of intervention may be needed to obtain a therapeutic change in parents. Further research implications on chatbots for parenting skills are discussed.

Online micro intervention for mood improvement: The role of confidence, motivation, and activity type.

BACKGROUND: Internet interventions provide a unique opportunity to increase widespread accessibility of treatment at reduced and scalable costs (Muñoz, 2010). Previous research has explored the impact of specific types of activities on participant's main depressive symptoms i.e., anhedonia, or enjoyment levels, and mood (Bunge et al., 2017).The aim of the current study is to improve the understanding of the effects of online micro interventions targeting motivation, enjoyment levels, and mood. METHODS: A total of 838 participants recruited from Amazon Mechanical Turk participated in an online calendar activity to improve mood. RESULTS: A regression analysis showed that confidence and motivation were significantly associated with mood (R2 = 0.467, p < .001). The total number of activities reported in the last two days was associated with participants' current mood (R2 = 0.203, p < .001) and enjoyment (R2 = 0.156, p < .001). Interestingly, only mastery and meaningful activities improved mood but not pleasant activities. Regarding enjoyment, pleasant and meaningful activities impacted current enjoyment of the day but not mastery activities. Lastly, only individuals who engaged with the calendar showed a significant increase in motivation and confidence. LIMITATIONS: Depression may moderate engagement and was not analyzed in the present study. Additionally, there were no follow-up analyses that looked at the long-term effects of the intervention or changes in actual activity engagement. CONCLUSIONS: Online micro interventions have a promising future as an intervention that can impact the mood and motivation for change. Future studies should examine increasing engagement to facilitate confidence and motivation to enact change.

Disseminating online parenting resources in the community during the COVID-19 pandemic: Lessons learned.

Online parenting programs are an effective way to teach behavioral management skills to parents in the absence of in-person resources. This community-engaged study aimed to examine strategies for disseminating online parenting resources in schools. Online resources were disseminated to parents in a Northern California school district. Dissemination strategies were informed by conversations with school principals, teachers, and parents and considered agent, message, and format. A total of 685 parents and teachers clicked on the online resources: 151 parents and 114 teachers attended synchronous classes. The use of dissemination strategies had a compounding influence on the number of synchronous class attendees and clicks. Emails sent by the school district yielded the greatest number of clicks, which was influenced by message content and format. A community-academic partnership (CAP) led to the dissemination of evidence-based online parenting resources to a large population and led to lessons learned that could inform future research involving CAPs.

Psychometric Properties of a Chatbot Version of the PHQ-9 With Adults and Older Adults.

Background: The Patient Health Questionnaire-9 (PHQ-9) is a brief depression measure that has been validated. A chatbot version of the PHQ-9 would allow the assessment of depressive symptoms remotely, at a large scale and low cost. Objective: The current study aims to: Assess the feasibility of administering the PHQ-9 in a sample of adults and older adults via chatbot, report the psychometric properties of and identify the relationship between demographic variables and PHQ-9 total scores. Methods: A sample of 3,902 adults and older adults in the US and Canada were recruited through Facebook from August 2019 to February 2020 to complete the PHQ-9 using a chatbot. Results: A total of 3,895 (99.82%) completed the PHQ-9 successfully. The internal consistency of the PHQ-9 was 0.896 (p < 0.05). A one factor structure was found to have good model fit [X 2 (27, N = 1,948) = 365.396, p < 0.001; RMSEA = 0.080 (90% CI: 0.073, 0.088); CFI and TLI were 0.925 and 0.900, respectively, and SRMR was 0.039]. All of the demographic characteristics in this study were found to significantly predict PHQ-9 total score, however; their effect was negligible to weak. Conclusions: There was a large sample of adults and older adults were open to completing assessments via chatbot including those over 75. The psychometric properties of the chatbot version of the PHQ-9 provide initial support to the utilization of this assessment method.

Bonding With Bot: User Feedback on a Chatbot for Social Isolation.

Social isolation has affected people globally during the COVID-19 pandemic and had a major impact on older adult's well-being. Chatbot interventions may be a way to provide support to address loneliness and social isolation in older adults. The aims of the current study were to (1) understand the distribution of a chatbot's net promoter scores, (2) conduct a thematic analysis on qualitative elaborations to the net promoter scores, (3) understand the distribution of net promoter scores per theme, and (4) conduct a single word analysis to understand the frequency of words present in the qualitative feedback. A total of 7,099 adults and older adults consented to participate in a chatbot intervention on reducing social isolation and loneliness. The average net promoter score (NPS) was 8.67 out of 10. Qualitative feedback was provided by 766 (10.79%) participants which amounted to 898 total responses. Most themes were rated as positive (517), followed by neutral (311) and a minor portion as negative (70). The following five themes were found across the qualitative responses: positive outcome (277, 30.8%), user did not address question (262, 29.2%), bonding with the chatbot (240, 26.7%), negative technical aspects (70, 7.8%), and ambiguous outcome (49, 5.5%). Themes with a positive valence were found to be associated with a higher NPS. The word "help" and it's variations were found to be the most frequently used words, which is consistent with the thematic analysis. These results show that a chatbot for social isolation and loneliness was perceived positively by most participants. More specifically, users were likely to personify the chatbot (e.g., "Cause I feel like I have a new friend!") and perceive positive personality features such as being non-judgmental, caring, and open to listen. A minor portion of the users reported dissatisfaction with chatting with a machine. Implications will be discussed.

Technology and psychotherapeutic interventions: Bibliometric analysis of the past four decades.

BACKGROUND: Rapid growth of the integration of technology and psychotherapeutic interventions has been noted, but no clear quantification of this growth has been done. AIMS: This bibliometric analysis seeks to quantify the growth, trends, and applications of technology in psychotherapeutic interventions over the last 40 years. METHODS: Searches were conducted in the Web of Science (WOS) database for all existing technology-psychotherapy-related publications from 1981 to October 2020. Search terms were refined using a systematic screening strategy, based upon Cochrane protocol, generating 52 technology terms. Analyses across 40 years and by decade from 1981 to 2020 were conducted. RESULTS: A total of 13,934 peer-reviewed articles were identified. Yearly publication rate has increased from one in 1981 to 1902 by October 2020. The growth rate of publications across decades consistently tripled in size (762.50% from the 1980s to 1990s, 539.71% from the 1990s to 2000s, and 337.24% from the 2000s to 2010s). The author, country, journal, and institution with the most publications were Andersson, G., USA, Journal of Medical Internet Research, and Karolinska Institute, respectively. The most frequent technology search term across all four decades was "internet*." The trends in percentages of peer-reviewed publications within each decade showed: 1) a declining trend for the term "computer," 2) an upward trend for the combined terms, "internet," "online," and "web," 3) and a steady but smaller proportion of publications for other terms ("cell phone," "phone/telephone," "technology," "video," "virtual reality or VR," "apps," "digital," "machine learning," "electronic," "robo," and "telehealth"). DISCUSSION: The rapid growth and trends identified in technology and psychotherapy publications can inform related policies addressing the role of technology in mental health. Moreover, pattern analyses may provide direction for a standard nomenclature to address terminology usage inconsistencies across the field.

Artificial Intelligence-Based Chatbot for Anxiety and Depression in University Students: Pilot Randomized Controlled Trial.

BACKGROUND: Artificial intelligence-based chatbots are emerging as instruments of psychological intervention; however, no relevant studies have been reported in Latin America. OBJECTIVE: The objective of the present study was to evaluate the viability, acceptability, and potential impact of using Tess, a chatbot, for examining symptoms of depression and anxiety in university students. METHODS: This was a pilot randomized controlled trial. The experimental condition used Tess for 8 weeks, and the control condition was assigned to a psychoeducation book on depression. Comparisons were conducted using Mann-Whitney U and Wilcoxon tests for depressive symptoms, and independent and paired sample t tests to analyze anxiety symptoms. RESULTS: The initial sample consisted of 181 Argentinian college students (158, 87.2% female) aged 18 to 33. Data at week 8 were provided by 39 out of the 99 (39%) participants in the experimental condition and 34 out of the 82 (41%) in the control group. On an average, 472 (SD 249.52) messages were exchanged, with 116 (SD 73.87) of the messages sent from the users in response to Tess. A higher number of messages exchanged with Tess was associated with positive feedback (F2,36=4.37; P=.02). No significant differences between the experimental and control groups were found from the baseline to week 8 for depressive and anxiety symptoms. However, significant intragroup differences demonstrated that the experimental group showed a significant decrease in anxiety symptoms; no such differences were observed for the control group. Further, no significant intragroup differences were found for depressive symptoms. CONCLUSIONS: The students spent a considerable amount of time exchanging messages with Tess and positive feedback was associated with a higher number of messages exchanged. The initial results show promising evidence for the usability and acceptability of Tess in the Argentinian population. Research on chatbots is still in its initial stages and further research is needed.

Development and usability of a Spanish/English smoking cessation website: lessons learned.

BACKGROUND: Smoking cessation Internet interventions have been shown to be comparable in effectiveness to the nicotine patch. The aim of this study was to develop a Spanish/English smoking cessation web app using input from low-income smokers, and to evaluate modifications to the online intervention in terms of its ability to engage smokers. METHODS: Three versions of a smoking cessation web app were developed and tested. Measures of engagement, such as completion of study registration, utilization of cigarette, mood, and craving trackers, and completion of follow-up assessments, were collected to determine whether changes in the website resulted in increased engagement. RESULTS: The third version of the website, which featured improved look-and-feel and fewer barriers to engagement, markedly increased tracker engagement from the first two versions. However, follow-up rates remained low across all three versions. CONCLUSIONS: The increase in engagement was attributed to the following modifications: A more inviting landing page with key intervention elements available immediately; an easily accessible dashboard with users' data; and tracking tools that were more user friendly. We conclude that in addition to adequate and functional elements, design principles are key factors in increasing engagement in online interventions.

Stress and burnout in psychology doctoral students.

Psychology Doctoral Students (PDS) have to deal with highly emotional situations with their clients and academic demands that can cause stress. However, there is limited research examining stress and burnout in PDS. This study aimed to examine levels of stress in PDS students compared to the general population and to analyze levels of stress and burnout per year in the program. An online survey was distributed among both PDS currently enrolled in APA-accredited clinical and counseling psychology doctoral programs and individuals in the general population. A total of 204 (67.3%) participants were PDS and 99 (32.7%) were from the general population. There were no significant differences in levels of stress between the PDS and participants from the general population. Third- and fourth-year students (grouped together) reported a significantly higher level of stress than PDS in other years (p=.00). Similarly, third- and fourth-year students (grouped together) reported significantly higher scores in the burnout emotional exhaustion subscale, than the rest of the students (p=.04). Stress levels in PDS were similar to those in the general population. Within PDS those in their third and fourth year of their programs presented higher levels of stress and more emotional exhaustion. Implications will be discussed.

Artificial Intelligence Chatbot for Depression: Descriptive Study of Usage.

BACKGROUND: Chatbots could be a scalable solution that provides an interactive means of engaging users in behavioral health interventions driven by artificial intelligence. Although some chatbots have shown promising early efficacy results, there is limited information about how people use these chatbots. Understanding the usage patterns of chatbots for depression represents a crucial step toward improving chatbot design and providing information about the strengths and limitations of the chatbots. OBJECTIVE: This study aims to understand how users engage and are redirected through a chatbot for depression (Tess) to provide design recommendations. METHODS: Interactions of 354 users with the Tess depression modules were analyzed to understand chatbot usage across and within modules. Descriptive statistics were used to analyze participant flow through each depression module, including characters per message, completion rate, and time spent per module. Slide plots were also used to analyze the flow across and within modules. RESULTS: Users sent a total of 6220 messages, with a total of 86,298 characters, and, on average, they engaged with Tess depression modules for 46 days. There was large heterogeneity in user engagement across different modules, which appeared to be affected by the length, complexity, content, and style of questions within the modules and the routing between modules. CONCLUSIONS: Overall, participants engaged with Tess; however, there was a heterogeneous usage pattern because of varying module designs. Major implications for future chatbot design and evaluation are discussed in the paper.

Children and adolescents attempting to participate in a worldwide online depression screener.

Depression rates are increasing among minors. Internet is central to the lives of many minors, and many of them look online for depression information. This report describes minors who attempted to screen themselves for depression in a worldwide online study. Google Ads were used to recruit individuals to a multilingual depression screening study that was meant to target and recruit adults. Of 158,170 individuals accessing the site, 30,396 (19.22%) were minors from 190 countries. Proportions of minors varied considerably between different cultures. Given youth's interest in depression information, online services to ethically and effectively address youth depression are needed.

Publication Trends in Psychotherapy: Bibliometric Analysis of the Past 5 Decades.

OBJECTIVE: Bibliometric analyses are commonly used to document publication trends over time; however, this methodology has not been used to investigate possible trends concerning publishing about psychotherapy brands. In this study, the authors sought to identify the publication trends of peer-reviewed articles about 30 psychotherapy brands. METHODS: Analyses were focused on the past 50 years and on each decade from 1970 to 2019. All searches were performed between October 2018 and January 2019 on the EbscoHost platform. Two databases were selected for the searches: PsycINFO and PubMed. RESULTS: In the 28,594 articles reviewed, most published articles concerned cognitive-behavioral therapy (CBT), and five brands accounted for almost 78% of all publications: CBT, psychoanalysis, family systems therapy, behavioral therapy, and cognitive therapy. Three trends were identified across decades: five therapies consistently yielded the largest number of publications, the number of publications focused on therapies with less research support declined from the 1970s to the 1990s, and publications about therapies with more of a research basis increased in the 1990s through the 2010s. Publications on meditation and mindfulness presented the most salient growth area for all psychotherapies across the 5 decades. A few psychotherapy brands have dominated the publishing realm during the past 50 years and across each decade. CONCLUSIONS: Possible explanations for these publication trends were considered, including the emergence of the evidence-based therapy movement and various sociohistorical changes. Potential psychotherapy publications trends in the future are discussed.

Effect of Three Types of Activities on Improving Mood and Enjoyment in a Brief Online Depression Study.

The goal of this study is to determine whether different types of activities have a differential effect on mood and enjoyment. Methods. A secondary analysis of the data of 754 participants (M age = 35.8 years, SD age = 12.6; M PHQ-9 = 7.6, SD PHQ-9 = 7.0) who were recruited via Amazon Mechanical Turk (AMT) to participate in a brief online study. Participants completed an activity log and reported retrospectively about three types of activities (Pleasant, Meaningful, and Mastery) at baseline and one week follow-up. A mixed effects ANOVA was used to analyze the effect of weekly activities on mood, and a temporal analysis model was used to test for the effect of daily activities on enjoyment. Results. Participants who reported higher number of Mastery activities for the week had higher mood ratings at follow-up (F (1, 39) = 4.89, p < .05), regardless of depression status at baseline. Pleasant and Meaningful activities did not have a significant effect on mood. Daily engagement in any of the three activity types increased enjoyment of that day (Pleasant: b = 0.312, t (1811) = 46.73, p < .001; Meaningful: b = 0.254, t (1814) = 11.65, p < .001; Mastery: b = 0.290, t (1816) = 13.07, p < .001]. Conclusions. These findings contribute to the understanding on how brief behavioral activation interventions delivered online may influence participants' mood and enjoyment, and can inform clinicians' recommendations about types of activities.

Impact of an online depression prevention intervention on suicide risk factors for adolescents and young adults.

BACKGROUND: Adolescent death by suicide is an emergent health crisis in the United States of America. Although many suicide prevention programs have been created to address suicide in this population, rates continue to increase. Online interventions can disseminate treatments world-wide and reach large numbers of users. Thus, the purpose of the present study was to determine the effects of CATCH-IT, an Internet-based depression prevention intervention on risk factors for suicide (i.e., suicidal ideation, hopelessness, low self-esteem and social isolation). METHODS: A total of 83 participants aged 14-21 years [mean =17.5; standard deviation (SD) =2.04] consented to take part in the intervention study. RESULTS: Results indicated that suicidal ideation decreased from baseline to post-intervention. For those who completed the entire CATCH-IT program, the effect size was moderate (d =0.60, P<0.05). For those who partially completed the program the effect size was small (d =0.22, P<0.05). Interestingly, scales measuring hopelessness and social isolation were not associated with changes in suicidal ideation. CONCLUSIONS: The findings provide initial evidence that online depression prevention programs could be related to decreased suicidal ideation, and that those who complete the entire program may benefit more than those who complete only a part of CATCH-IT.

Facebook for recruiting Spanish- and English-speaking smokers.

BACKGROUND: Recruitment for research is usually expensive and time consuming. Facebook (FB) recruitment has become widely utilized in recent years. The main aim of this study was to assess FB as a recruitment tool in a study for Spanish- and English-speaking smokers. Additionally, the study set out to compare performance of ads by language (Spanish vs. English), location (U.S. vs. San Francisco) and content (self-efficacy ad vs. fear appeal ad). METHODS: Participants of a one-condition smoking cessation webapp study were recruited utilizing FB ads and posts through two phases: a recruitment-focused phase and an experimental phase comparing language, location and content. RESULTS: During the recruitment phase 581 participants in total (U.S. = 540, San Francisco = 41) provided consent. Of the U.S. participants 275 were Spanish-speakers and 265 English-speakers. The cost-per-consent was $25.81 for Spanish-speakers, and $15.49 for English-speakers. During the experimental phase U.S. users performed better (i.e. more clicks, engagement and social reach) than San Francisco users, Spanish-speakers engaged more than English-speakers, and the self-efficacy ad performed better than the fear appeal ad. CONCLUSIONS: This study showed that although there were differences in cost-per-consent for Spanish- and English-speakers, recruitment of Spanish-speakers through Facebook is feasible. Furthermore, comparing performance of ads by location, language, and ad content may contribute to developing more efficient campaigns.

Microinterventions produce immediate but not lasting benefits in mood and distress.

Untreated depression remains one of the largest public health concerns. However, barriers such as unavailability of mental health providers and high cost of services limit the number of people able to benefit from traditional treatments. Though unsupported Internet interventions have proven effective at bypassing many of these barriers given their reach and scalability, attrition from interventions has been an ongoing concern. Microinterventions, or ultra-brief online tools meant to produce a rapid improvement in mood, may offer a way to provide the benefits of unsupported Internet interventions quickly, before attrition might occur. This study examined the immediate and lasting effects of three microinterventions (Breathing Exercises, Thought Records, and a Pleasant Activities Selector) on mood and distress. Participants (N=122) were randomized into three groups, each group completing two of the three microinterventions. Participants were asked to rate their mood and level of distress before and after completing the microintervention. Depression and perceived stress were assessed at baseline and at four weekly follow-ups. Although lasting effects were not found, a significant within-group reduction in distress and improvement in mood were observed immediately following the completion of the microintervention. This study demonstrates the potential benefits of microinterventions to individuals for their immediate needs vis-à-vis mood and distress.

Using Behavioral Intervention Technologies to Help Low-Income and Latino Smokers Quit: Protocol of a Randomized Controlled Trial.

BACKGROUND: The Institute for International Internet Interventions for Health at Palo Alto University proposes to develop digital tools specifically to help low-income English- and Spanish-speaking smokers to quit. Individuals from lower-income countries and those with lower social status quit at lower rates than those from high-income countries and those with higher social status. OBJECTIVE: We plan to launch a project designed to test whether a mobile-based digital intervention designed with systematic input from low-income English- and Spanish-speaking smokers from a public-sector health care system can significantly improve its acceptability, utilization, and effectiveness. METHODS: Using human-centered development methods, we will involve low-income patients in the design of a Web app/text messaging tool. We will also use their input to improve our recruitment and dissemination strategies. We will iteratively develop versions of the digital interventions informed by our human-centered approach. The project involves three specific aims: (1) human-centered development of an English/Spanish smoking cessation web app, (2) improvement of dissemination strategies, and (3) evaluation of resulting smoking cessation web app. We will develop iterative versions of a digital smoking cessation tool that is highly responsive to the needs and preferences of the users. Input from participants will identify effective ways of reaching and encouraging low-income English- and Spanish-speaking smokers to use the digital smoking cessation interventions to be developed. This information will support ongoing dissemination and implementation efforts beyond the grant period. We will evaluate the effectiveness of the successive versions of the resulting stop smoking Web app by an online randomized controlled trial. Increased effectiveness will be defined as increased utilization of the Web app and higher abstinence rates than those obtained by a baseline usual care Web app. RESULTS: Recruitment will begin January 2016, the study is intended to be completed by summer 2018, and the results should be available by fall 2019. CONCLUSIONS: This study will provide useful knowledge in developing, testing, and disseminating mobile-based interventions for low-income smokers. CLINICALTRIAL: ClinicalTrials.gov NCT02666482; https://clinicaltrials.gov/ct2/show/NCT02666482 (Archived by WebCite at http://www.webcitation.org/6gtcwaT28).

Satisfacción y Tipo de Servicios de Salud Mental para Niños y Adolescentes / Satisfaction with and types of mental health services for children and adolescents / Satisfação e tipo de serviços de saúde mental para crianças e adolescentes

La satisfacción del usuario (SU) es actualmente considerada un factor importante en la evaluación de la calidad de los servicios de salud mental. No obstante, no ha sido todavía investigada en gran medida en los servicios de salud mental para niños, niñas y adolescentes (SSMNA). Nuestro objetivo en este estudio fue conocer el grado de satisfacción percibida por usuarios que recibieron atención en tres SSMNA privados de Buenos Aires, cada uno con una orientación teórica distinta. Utilizamos como instrumentos, cuestionarios de auto-informe que nos proveyeron datos para un análisis cuantitativo y cualitativo. Hallamos que los padres y madres que llevaron a sus hijos o hijas a los servicios de orientación cognitiva o sistémica, refirieron niveles de satisfacción similares entre sí y un mayor grado de satisfacción que los padres y madres cuyos hijos e hijas recibieron tratamiento psicodinámico.

User satisfaction (US) is currently considered an important factor in the assessment of the quality of mental health services. However, it has not yet been researched extensively in the area of child and adolescent mental health services (CAMHS). The aim of this study was to identify the level of satisfaction perceived by users who received treatment at three private CAMHS in Buenos Aires, each with a different theoretical orientation. Self-report questionnaires that provided data for quantitative and qualitative analysis were used as instruments. It was found that parents who brought their children to the services that provide cognitive or systemic orientation reported similar levels of satisfaction with the services and a higher level of satisfaction than parents whose children received psychodynamic treatment.

Atualmente, a satisfação do usuário (SU) é considerada um fator importante na avaliação da qualidade dos serviços de saúde mental. Porém, ainda não tem sido pesquisada em profundidade nos serviços de saúde mental para crianças e adolescentes (SSMCA). O objetivo deste estudo foi conhecer o grau de satisfação percebida por usuários que receberam atenção em três SSMCA privados de Buenos Aires, cada um com uma orientação teórica diferente. Como instrumentos, foram utilizados questionários autoinformativos que reuniram dados para uma análise quantitativa e qualitativa. Constatou-se que os pais que levaram seus filhos e filhas nos serviços de orientação cognitiva ou sistêmica tiveram níveis de satisfação semelhantes entre si e um maior grau de satisfação do que os pais cujos filhos e filhas receberam tratamento psicodinâmico.

Mood management effects of brief unsupported internet interventions.

BACKGROUND: Most users of unsupported Internet interventions visit that site only once, therefore there is a need to create interventions that can be offered as a single brief interaction with the user. OBJECTIVE: The main goal of this study was to compare the effect of a one-session unsupported Internet intervention on participants' clinical symptoms (depressive and anxiety symptoms) and related variables (mood, confidence and motivation). METHOD: A total of 765 adults residing in the United States took part in a randomized controlled trial. Participants were randomly assigned to one of five brief plain text interventions lasting 5-10 min. The interventions designed to address depressive symptoms were: thoughts (increasing helpful thoughts), activities (increasing activity level), sleep hygiene, assertiveness (increasing assertiveness awareness), Own Methods (utilizing methods that were previously successful). They were followed-up one week after consenting. RESULTS: A main effect of time was observed for both depression (F(1, 563) = 234.70, p < 0.001) and anxiety (F(1, 551) = 170.27, p < 0.001). In all cases, regardless of assigned condition and Major Depressive Episode status, mean scores on both positive outcomes (mood, confidence and motivation) and negative outcome scores (depression and anxiety) improved over time. CONCLUSIONS: Brief unsupported Internet interventions can improve depressive symptoms at one-week follow-up. Further outcome data and research implications will be discussed.