Zagorscak R, Heinrich M, Sommer D, Wagner B, Knaevelsrud C. (2018). Benefits of individualized feedback in internet-based interventions for depression: A randomized controlled trial. Psychotherapy and Psychosomatics. 87: 32-45. doi: 10.1159/000481515
Researchers recruited 1,089 individuals with depression from a German health insurance company to compare automated standardized feedback to individualized feedback from a counselor as an augment to a web-based intervention for depression. All participants received a 7-session web-based intervention for depression, with content based on cognitive behavioral therapy. Participants were randomized to receive standardized automated feedback (n=534) or to receive individualized feedback from an assigned counselor (n=555) after completing each intervention session. Feedback was delivered through the intervention platform. Participants in both groups could also receive additional assistance with technical issues and symptom exacerbation. Participants completed assessments of depression and anxiety symptoms, well-being, social support, emotional self-efficacy, and perseverative thinking at baseline, post-intervention, and 3-, 6-, and 12-months follow-up. Significantly higher rates of attrition were observed in the automatic feedback group (21.5%) than in the counselor feedback group (17.3%). Both groups experienced significant improvements in all outcomes except social support and emotional self-efficacy between baseline and post-intervention, 3, 6, and 12 months. Social support did not improve in the automated feedback group between baseline and 3 and 6 months, nor in the counselor feedback group between baseline and 6 and 12 months. Emotional self-efficacy did not improve in the automated feedback group between baseline and 6 months. There were no significant between-group differences in magnitude of change in outcomes at any time point. Results suggest that personalized feedback from a counselor adds no significant benefit to a web-based intervention for depression compared to automated feedback in terms of behavioral outcome.