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Uptake, adherence, and dropout rates for Internet-based programs for depression are in need of improvement. Excessive user burden (eg, heavy content, extended duration) may undermine engagement and precipitate dropout. To address this problem, an alternative format was proposed: Brief Interactive Training Sessions (BITS). BITS target a narrow behavioral health skill and require 3–4 hours to complete. A depression-focused version of BITS that provides training in cognitive distortion/restructuring was tested. Fifty-two depressed college students were randomly assigned to BITS or to a wait-list. Students competed pre-and post-test (7 week) assessments of depression and cognitive distortions. Uptake rate was 83%. Among study completers, adherence was 96%. The dropout rate did not improve. Compared to the control group, the experimental group reported a significant reduction in depression and in cognitive distortions. The BITS format is a promising vehicle for improving uptake and adherence while achieving positive clinical outcomes.

A pilot test of Internet-delivered brief interactive training sessions for depression: Evaluating dropout, uptake, adherence, and outcome