Research examining e-health interventions for depression based on CBT therapies has found evidence of successful outcomes [449], and their use as the optimal low-intensity treatment for adults experiencing depression has been recommended by the UK NICE Guidelines [444]. Recommended programs include Beating the Blues and MoodGYM both of which have been found to improve a range of depression outcomes [651-653]. Neither of these programs, however, address comorbid AOD use.
A small number of e-health interventions specifically designed to treat comorbid depression and AOD use have been evaluated. The SHADE program, consisting of nine sessions of interactive exercises based on MI and CBT, has been associated with moderate to large effect sizes for alcohol consumption and significant reductions in depression scores over 12-month follow-up [654, 655]. More recently, a brief (4-session) early intervention program called the DEAL Project was developed, targeting young people experiencing depression with harmful patterns of alcohol use [656]. The program is undertaken entirely online with no clinician support. In evaluating the intervention, Deady and colleagues [657] found that individuals randomised to receive the DEAL Project demonstrated a greater reduction in symptoms of depression and alcohol use compared to individuals randomised to an attention-control condition.
One other study has examined the use of a single-session of online personalised feedback and psychoeducation provided to college students [658]. The study compared alcohol feedback only, depressed mood feedback only, integrated feedback, and an assessment only condition. At 1-month follow-up, no differences in depressed mood or alcohol use were found across the conditions.