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Osgood-Hynes, Deborah J., John H. Greist, Isaac M. Marks, Lee Baer, Susan W. Heneman, Keith W. Wenzel, Peter A. Manzo, J. Richard Parkin, Christopher J. Spierings, Susan L. Dottl, Helene M. Vitse: Self-Administered Psychotherapy for Depression Using a Telephone-Accessed Computer System Plus Booklets: An Open U.S. - U.K. Study. Journal of Clinical Psychiatry 59(7): 358-365, 1998.

Objective To evaluate the efficacy and acceptability of a self-help program for mild-to-moderate depression that combined treatment booklets and telephone calls to a computer-aided Interactive Voice Response (IVR) system.

Method In an open trial, 41 patients from Boston, Massachusetts; Madison, Wisconsin; and London, England, used COPE, a 12-week self-help system for depression. COPE consisted of an introductory videotape and 9 booklets accompanied by 11 telephone calls to an IVR system that made self-help recommendations to patients based on information they entered.

Results All 41 patients successfully completed the self-assessment in the booklets and telephone calls; 28 (68.8%) also completed the 12-week self-help program. Hamilton Rating Scale for Depression (HAM-D) and Work and Social Adjustment scores improved significantly (41% and 42% mean reduction in the intent-to-treat sample, respectively, p < .001). Eighteen (64%) of the 28 completers were considered responders on the basis of ≥ 50% reduction in their HAM-D scores. There was a higher percentage of completers in the pooled U.S. sites (82% vs. 43%), and U.S. completers improved more than those in the United Kingdom (73% vs. 43% were responders). Most (68%) of the calls were made outside usual office hours, Monday–Friday, 9:00 a.m. to 5:00 p.m. Expectation of effectiveness and time spent making COPE calls (more treatment modules) correlated positively with improvement over 12 weeks. Mean call length for completers was 14 minutes.

Conclusion A self-help system compromised of a computer-aided telephone system and a series of booklets was used successfully by people with mild-to-moderate depression. These preliminary results are encouraging for people who cannot otherwise access ongoing, in-person therapy.