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E-COUCH SELF-HELP

e-couch can help you to manage and prevent the symptoms of common mental health
issues.



 * Information about what you might be going through

 * How to get help and which treatments work

 * Evidence-based strategies

 * Practical advice and self-help

 * Interactive workbooks




HOW IS E-COUCH STRUCTURED?

e-couch offers five programs: Depression, Anxiety & Worry, Social Anxiety,
Divorce & Separation and Loss & Bereavement.

Each program includes a comprehensive information module, as well as self-help
modules with interactive exercises and workbooks which teach evidence-based
strategies.

Depression program

The Depression program may be helpful for people who are experiencing symptoms
of depression. It provides information about depression and teaches a range of
evidence-based approaches to help you reduce depressive symptoms and improve
your life.

Depression information

What depression feels like, how common it is, how to get help and which
treatments work.

Cognitive Behaviour Therapy (CBT)

Deal with unhelpful thoughts to improve your mood and the way you think about
yourself.

Interpersonal Psychotherapy (IPT)

Learn to change how you feel by changing the way you interact with people.

Problem-solving

Skills to work through difficulties to cope better with stressful situations.

Physical activity

Increase or maintain your physical activity levels to improve depression.

Relaxation

Mindfulness meditation and progressive muscle relaxation exercises.

Anxiety & Worry program

The Anxiety & Worry program may be helpful for people who experience anxiety and
worry about many different areas of life. It provides information about common
anxiety disorders and teaches a range of evidence-based approaches to help you
reduce the effects of anxiety & worry, and improve your life.

Anxiety & Worry information

Stress, anxiety, worry; types of anxiety disorders, how worry can feel out of
control, how to get help and which treatments work.

CBT: Meaning and purpose of worry

Beliefs about worry and how to deal with uncertainty.

CBT: The act of worry

Detect when you are worrying and turn your attention away from worry.

CBT: The content of your worries

Put your worries into words and learn skills to solve problems and change your
thinking.

CBT: Your feelings

Get in touch with your feelings in order to worry less.

Relaxation

Mindfulness meditation and progressive muscle relaxation exercises.

Physical activity

Increase or maintain your physical activity levels to reduce anxiety.

Social Anxiety program

The Social Anxiety program provides information about social anxiety or social
phobia - the intense anxiety that some people experience in social or
performance situations. It also teaches a range of evidence-based approaches to
help you to manage your symptoms and improve your life.

Social Anxiety information

What social anxiety feels like and when it can become a problem, how to get help
and which treatments work.

Exposure practice

Lower your anxiety in the situations you fear, and stop avoiding experiences
which may be necessary for your personal development.

Modifying your thinking (CBT)

Shift the way you think about social or performance situations.

Social skills training

Increase your confidence by developing your social skills.

Attention practice

Change your focus in social or performance situations to feel less
self-conscious.

Relaxation

Breathing and relaxation exercises to help reduce the physical symptoms of
anxiety.

Divorce & Separation program

The Divorce & Separation program may be helpful for people currently going
through a relationship separation or who have separated recently. It provides
information about factors that might affect how you are feeling, and practical
advice about how to cope. It also teaches a range of evidence-based approaches
to support your mental health and wellbeing.

Divorce & Separation information

The emotional rollercoaster, different reactions, adjustments, how to look after
yourself and your children.

Problem-solving

Strategies to help work through some of the difficulties you may be
experiencing.

Cognitive Behaviour Therapy (CBT)

Deal with unhelpful thoughts to improve your mood and the way you think about
yourself.

Dealing with anger

Refocus goals to help shed resentment and learn to manage anger to feel better.

Physical activity

Increase or maintain your physical activity levels to reduce the risk of
depression and anxiety.

Loss & Bereavement program

The Loss & Bereavement program may be helpful for people who have recently lost
someone they care about. It provides information about common reactions to loss
and ideas to help with your grief. It also teaches a range of evidence-based
approaches to support your mental health and wellbeing.

Loss & Bereavement information

How loss can feel catastrophic, myths, different ways of grieving, stigma and
denial, and the risk of depression.

Self-help for grief

Ideas which may be useful to help with your grief.

Changing your thinking (CBT)

Tackle depressive or anxious thinking that might develop from your grief.


EVIDENCE FOR EFFECTIVENESS

The information and strategies presented in the e-couch programs are based on
the best available scientific evidence.



The programs have also been evaluated by research groups from around the world
who have studied their effectiveness with different populations:

The e-couch Depression program has been evaluated in three randomised controlled
trials (RCTs). It has been shown to reduce depressive symptoms, compared to a
control, in a randomly selected community sample and in people over 45 years old
with a history of cardiovascular disease. The CBT and IPT depression modules
have also been shown to be as effective as the extensively evaluated moodgym
program in reducing depression symptoms.

The e-couch Anxiety & Worry program has been found to be effective in the
treatment of Generalised Anxiety Disorder (GAD) in 18-30 year old individuals in
the community, with both the e-couch program and SSRI medication found to be
effective compared to a control website. The program has also been trialled for
prevention of anxiety in young adults and when combined with email reminders was
found to significantly reduce sensitivity to anxiety and ‘number of days out of
role’.

The e-couch Social Anxiety program has been evaluated in a randomised controlled
trial with a large sample of community users which showed a small but
statistically significant improvement in social anxiety symptoms. A study with a
smaller sample also found that the program resulted in a significant reduction
of symptoms in participants with social anxiety.

Research references

E-COUCH DEPRESSION PROGRAM

Crisp DA, & Griffiths KM. (2016). Reducing Depression Through an Online
Intervention: Benefits from a User Perspective. Journal of Medical Internet
Research, 3(1), 1-11.

Crisp D, Griffiths K, et al. (2014). An online intervention for reducing
depressive symptoms: secondary benefits for self-esteem, empowerment and quality
of life. Psychiatry Res, 216(1), 60-6.

Donker T, Batterham PJ, et al. (2013). Predictors and moderators of response to
internet-delivered Interpersonal Psychotherapy and Cognitive Behavior Therapy
for depression. J Affect Disord, 151(1), 343-51.

Donker T, Bennett K, et al. (2013). Internet-Delivered Interpersonal
Psychotherapy Versus Internet-Delivered Cognitive Behavioral Therapy for Adults
With Depressive Symptoms: Randomized Controlled Noninferiority Trial. Journal of
Medical Internet Research, 15(5), e82.

Donkin L, Hickie IB, et al. (2013). Rethinking the dose-response relationship
between usage and outcome in an online intervention for depression: randomized
controlled trial. Journal of Medical Internet Research, 15(10), e231.

Glozier N, Christensen H, et al. (2013). Internet-delivered cognitive
behavioural therapy for adults with mild to moderate depression and high
cardiovascular disease risks: a randomised attention-controlled trial. PLoS One,
8(3), e59139.

Donkin L, & Glozier N. (2012). Motivators and motivations to persist with online
psychological interventions: a qualitative study of treatment completers.
Journal of Medical Internet Research, 14(3), e91.

Donkin L, Hickie IB, et al. (2012). Sampling bias in an internet treatment trial
for depression. Translational Psychiatry 2(10): e174.

Griffiths KM, Mackinnon AJ, et al. (2012). The effectiveness of an online
support group for members of the community with depression: a randomised
controlled trial. PLoS One, 7(12), e53244.

Cockayne N, Glozier N, et al. (2011). Internet-based treatment for older adults
with depression and co-morbid cardiovascular disease: protocol for a randomised,
double-blind, placebo controlled trial. BMC Psychiatry, 11(1), 10.

Griffiths K, Crisp D, et al. (2010). The ANU WellBeing study: a protocol for a
quasi-factorial randomised controlled trial of the effectiveness of an Internet
support group and an automated Internet intervention for depression. BMC
Psychiatry, 10(1), 20.

E-COUCH ANXIETY & WORRY PROGRAM

Calear AL, Batterham, PJ, et al. (2016). Cluster randomised controlled trial of
the e-couch Anxiety and Worry program in schools. Journal of Affective
Disorders, 196, 210-7.

Calear AL, Christensen H, et al. (2016). A pilot randomized controlled trial of
the e-couch anxiety and worry program in schools. Internet Interventions, 6,
1-5.

Christensen H, Batterham P, et al. (2014). Prevention of Generalized Anxiety
Disorder Using a Web Intervention, iChill: Randomized Controlled Trial. Journal
of Medical Internet Research, 16(9), e199.

Christensen H, Mackinnon AJ, et al. (2014). The effectiveness of an online
e-health application compared to attention placebo or SSRI in the treatment of
Generalised Anxiety Disorder. Internet Interventions, 16(9).

Christensen H, Griffiths KM, et al. (2010). Protocol for a randomised controlled
trial investigating the effectiveness of an online e health application for the
prevention of Generalised Anxiety Disorder. BMC Psychiatry, 10, 25.

Christensen H, Guastella, AJ, et al. (2010). Protocol for a randomised
controlled trial investigating the effectiveness of an online e-health
application compared to attention placebo or SSRI in the treatment of
generalised anxiety disorder. Trials, 11, 48.

E-COUCH SOCIAL ANXIETY PROGRAM

Powell J, Williams V, et al. (2020). Effectiveness and cost-effectiveness of a
self-guided internet intervention for social anxiety symptoms in a general
population sample: randomized controlled trial. J Med Internet Res,
22(1):e16804.

Powell J, Atherton H, et al. (2017). Effectiveness and cost-effectiveness of a
fully self-guided internet-based intervention for sub-clinical social anxiety
symptoms: Protocol for a randomised controlled trial. Digital Health, 3,
2055207617702272.

Bowler JO, Mackintosh B, et al. (2012). A comparison of cognitive bias
modification for interpretation and computerized cognitive behavior therapy:
effects on anxiety, depression, attentional control, and interpretive bias. J
Consult Clin Psychol, 80(6), 1021-33.




FREQUENTLY ASKED QUESTIONS

What is e-couch?

e-couch is an online, self-directed training program which provides interactive
self-help and evidence-based information to help users to understand and manage
symptoms associated with common mental issues.

The program is like an interactive self-help book, which you can log back in to
at any time to learn more skills or to add to your workbooks.

e-couch offers five programs: Depression, Anxiety & Worry, Social Anxiety,
Divorce & Separation and Loss & Bereavement. Each program includes a
comprehensive information module, as well as self-help modules with interactive
exercises and workbooks which teach evidence-based strategies.

e-couch is accredited to the National Safety and Quality Digital Mental Health
standards . These standards improve the quality of digital mental health
services and protect service users and their support people from harm.

Does e-couch follow established clinical practice guidelines?

Yes. e-couch provides training in cognitive behaviour therapy (CBT),
interpersonal psychotherapy (IPT) and psychoeducation, which are recommended
treatments for depression and anxiety disorders in the clinical practice
guidelines published by Royal Australian and New Zealand College of
Psychiatrists. Digital CBT or Internet-delivered CBT (iCBT) is also recognised
in the guidelines.

You can access the clinical practice guidelines through the following links:

 * 2020 Royal Australian and New Zealand College of Psychiatrists clinical
   practice guidelines for mood disorders
 * Royal Australian and New Zealand College of Psychiatrists clinical practice
   guidelines for the treatment of panic disorder, social anxiety disorder and
   generalised anxiety disorder

Who is e-couch for?

e-couch provides information about emotional problems - what causes them, how to
prevent them and how to treat them. It includes exercises to help you understand
yourself and others. Even better, it provides you with a set of strategies that
might help you to improve your life.

Perhaps you are feeling anxious or depressed. You may be upset by a divorce or
separation or a recent loss of someone close. If so, e-couch may help you work
through your feelings. One in five people have an emotional problem in any
twelve month period... so this site is designed for lots of people!

Note that if your symptoms are distressing or limiting we suggest that you seek
the advice of a GP, mental health professional, psychologist or a specialist
medical practitioner to check out your mental health status.

Click here to take a brief screening quiz for feedback about your symptoms of
depression, anxiety or social anxiety, and whether e-couch may be helpful for
you.

The e-couch program content is suitable for users aged 16 years or older.
However, the e-couch Terms of Use require that users are aged 14 years or older,
or aged 18 years or older if from the USA.

Does e-couch work?

The information and strategies presented in the e-couch programs are based on
the best available scientific evidence. The programs have also been evaluated by
research groups from around the world who have studied their effectiveness with
different populations:

e-couch Depression program

A randomised controlled trial (RCT) showed that the e-couch Depression program
yielded a greater reduction in depressive symptoms immediately post-test than an
attention control, with the combination of e-couch and an online support group
showing longer term positive outcomes for participants. Most participants
perceived the e-couch Depression program to be beneficial. Reported benefits
included an increased understanding of depression, increased work productivity,
a better ability to cope with everyday stress, an improved ability to relate to
others, and improved enjoyment of life.

The e-couch CBT and IPT depression toolkits have also been shown to be as
effective as the extensively evaluated moodgym program in an equivalence RCT
undertaken among spontaneous community users. All groups showed moderate to
large within-groups effect sizes for reduction in depression symptoms.

An additional RCT demonstrated that the e-couch Depression program was effective
in the reduction of depressive symptoms in people aged 45 years or more with a
history of, or risks for, cardiovascular disease, compared to an attention
placebo control.

e-couch Anxiety & Worry program

The e-couch Anxiety and Worry program has been trialled as a preventive program
for 18–30-year-old individuals in the community (the iChill trial). This RCT
found that when combined with email reminders, e-couch significantly decreased
sensitivity to anxiety and ‘number of days out of role’ for participants, at
least 12 months after using the program.

In a separate arm of this RCT, the e-couch Anxiety and Worry program was found
to be effective in the treatment of Generalised Anxiety Disorder (GAD) in
18–30-year-old individuals in the community. Both the online program and SSRI
medication were found to be effective in the treatment of GAD compared to a
control website.

The program has also been evaluated in a clustered randomised controlled trial
as a preventive program in Australian schools. No significant differences were
found for anxiety symptoms across study conditions, suggesting that a different
approach (such as the moodgym program ) is more appropriate for reducing anxiety
in younger, school-based populations.

e-couch Social Anxiety program

The e-couch Social anxiety program has been studied in a recent, large RCT with
self-selected community users in England. This trial showed showed that use of
the program was associated with a small but statistically significant
improvement in social anxiety symptoms.

A previous, smaller study also found that the e-couch Social anxiety program
resulted in a significant reduction of social anxiety and depression in
participants with high social anxiety compared to a control group.


REFERENCES

E-COUCH DEPRESSION PROGRAM

Crisp DA, & Griffiths KM. (2016). Reducing Depression Through an Online
Intervention: Benefits from a User Perspective. Journal of Medical Internet
Research, 3(1), 1-11.

Crisp D, Griffiths K, et al. (2014). An online intervention for reducing
depressive symptoms: secondary benefits for self-esteem, empowerment and quality
of life. Psychiatry Res, 216(1), 60-6.

Donker T, Batterham PJ, et al. (2013). Predictors and moderators of response to
internet-delivered Interpersonal Psychotherapy and Cognitive Behavior Therapy
for depression. J Affect Disord, 151(1), 343-51.

Donker T, Bennett K, et al. (2013). Internet-Delivered Interpersonal
Psychotherapy Versus Internet-Delivered Cognitive Behavioral Therapy for Adults
With Depressive Symptoms: Randomized Controlled Noninferiority Trial. Journal of
Medical Internet Research, 15(5), e82.

Donkin L, Hickie IB, et al. (2013). Rethinking the dose-response relationship
between usage and outcome in an online intervention for depression: randomized
controlled trial. Journal of Medical Internet Research, 15(10), e231.

Glozier N, Christensen H, et al. (2013). Internet-delivered cognitive
behavioural therapy for adults with mild to moderate depression and high
cardiovascular disease risks: a randomised attention-controlled trial. PLoS One,
8(3), e59139.

Donkin L, & Glozier N. (2012). Motivators and motivations to persist with online
psychological interventions: a qualitative study of treatment completers.
Journal of Medical Internet Research, 14(3), e91.

Donkin L, Hickie IB, et al. (2012). Sampling bias in an internet treatment trial
for depression. Translational Psychiatry 2(10): e174.

Griffiths KM, Mackinnon AJ, et al. (2012). The effectiveness of an online
support group for members of the community with depression: a randomised
controlled trial. PLoS One, 7(12), e53244.

Cockayne N, Glozier N, et al. (2011). Internet-based treatment for older adults
with depression and co-morbid cardiovascular disease: protocol for a randomised,
double-blind, placebo controlled trial. BMC Psychiatry, 11(1), 10.

Griffiths K, Crisp D, et al. (2010). The ANU WellBeing study: a protocol for a
quasi-factorial randomised controlled trial of the effectiveness of an Internet
support group and an automated Internet intervention for depression. BMC
Psychiatry, 10(1), 20.

E-COUCH ANXIETY & WORRY PROGRAM

Calear AL, Batterham, PJ, et al. (2016). Cluster randomised controlled trial of
the e-couch Anxiety and Worry program in schools. Journal of Affective
Disorders, 196, 210-7.

Calear AL, Christensen H, et al. (2016). A pilot randomized controlled trial of
the e-couch anxiety and worry program in schools. Internet Interventions, 6,
1-5.

Christensen H, Batterham P, et al. (2014). Prevention of Generalized Anxiety
Disorder Using a Web Intervention, iChill: Randomized Controlled Trial. Journal
of Medical Internet Research, 16(9), e199.

Christensen H, Mackinnon AJ, et al. (2014). The effectiveness of an online
e-health application compared to attention placebo or SSRI in the treatment of
Generalised Anxiety Disorder. Internet Interventions, 16(9).

Christensen H, Griffiths KM, et al. (2010). Protocol for a randomised controlled
trial investigating the effectiveness of an online e health application for the
prevention of Generalised Anxiety Disorder. BMC Psychiatry, 10, 25.

Christensen H, Guastella, AJ, et al. (2010). Protocol for a randomised
controlled trial investigating the effectiveness of an online e-health
application compared to attention placebo or SSRI in the treatment of
generalised anxiety disorder. Trials, 11, 48.

E-COUCH SOCIAL ANXIETY PROGRAM

Powell J, Williams V, et al. (2020). Effectiveness and cost-effectiveness of a
self-guided internet intervention for social anxiety symptoms in a general
population sample: randomized controlled trial. J Med Internet Res,
22(1):e16804.

Powell J, Atherton H, et al. (2017). Effectiveness and cost-effectiveness of a
fully self-guided internet-based intervention for sub-clinical social anxiety
symptoms: Protocol for a randomised controlled trial. Digital Health, 3,
2055207617702272.

Bowler JO, Mackintosh B, et al. (2012). A comparison of cognitive bias
modification for interpretation and computerized cognitive behavior therapy:
effects on anxiety, depression, attentional control, and interpretive bias. J
Consult Clin Psychol, 80(6), 1021-33.

Who is behind e-couch?

e-couch was originally developed and evaluated over 10 years by researchers at
the Australian National University - the same team that developed the well-known
moodgym program for depression and anxiety. The principal authors of the content
were Professor Kathy Griffiths, Georgia Tayler and Professor Helen Christensen.

The development and delivery of e-couch is now undertaken by e-hub Health – an
ANU spin-off company managed by the senior members of the original team. e-hub
Health is committed to the ongoing development of quality resources which make a
measurable impact in the wellbeing of users. e-hub Health is part of the
Dialogue group of companies.

More FAQs

Page: https://www.ecouch.com.au/




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