Effects of internet-based cognitive behavioral therapy on depressive symptoms among new graduate nurses: a pilot study

Objectives: To preliminarily determine the effects of an Internet-based cognitive behavioral therapy program for the stress management of new graduate nurses on improving depressive symptoms and other psychological outcomes using a pre-post experimental design. Methods: A 6-week, six-lesson Internet-based cognitive behavioral therapy program was developed through an extensive interviewing of nurses. The program utilized major cognitive behavioral therapy skills (self-monitoring, cognitive restructuring, assertiveness, problem-solving, and relaxation). We administered the Internet-based cognitive behavioral therapy program to participants who were at 5 months after starting their job. At baseline and post-intervention, we measured the primary outcome of depressive symptoms along with the secondary outcomes of psychological distress, dysfunctional attitude, and knowledge of and self-efficacy for the components of cognitive behavioral therapy. Results: Twenty-three new graduate nurses were recruited, although only 21 actually took part in the program. Twelve (57%) participants completed all six lessons, and about one-third of participants completed less than three lessons. At post-intervention, only 12 of the 21 participants had completed the post-intervention survey. The program failed to show significant intervention effects on depressive symptoms, psychological distress, and dysfunctional attitude, but it did show significant or marginally significant improvements in knowledge of and self-efficacy for most cognitive behavioral therapy components. Conclusions: The relatively low intensity of the program may explain the null findings. This suggests a need for further improvement of the content and mode of delivery. Nevertheless, the program was able to improve knowledge of and self-efficacy for most cognitive behavioral therapy components.