Randomized Controlled Trial of Two Transdiagnostic Web-Based Interventions – REMOTION (compensation-oriented) and Res-Up! (capitalization-oriented) – in Routine Outpatient Psychotherapy: Therapy Online Plus (TOP) (Preprint)

BACKGROUND Internet–based interventions can improve treatment accessibility, prevent chronicity and reduce waiting times. Transdiagnostic approaches to such interventions may adopt one of two orientations: a compensation (COMP) focus, aimed at addressing deficits, or a capitalization (CAP) focus, which seeks harnessing individuals’ existing strengths. Despite their potential, the effectiveness of transdiagnostic internet–based interventions for individuals on waiting lists and their integration into routine care remains insufficiently evaluated. OBJECTIVE Aim of this study was to examine two transdiagnostic web-based interventions focusing on improving emotion regulation (COMP) and improving resilience (CAP) compared to a control group in individuals waiting for routine outpatient psychotherapy. METHODS At four outpatient centers in Germany, adult participants were recruited and randomized into one of two intervention groups: "REMOTION" [COMP] and "Res-Up!" [CAP], or the control group without access to the interventions. Assessments occurred at baseline, 6-weeks post and 12-weeks follow-up. Primary outcome was symptom severity. Secondary outcomes focused on emotion regulation and resilience. Other outcomes included depressive symptoms, self-compassion and self-esteem. RESULTS No significant differences were found between the intervention groups and the control group for the primary outcome symptom severity (BSI-18), while all groups significantly improved over time. Secondary outcomes for emotion regulation improvement found significant between-groups differences only in comparing REMOTION [COMP] to CG in acceptance of negative emotions (FrAGe NE). For resilience and all other outcomes, most groups improved significantly over time, but treatment groups did not differ from CG. CONCLUSIONS Though we were able to find significant improvements across time for the treatment groups, participants in the control group improved significantly as well. Findings for between-groups interactions show small additional benefits for participation in REMOTION [COMP] for emotion regulation compared to the CG only. The study provides information for future research concerning the effectiveness of transdiagnostic internet–based interventions during waiting times and beyond. CLINICALTRIAL ClinicalTrials.gov NCT04352010, International Registered Report Identifier (IRRID) INTERNATIONAL REGISTERED REPORT RR2-10.2196/41413