{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:43:28Z","timestamp":1785545008442,"version":"3.56.0"},"reference-count":66,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Mhealth Uhealth"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Despite the high prevalence of depressive disorders, access to effective treatment remains limited due to financial, geographic, and social barriers. Online self-help groups offer a promising and scalable form of peer-based support beyond traditional clinical settings. Integrating cognitive behavioral therapy (CBT) techniques such as cognitive restructuring and behavioral activation into self-help groups may enhance their effectiveness.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study evaluated the efficacy of a cognitive behavioral therapy\u2013based online self-help group (COS) that integrates structured CBT techniques with peer-led group support as a low-intensity intervention for individuals with depressive symptoms. A randomized controlled trial (RCT) comparing COS with a CBT-based mobile application was conducted. Additionally, a separately recruited waitlist control group was included as a supplementary comparison condition.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Participants were recruited online. After eligibility screening via a structured clinical interview, participants were randomly assigned to a COS group (n=79) or a CBT-based mobile application group (n=39). An additional waitlist control group (n=48) was recruited separately during the second phase of the study. The COS intervention involved 7 videoconferencing sessions that incorporated peer-led group discussions, sharing lived experiences, and core CBT techniques such as cognitive restructuring. The primary outcome measure was depressive symptoms, assessed using the Beck Depression Inventory-II, and the secondary outcome was suicidal ideation, estimated using the Beck Scale for Suicide Ideation, measured at baseline, postintervention, and 3-month follow-up. Linear mixed models were used to evaluate group \u00d7 time interaction effects. Reliable change indices were also calculated to assess clinical significance. All statistical tests were 2-tailed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among participants assigned to the COS group, 61% (48\/79) completed all 7 sessions, and 84% (66\/79) attended 5 or more sessions. A significant time \u00d7 group interaction was observed for depressive symptoms (\n F<\/jats:italic>\n 4,288.47<\/jats:sub>\n =7.23,\n P<\/jats:italic>\n <.001). The COS group exhibited a substantial reduction in depressive symptoms from baseline to postintervention (\n t<\/jats:italic>\n 285.76<\/jats:sub>\n =10.77, two-tailed;\n P<\/jats:italic>\n <.001), with a large within-group effect size (\n d<\/jats:italic>\n =1.38); this improvement was maintained at the 3-month follow-up. Suicidal ideation also significantly decreased in the COS group (\n t<\/jats:italic>\n 277.11<\/jats:sub>\n =4.55, two-tailed;\n P<\/jats:italic>\n <.001), with sustained effects at follow-up. Clinically meaningful improvement in depressive symptoms, as defined by the reliable change index, was observed in 75% (56\/75) of COS participants. While both the COS and app-based CBT groups achieved comparable reductions in depressive symptoms, only the COS group demonstrated a significant reduction in suicidal ideation.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This RCT provides evidence that a structured, CBT-informed online self-help group can reduce depressive symptoms and suicidal ideation. The COS program offers a scalable, accessible alternative to traditional therapy, particularly in settings with limited access to mental health professionals.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/76028","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:10:07Z","timestamp":1777335007000},"page":"e76028-e76028","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of a Cognitive Behavioral Therapy\u2013Based Online Self-Help Group for Depression and Suicide Ideation: Randomized Controlled Trial"],"prefix":"10.2196","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6833-9583","authenticated-orcid":false,"given":"Minkyung","family":"Yim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1024-9147","authenticated-orcid":false,"given":"Haeun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8929-9640","authenticated-orcid":false,"given":"Soo-Eun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3689-3846","authenticated-orcid":false,"given":"Eunjin","family":"Jo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1939-7365","authenticated-orcid":false,"given":"Ji-Won","family":"Hur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"issue":"6","key":"R1","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1007\/s40273-021-01019-4","article-title":"The economic burden of adults with major depressive disorder in the United States (2010 and 2018)","volume":"39","author":"Greenberg","journal-title":"Pharmacoeconomics"},{"issue":"1","key":"R2","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1111\/acps.13414","article-title":"Clinical and societal burden of incident major depressive disorder: a population-wide cohort study in Stockholm","volume":"146","author":"Lundberg","journal-title":"Acta Psychiatr Scand"},{"issue":"10028","key":"R3","doi-asserted-by":"publisher","first-page":"1672","DOI":"10.1016\/S0140-6736(15)00390-6","article-title":"Addressing the burden of mental, neurological, and substance use disorders: key messages from Disease Control Priorities, 3rd edition","volume":"387","author":"Patel","journal-title":"Lancet"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2015.01.014","article-title":"Duration of untreated depression influences clinical outcomes and disability","volume":"175","author":"Ghio","journal-title":"J Affect Disord"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2021.09.046","article-title":"What is the short-term remission rate for people with untreated depression? 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