Entre or Sampler? A Randomized Controlled Trial of Two Approaches to Single Session Internet-Based Interventions

BackgroundInterventions teaching cognitive-behavioral skills feature prominently among evidence-based treatments for emotional disorders. However, the relative impact of interventions that teach one cognitive-behavioral skill in-depth (i.e., an entree intervention) versus those that provide limited coverage of multiple skills (i.e., a sampler intervention) remains unclear. In this study, we compared these two approaches using unguided single-session internet-based cognitive-behavioral interventions.MethodsA total of 657 participants living in the U.S. with elevated depressive symptoms were randomly assigned to the entree, sampler, or no-intervention control conditions. The entree approach focused in-depth on developing one skill and the sampler condition introduced three skills. Both interventions lasted approximately 30 min. All participants completed measures of depressive symptoms, loneliness, and coping skill use and quality before the intervention and a week after the intervention.ResultsThere were no condition differences in change in depressive symptoms, coping skill usage, coping skill quality, or loneliness. Those in the sampler condition were less likely to drop out than those in the entree condition. In addition, condition differences were moderated by initial depressive symptom severity, such that among the more severely depressed the sampler condition led to greater symptom reduction than the entree and control conditions.ConclusionsWe did not find overall differences between the entree, sampler, and control conditions on primary outcomes. Nonetheless, the differences that did emerge suggest offering a variety of skills improves retention and provides greater relief for those with high initial depressive symptom severity in single-session internet-based interventions.Clinicaltrials.gov ID NCT04643964, registered on 11/12/2020.ConclusionsWe did not find overall differences between the entree, sampler, and control conditions on primary outcomes. Nonetheless, the differences that did emerge suggest offering a variety of skills improves retention and provides greater relief for those with high initial depressive symptom severity in single-session internet-based interventions.Clinicaltrials.gov ID NCT04643964, registered on 11/12/2020.