Online program offers free behavioral therapy as COVID quarantine lingers

For millions of Americans, riding out the COVID-19 pandemic means making it through more than long lines at the grocery store or missed paychecks. A survey from the American Psychiatric Association reveals that nearly half of U.S. adults now struggle with anxiety, and more than a third report the pandemic has “serious” effects on their mental health.

“In speaking with our medical students and trainees, we have discovered that this has caused a significant amount of anxiety for them,” said Elizabeth Newlin, MD, associate professor of psychiatry at McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth) and associate executive director of the UTHealth Trauma and Resilience Center.

In a time of social isolation, UTHealth brings help directly to phone, laptop, and tablet screens through a digital cognitive behavioral therapy (DCBT) program. Developed by Magellan Health, the program offers research-proven therapy through online modules tailored to six specific areas: anxiety disorders, mild to moderate depression, chronic pain, obsessive-compulsive disorder, substance use, and sleep difficulties.

“We moved toward telehealth because we saw that people had barriers to in-person care such as transportation or travel costs, and we had a lot of cancellations,” said Ron Acierno, PhD, professor of psychiatry and executive director of the Trauma and Resilience Center. “We wanted to have services that people can access anywhere…to meet people ‘where they’re at’ so to speak.”

The DCBT program, available for free to all Houston and Harris County adults, screens users to determine which modules best suit their needs, and can track the progress of symptoms based on user input. If a person’s condition deteriorates, the program will prompt them to call the Trauma and Resilience Center or the National Suicide Prevention Lifeline – otherwise known as the Suicide Hotline.

“Ideally the program forms part of a stepped care process,” Newlin said. “It can help for milder symptoms, and then as people have greater severity, you add additional intervention, including home telemental health, such as that delivered by a Trauma and Resilience Center therapist.”

Users can access the different modules through a computer or app on a smart device:

• MoodCalmer – Designed to alleviate mild to moderate depression, the four-session program helps people identify signs of depression, reverse thinking errors, and schedule pleasant activities.
• FearFighter® – Aimed at people with anxiety disorders, the nine-session program includes steps to reduce panic and phobia, which are rooted in fear. Exercises include tightening and relaxing muscles, diaphragmatic breathing, and “catching” your breath.
• OCFighter – Nine sessions help users identify triggers for obsessive-compulsive behavior, prevent exposure and response, and get help for depression and disassociation.
• RESTORE® – These six sessions are designed to improve sleep problems by targeting four main areas: thoughts, habits, arousal, and consequences. Participants identify problem habits, learn about the relationship between sleep and emotional disturbances, and practice “applied relaxation” techniques.
• Shade – This 10-session program helps people with alcohol or substance misuse. The program includes mood monitoring, identifying problematic thought patterns, and developing effective drug refusal skills.
• ComfortAble – Chronic pain is addressed in seven sessions to improve comfort ranging from pacing physical activity to relaxation exercises to planning for future flare-ups. It also helps people change unproductive thoughts and behaviors.

Acierno, who also serves as vice chair for veteran affairs in the Faillace Department of Psychiatry and Behavioral Sciences at UTHealth, said that “slow-moving” traumas like the COVID-19 pandemic can especially affect those with histories of acute trauma, such as combat veterans and sexual assault survivors.

“Their capacity to deal with prolonged stress may be lower than it used to be,” he said, adding that first responders and health care workers can also benefit from the program as they carry heavy mental and emotional loads serving on the front lines of the crisis.

As Americans continue to live isolated – at least physically – from many of their supportive relationships, Newlin said they may need new ways to cope, and programs like DCBT can play an important part in that. 

“Even those of us who might be coping really well, it’s not a bad idea to shore up your coping capacity  so you’re well prepared for the ongoing mental health demands related to the pandemic,” she said.

To learn more or access the DCBT program, visit: https://uthealth.ontobetterhealth.com/