"Working through a selfhelp program online can prevent or delay major depression disorder in people who are vulnerable a study finds. Similar programs have been used to treat depression but this may be the first one tested to prevent it the researchers say. Online programs for mental health problems can be as effective as facetoface treatment and offer some advantages Low cost available at any time and customizable. But theyre not panaceas. In this experiment half of the participants were asked to do six halfhourlong exercises that were based on cognitive behavioral therapy and problemsolving therapy which are techniques commonly used for inperson therapy. In the cognitive behavioral therapy participants were asked to identify positive activities they used to engage in and then are asked to actively plan those activities again. At the next session participants reflect on their experiences. For the problemsolving therapy people were asked to create a list of the things that matter most to them in their lives and brainstorm on how to incorporate those things into daily life. They next were asked to categorize problems and worries into manageable and unmanageable the main focus in problemsolving therapy is to tackle those problems that are considered manageable. Article continues after this message from our sponsor Both cognitivebehavioral therapy and problemsolving therapy are intended to change negative thinking in order to alter mood and behavior. After completing each exercise participants in the intervention group received written individualized feedback from an online trainer. The trainers did not offer any therapeutic advice only motivation and encouragement to continue the exercises. Participants also could repeat the online sessions as often as they liked. The control group received information about depression but was under no obligation to read it. The study which was conducted by researchers from Leuphana University in Lueneburg Germany recruited  people with subthreshold depression which is defined as having some symptoms of depression but not enough to be diagnosed with major depressive disorder. It was published httpjama.jamanetwork.comarticle.aspxarticleid Tuesday in JAMA the journal of the American Medical Association. Of the  participants that began the study  completed the telephone followup at the end of  months. Twentyseven percent in the intervention group experienced depression compared with  percent in the control group. It is unclear if the people who went on to develop major depressive disorder had experienced it before. Lead author Claudia Buntrock httpfox.leuphana.deportaldepersonsclaudiabuntrockdedafabebbbddaef.html a PhD candidate in clinical psychology at Leuphana says that because the study only tracked participants mental health over the course of  months the longterm effectiveness of the intervention is unknown. Its also not clear if this kind of program could be scaled up. It took the trainers about  minutes to provide feedback for each session and they also stayed in touch with participants via instant messaging Buntrock says. Other experiments  http online therapy have found that people didnt continue it if it wasnt guided by an actual human. One reason could be that when people are depressed they can have a hard time getting motivated to do things. More studies are needed to evaluate the preventive effects of unguided webbased interventions on the onset of major depressive disorder Buntrock wrote in an email. Still Buntrock seems pleased with the results especially since the German insurance company BARMER GEK that sponsored the trial is now providing it to its customers. I was surprised by the big response to our study Buntrock wrote. And of course Im surprised about what happens now that a health insurance company offers the intervention to its members. Its a success story you might dream of when you start but it actually seeing to happen is a great feeling."