Evaluation of Two Web-Based Interventions (REMOTION and Res-Up!) for Clients From Psychotherapy Waitlists in Routine Outpatient Psychotherapy (Therapy Online Plus-TOP): Randomized Controlled Trial.

Background: Internet-based interventions can improve treatment accessibility, prevent chronicity, and reduce waiting times. 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: This study aimed to compare 2 transdiagnostic web-based interventions focusing on improving emotion regulation and resilience to a control group (CG) in individuals recruited from waiting lists for routine outpatient psychotherapy. Methods: At 4 outpatient centers in Germany, 421 adult participants were recruited from respective waiting lists and randomized into 1 of 2 intervention groups (ie, "REMOTION" and "Res-Up!") or the CG without access to the interventions. Participants were not restricted from accessing face-to-face psychotherapy during the course of the study. Assessments occurred at baseline, 6 weeks after intervention, and at 12-week follow-up. The primary outcome was symptom severity. The 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 CG for the primary outcome symptom severity, although all groups significantly improved over time. The secondary outcomes for emotion regulation improvement found significant between-group differences only when comparing REMOTION to CG in acceptance of negative emotions. For resilience and all other outcomes, most groups improved significantly over time, but treatment groups did not differ from CG. Conclusions: Although we were able to find significant improvements across time for the treatment groups, participants in the CG improved significantly as well. Findings for between-group interactions show small additional benefits for participation in REMOTION for emotion regulation compared to the CG only. The study provides information for future research concerning the effectiveness of and difficulties in implementing transdiagnostic internet-based interventions during waiting times for psychotherapy. Our findings suggest that transdiagnostic internet-based interventions do not seem to be more effective than simply waiting for psychotherapy.