Adaptive actions in ICBT: Comparison with homework engagement

Why was the study done?

We wanted to understand what helps people get better during online CBT. We looked at “adaptive actions”, the small, helpful steps people take in daily life (like reaching out to someone, doing something enjoyable, setting goals, following healthy routines, balanced thinking). We wanted to see if these actions explained why symptoms improve during treatment.

What was done in the study?

We reviewed information from 625 people who completed the 8-week Wellbeing Course in Saskatchewan. Everyone did five online lessons, and completed questionnaires before, during and after treatment. We looked at how many adaptive actions people took and how this related to symptoms like depression, anxiety, PTSD, panic, social anxiety, sleep problems, and overall wellbeing.

What did we find out?

This study reached the following conclusions:

1. People performed more adaptive actions during treatment and kept them up afterward.
2. These actions were one of the strongest factors linked to feeling better.
3. When people made more adaptive actions, their symptoms improved, and as symptoms improved, people continued doing more helpful actions.
4. Homework (between-session activities designed to support learning and change) was related to taking adaptive actions but was less predictive of improvement compared to adaptive actions.

Where do we go from here?

Helping people take small, meaningful steps early in treatment may make online CBT even more effective. Future research could explore ways to support and encourage adaptive actions, such as weekly check-ins or gentle reminders to help people use their skills in daily life.