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Development of the Internet-based Cognitive Behavioral Therapy Program
for Decreasing Depression Among Nursing Students: An Intervention Mapping
Protocol

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D. Kansai, S. Skulphan, C. Suvanayos, and P. Thungjaroenkul 1
1 Faculty of Nursing, Chiang Mai University, Thailand

Background: Depression is a common psychological health issue, especially among nursing students
who need to interact with clients and health professionals while exerting high accountability during
practice. Internet-based cognitive behavioral therapy is a potential technique aiming at restructuring
cognitions and beliefs that provide a greater sense of anonymity and convenience.

Objective: To present the development of the internet-based cognitive behavioral therapy program
for decreasing depression among nursing students using intervention mapping protocol.

Methods: The program was developed following six steps of intervention mapping protocol: (1) needs
assessment from literature review related to nursing students, (2) performance objectives to
decrease depression among nursing students, (3) theory-based intervention involved developing the
program based on cognitive behavioral therapy, (4) intervention plan to design cognitive behavioral
therapy strategies on a website, (5) implementation in nursing colleges, and (6) evaluation using
a randomized control trial.

Results: The literature showed that nursing students lacked an understanding of depression, its
symptoms and causes, had inadequate support specific to addressing depression, and needed a
self-help channel that was easily accessible and stigma-free. The program was guided by cognitive
behavioral therapy with six sessions in three weeks with five strategies: 1) psychoeducation, 2) case
formulation, 3) three steps of cognitive behavioral therapy (identifying, evaluating, and responding to
negative automatic thoughts), 4) homework assignment, and 5) evaluation and feedback. The
program was reviewed and revised following expert suggestions. It will be implemented and
Poster Presentation Abstracts
evaluated in a randomized control trial involving 154 nursing students with mild to moderate
depression in four nursing colleges in northern Thailand.

Conclusion: The internet-based cognitive behavioral therapy program provides an accessible and
stigma-free alternative to the face-to-face therapy. The program is expected to alleviate depression
by using cognitive techniques and behavioral techniques in addressing specific misconceptions and
maladaptive assumptions. However, more investigation is needed to confirm its efficacy in clinical
practice.

Keywords: Cognitive Behavioral Therapy, depression, development, internet, intervention mapping
protocol, nursing students

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Correspondence: Sombat Skulphan, Faculty of Nursing, Chiang Mai University, Thailand
E-mail: sombat.sk@cmu.ac.th

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