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Stepped Care

Stepped care is a model of treatment delivery in which patients are first provided a low-intensity treatment, are systematically monitored for progress and are stepped up to more intensive treatments if they fail to show adequate improvement. In this project, the stepped care program initiated treatment for depression with ThinkFeelDo, our web-based digital mental health treatment, and stepped up those who did not meet improvement criteria to telephone administered cognitive behavioral therapy (tCBT). This trial found that stepped care was approximately half as costly to deliver but no less effective than tCBT.

The PI is David C. Mohr, PhD.

Project Name


  • National Intstitue of Mental Health grant R01 MH095753 (Mohr)

Evaluation Groups

  • Adults (18+) with depression


  • Mohr, D.C., Lattie, E.G., Tomasino, K.N., Kwasny, M.J., Kaiser, S.M., Gray, E.L., Alam, N. Jordan, N., Schueller, S.M. (2019) A randomized noninferiority trial evaluating remotely-delivered stepped care for depression using internet cognitive behavioral therapy (CBT) and telephone CBT. Behaviour Research and Therapy, 123, 103485
  • Nicholas, J., Ringland, K.E., Graham, A.K., Knapp, A.A., Lattie, E.G., Kwasny, M.J., Mohr, D.C. (2019) Stepping up: Predictors of “stepping” with in an iCBT stepped-care intervention for depression. International Journal of Environmental and Public Health, 4689.
  • Nicholas, J., Knapp, A.A., Vergara, J.L., Graham, A., Gray, E.L., Lattie, E.G., Kwasny, M.J., Mohr, D.C. (in press) A brief head-to-head non-inferiority comparison of an internet-based and telephone-delivered CBT intervention for adults with depression. Journal of Affective Disorders,
  • Graham, A., Nicholas, J., Gray, E., Knapp, A.A., Lattie, E.G., Kaiser, S.M., Kwasny, M.J., Mohr, D.C., (under review) Trajectories of symptom change over the course of remotely-delivered treatment for depression, Behaviour Research and Therapy,

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