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Currently submitted to: JMIR Research Protocols

Date Submitted: Oct 22, 2020
Open Peer Review Period: Oct 22, 2020 - Dec 17, 2020
(currently open for review)

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Online delivery of psychotherapy tailored to patients suffering from mental health problems due to the COVID-19 pandemic: Method/Study Design

  • Nazanin Alavi; 
  • Megan Yang; 
  • Callum Stephenson; 
  • Niloofar Nikjoo; 
  • Niloufar Malakouti; 
  • Gina Layzell; 
  • Jasleen Jagayat; 
  • Amirhossein Shirazi; 
  • Dianne Groll; 
  • Mohsen Omrani; 
  • Sarosh Khalid-Khan; 
  • Rafael Freire; 
  • Elisa Brietzke; 
  • Fabiano Alves Gomes; 
  • Roumen Milev; 
  • Claudio N Soares



The impact of the COVID-19 pandemic has gone far beyond the direct overload of the hospital care system, with physical distancing, financial uncertainty, and the stress of well-being having largely negative consequences on individuals’ mental health. Adding to these stressors is the personal and public trauma of lost lives, with an increasing fear of an unprecedented mental health epidemic with crushing effects on the public health sector and economy. To meet this overwhelming and growing demand for mental health care on an already strained health care system, we must have innovative approaches to significantly expand the capacity of care delivery. While it is not feasible in the short term to increase the number of mental health care providers or the number of hours they work, improving their time efficiency may be a viable solution. Virtual care and online delivery of psychotherapy, shown to be clinically effective, efficient, and cost-effective, presents itself as a promising means to address the ever-growing demand for mental health care. To our knowledge, we have established the first academic online psychotherapy clinic that aims to manage mental health problems secondary to the COVID-19 pandemic.


The goal of this research protocol is to evaluate the feasibility and efficacy of treating mental health issues aggravated by the stressors associated with the COVID-19 pandemic through an online platform.


This non-randomized control trial intervention will be delivered through the Online Psychotherapy Tool (OPTT), a secure, cloud-based, digital mental health platform. Participants will be offered a 9-week, diagnosis-specific, online cognitive behavioural therapy (e-CBT) program tailored to address mental health problems in the context of the COVID-19 pandemic. Participants (n = 80) will receive personalized feedback and interaction with a therapist throughout the program.


The study received ethics approval in June 2020, and the recruitment of participants began in June 2020. Participant recruitment is being conducted via social media, web-based communities, and physician referrals. Data collection is expected to conclude by November 2020, and analyses are expected to be completed by December 2020 with linear regression analysis (for continuous outcomes) and binomial regression analysis (for categorical outcomes) being conducted.


If proven feasible, this method of care delivery could increase care capacity by four-folds. The findings from this project have the potential to influence clinical practice and policy and increase accessibility to care during the COVID-19 pandemic, without sacrificing the quality of care. Clinical Trial: ClinicalTrials.Gov Protocol Registration and Results System (NCT0446667);


Please cite as:

Alavi N, Yang M, Stephenson C, Nikjoo N, Malakouti N, Layzell G, Jagayat J, Shirazi A, Groll D, Omrani M, Khalid-Khan S, Freire R, Brietzke E, Gomes FA, Milev R, Soares CN

Online delivery of psychotherapy tailored to patients suffering from mental health problems due to the COVID-19 pandemic: Method/Study Design

JMIR Preprints. 22/10/2020:24913

DOI: 10.2196/preprints.24913


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