For this study, an open-label, nonrandomized controlled trial study design will be used to compare the efficacy and feasibility of the web-based program with the in-person treatment option in a controlled manner. Blinding will not be possible, as patients will be aware of whether their treatment is occurring in person or remotely. Qualitative focus groups will be conducted with patients to gather personal, social, and cultural factors. These focus groups will be conducted to allow for a natural and open conversation on how participant factors can impact the treatment experience with the program. Additional focus groups will be conducted with therapists to gather information regarding the feasibility of implementing a web-based psychotherapy tool. This will be done to better understand how web-based treatment compares with in-person in terms of usability, time efficiency, and perceived connectedness to patients. These focus groups will occur posttreatment.

Quantitative analyses of e-CBT treatment efficacy will be conducted using standardized and clinically validated symptomology questionnaires. This data collection will occur at baseline, at week 6 and week 12 (posttreatment), and at a 6-month follow-up. In addition, a qualitative analysis of focus group interviews will be conducted with theme extraction. We hypothesize that the e-CBT program will offer results comparable with those of the in-person treatment program regarding symptom reduction and quality of life improvement. On the basis of this design, both the efficacy and feasibility of the e-CBT program can be evaluated and compared with in-person treatment for MDD. All study procedures have been approved by the Queen’s University Health Sciences and Affiliated Teaching Hospitals Research Ethics Board (HSREB; file number 6020045).

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