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Completed

NCT Number: NCT07597967

The Effectiveness of a One-stop Electronic Clinic for Psychological Service (eClinic) in Hong Kong

With an increasing need for effective and accessible mental health services, telepsychology can be one promising solution to narrowing the gap between demand and supply. Our one-stop electronic clinic of psychological service (eClinic) aims to deliver evidence-based treatments to individuals with moderate to severe emotional disorders of various kinds in Hong Kong. This study examines the cost-effectiveness and cost-efficiency of a hybrid model of telepsychology, in which contact with therapists focuses on facilitating service users' self-learning based on our online interactive modules. Results will shed light on the benefits of telepsychology to promoting access to mental health services in Hong Kong.

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Key information

Conditions

Anxiety Anxiety Disorders Behavior Behavioral Symptoms Common Mental Disorder Depression Depression / Major Depressive Disorder Depressive Disorder Depressive Disorder, Major Mental Disorders Mood Disorders

Age range

15 year–35 year

Sex eligibility

All sexes

Study type

Observational

Primary location

New Life Psychiatric Rehabilitation Association

Hong Kong

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Screened eligible for and enrolled in the eClinic service
  • Age between 15 and 35 years
  • Speak, read, and write Chinese
  • Present with moderate to severe depression (i.e., Patient Health Questionnaire-9 (PHQ-9) total score ≥ 10) or anxiety (i.e., Generalized Anxiety Disorder-7 (GAD-7) total score ≥ 8)

Exclusion criteria

  • Present with a history of psychosis in the recent 2 years
  • Present with severe risk for self-harm/suicide (i.e., indicated as being at higher risk on the P4 suicidality screener during the service-related screening procedure prior to enrollment in the eClinic service)
  • Present with active homicidal ideations (i.e., assessed during the service-related screening procedure prior to enrollment in the eClinic service)
  • Demonstrate sub-average intelligence (e.g., based on a history of intellectual disability)
  • Concurrently receive other psychological services

Treatment and study plan

Internet-based Unified Protocol (UP) Intervention

Other

An Electronic Clinic for Psychological Services (eClinic) was developed in Hong Kong to provide evidence-based internet intervention for local Chinese youths/young adults, particularly those with moderate-to-severe emotional problems, e.g., depression and anxiety, via an easily accessible and private, stigma-free online platform. It offered maximum flexibility in terms of time and location for participants to attend the services. The first internet intervention offered from the eClinic was adapted from the UP, a transdiagnostic intervention for emotional problems. Its internet version operated in a hybrid format, comprising essentially scripted modules for self-learning, plus weekly video conferencing sessions with therapists.

Primary outcomes

  1. Patient Health Questionnaire-9 (PHQ-9)

    Time frame: Baseline (week 0), post-intensive (week 5; after completion of core modules), posttreatment (week 14; completion of the intervention), and 1-, 2-, 3-, 6-, and 12-month follow-up

    The PHQ-9 measures the presence of depressive symptoms in the recent two weeks. The scale measures the nine diagnostic criteria of major depressive disorder on a scale from 0 = not at all to 3 = nearly every day, according to Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). Total score on the PHQ-9 ranges from 0 to 27, with higher scores indicating higher distress.

  2. Generalized Anxiety Disorder-7 (GAD-7)

    Time frame: Baseline (week 0), post-intensive (week 5; after completion of core modules), posttreatment (week 14; completion of the intervention), and 1-, 2-, 3-, 6-, and 12-month follow-up

    The GAD-7 assesses Generalized Anxiety Disorder (GAD) symptoms in the recent two weeks. It consists of 7 items, each rated on a 4-point Likert scale from 0 = not at all to 3 = nearly every day. Total score on the GAD-7 ranges from 0 to 21. A higher GAD-7 score indicates more severe impairment related to GAD symptoms.

Secondary outcomes

  1. Brief Experiential Avoidance Questionnaire (BEAQ)

    Time frame: Baseline (week 0), post-intensive (week 5; after completion of core modules), posttreatment (week 14; completion of the intervention), and 3- and 12-month follow-up

    The 15-item BEAQ assesses several domains of experiential avoidance. Items are rated on a 6-point Likert scale of 1 = strong disagree to 6 = strong agree. Total score of the BEAQ ranges from 15 to 90, with a higher score representing greater experiential avoidance.

  2. Difficulties in Emotion Regulation Scale-16 (DERS-16)

    Time frame: Baseline (week 0), post-intensive (week 5; after completion of core modules), posttreatment (week 14; completion of the intervention), and 3- and 12-month follow-up

    The DERS-16 assesses level of difficulties with emotion regulation. Each of the 16 items is rated on a 5-point Likert scale of 1 = almost never to 5 = almost always, with a total score ranges from 16 to 80.

  3. Cognitive Distortions Questionnaire (CD-Quest)

    Time frame: Baseline (week 0), post-intensive (week 5; after completion of core modules), posttreatment (week 14; completion of the intervention), and 3- and 12-month follow-up

    The CD-Quest is a self-report measure that contains 15 bi-dimensional items that measure the frequency and intensity of 15 cognitive distortions. For each type of cognitive distortions, participants indicate if it has occurred or not; for any occurrence, individuals rate the frequency and intensity of the cognitive distortion on a 3x3 grid. Therefore, score on each item ranges from 0 = no (it did not occur) to 5 = occurs almost all the time and with an intensity of more than 70%. Total score of the CD-Quest ranges from 0 to 75, with a higher score representing a higher frequency and intensity of cognitive distortions.

  4. Cognitive Flexibility Inventory (CFI)

    Time frame: Baseline (week 0), post-intensive (week 5; after completion of core modules), posttreatment (week 14; completion of the intervention), and 3- and 12-month follow-up

    The CFI is a self-report measure of cognitive flexibility. 20 items of the CFI are rated on a 7-point Likert scale of 1 (strongly disagree) to 7 (strongly agree). Total score of the CFI ranges from 20 to 140, with higher scores indicating greater cognitive flexibility.

  5. Gratitude Questionnaire-5 (GQ-5)

    Time frame: Baseline (week 0), post-intensive (week 5; after completion of core modules), posttreatment (week 14; completion of the intervention), and 3- and 12-month follow-up

    The GQ-5 is a self-reported instrument that assesses gratitude. Five items of the GQ-5 are rated on a 7-point Likert scale from 1 = strongly disagree to 7 = strongly agree. Total score of the GQ-5 ranges from 5 to 35, with higher scores indicating higher level of gratitude.

  6. Penn State Worry Questionnaire (PSWQ)

    Time frame: Baseline (week 0), post-intensive (week 5; after completion of core modules), posttreatment (week 14; completion of the intervention), and 1-, 2-, 3-, 6-, and 12-month follow-up

    The PSWQ is a 16-item self-report instrument designed to measure the construct of worry. Each item is rated on a 5-point Likert scale that ranges from 1 = not at all typical of me to 5 = very typical of me. Five items are reversely scored to obtain a total score ranges from 16 to 80.

  7. Liebowitz Social Anxiety Scale (LSAS)

    Time frame: Baseline (week 0), post-intensive (week 5; after completion of core modules), posttreatment (week 14; completion of the intervention), and 1-, 2-, 3-, 6-, and 12-month follow-up

    The LSAS assesses fear and avoidance related to social anxiety disorder. The 24-item scale is divided into two broad domains of situations, with 11 items on social anxiety and 13 items on performance fear. Each of the 24 items is rated on a 4-point Likert scale of 0 = none to 3 = severe for anxiety items or usually for avoidance items. The total score of LSAS ranges from 0 to 144.

  8. Obsessive-Compulsive Inventory-Revised (OCI-R)

    Time frame: Baseline (week 0), post-intensive (week 5; after completion of core modules), posttreatment (week 14; completion of the intervention), and 1-, 2-, 3-, 6-, and 12-month follow-up

    The OCI-R is an 18-item self-report scale for measuring the severity of obsessive-compulsive symptoms. Each item is rated on a 5-point Likert scale of 0 = not at all to 4 = extremely. The OCI-R total score ranges from 0 to 72, with higher scores indicating a greater likelihood of OCD.

  9. Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5)

    Time frame: Baseline (week 0), post-intensive (week 5; after completion of core modules), posttreatment (week 14; completion of the intervention), and 1-, 2-, 3-, 6-, and 12-month follow-up

    The PCL-5 is a self-report measure of posttraumatic stress disorder (PTSD) symptom severity, based on its diagnostic criteria in Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5). Each of the 20 items is rated on a 5-point Likert scale of 0 = not at all to 4 = extremely. The PCL-5 total score ranges from 0 to 80, with higher scores indicating greater PTSD severity.

  10. Insomnia Severity Index (ISI)

    Time frame: Baseline (week 0), post-intensive (week 5; after completion of core modules), posttreatment (week 14; completion of the intervention), and 1-, 2-, 3-, 6-, and 12-month follow-up

    The ISI evaluates the nature, severity, and impact of insomnia. It consists of 7 items rated on a 5-point Likert scale from 0 = no problem to 4 = very severe problem, with a total score ranging from 0 to 28. Higher scores on the ISI indicate more severe insomnia.

  11. Short Health Anxiety Inventory (SHAI)

    Time frame: Baseline (week 0), post-intensive (week 5; after completion of core modules), posttreatment (week 14; completion of the intervention), and 1-, 2-, 3-, 6-, and 12-month follow-up

    The SHAI is an 18-item self-report measure that assesses an individual's concern about possibly having health illnesses of different kinds, and the catastrophic thinking about having the illnesses. Total score of the SHAI ranges from 0 to 54, where higher scores indicate greater health anxiety.

  12. Work and Social Adjustment Scale (WSAS)

    Time frame: Baseline (week 0), post-intensive (week 5; after completion of core modules), posttreatment (week 14; completion of the intervention), and 3- and 12-month follow-up

    The WSAS is a 5-item scale that measures self-report severity of impairment across five domains of functioning. Each item is rated on a 9-point Likert scale of 0 = not at all to 8 = very severely. Total score of the WSAS ranges from 0 to 40, where higher scores indicate greater functional impairment.

  13. Rosenberg Self-Esteem Scale (RSES)

    Time frame: Baseline (week 0), post-intensive (week 5; after completion of core modules), posttreatment (week 14; completion of the intervention), and 3- and 12-month follow-up

    The RSE has 10 items that assess self-esteem, each rated on a 4-point Likert scale of 1 = strongly agree to 4 = strongly disagree. Total score of the RSE ranges from 0 to 30, with lower scores suggesting lower self-esteem.

Sponsors and collaborators

Lead sponsor

New Life Psychiatric Rehabilitation Association

Other

Collaborators

  • Chinese University of Hong Kong
  • The Hong Kong Jockey Club Charities Trust

Registry information

Important dates

Study start
2022
Primary completion
2025
Study completion
2025
First posted
May 20, 2026
Registry last updated
May 20, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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