Kleur je leven (Colour your life)
The Kleur je Leven program is a self-help intervention based on principles of cognitive behavioural therapy (CBT). The program helps you learn about how to manage and prevent depression by changing the way you think and behave. There are eight modules to be completed, one per week, plus a final revision module which is completed 12 weeks later. The program makes use of text, CBT exercises, audio and short videos. It includes instruction on communication, assertiveness, stress, problem-solving and planning.
- Service URL:
- Agency Responsible:
- Trimbos Instituut: Netherlands Institute of Mental Health and Addiction.
- Intervention Type:
- Psychological – CBT.
- Course Length:
- Long (more than 5 modules). 8 modules plus 1 revision module after 12 weeks
- Support Option:
- Automated only.
- Primary Category:
- Target Audience:
- Open: With registration.
- Contact Details:
- Research Trials:
- Research RCTs:
- Outcome Summary:
Kleur je Leven (Colour your life - CYL) has been tested in a randomised controlled trial (RCT) with people over 50 years of age with sub-threshold depression. This RCT compared the program to group cognitive behavioural therapy (CBT) and to a wait-list control group. A moderate effect size of d = 0.55 was found comparing the program to the wait-list control condition. There was no significant difference between CYL and group CBT. One year after the start of treatment, the CYL program was still significantly more effective than a wait-list condition; a moderate between-group effect size of d = 0.53 was found. Another RCT with adults aged over 18 years compared CYL to internet-based Problem Solving Therapy (PST) and to a wait-list control group. After 8 weeks, a moderate between-group effect size for depressive symptoms of d = 0.54 was found for the CYL program. The effect of the program was further improved at 12 weeks, with a between-group effect size of d = 0.69. The number of participants showing clinically significant change at 12 weeks was significantly higher for both CYL and PST compared to the wait-list group. The effectiveness of the CYL program has also been compared to that achieved through treatment as usual (TAU) by a General Practitioner and to a combination of CYL and TAU. Although medium improvement effect sizes in depression severity were found for all three interventions, there were no significant differences in outcome between the three groups. A follow-up analysis from the same trial found that more optimistic patients might benefit most from the CYL program, but a combination of CYL with TAU might be the most suitable for those with more severe vulnerability characteristics.
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Research paper citations
- de Graaf, L.E., et al. (2009). Clinical effectiveness of online computerized cognitive behavioural therapy without support for depression in primary care: a randomized trial. British Journal of Psychiatry, 195, 73-80.
- de Graaf, L.E., Hollon, S.D., Huibers, M.J. (2010). Predicting outcome in computerized cognitive behavioral therapy for depression in primary care: A randomized trial. Journal of Consulting and Clinical Psychology, 78(2), 184-189.
- Spek, V., Nyklicek, I., Smits, N., Cuijpers, P., Riper, H., Keyzer, J. & Pop, V. (2007). Internet-based cognitive behavioural therapy for subthreshold depression in people over 50 years old: A randomized controlled clinical trial. Psychological Medicine, 37, 1797-1806.
- Spek, V., Cuijpers, P., Nyklicek, I., Smits, N., Riper,H., Keyzer, J., & Pop, V. (2008). One-year follow-up results of a randomized controlled clinical trial on internet-based cognitive behavioural therapy for subthreshold depression in people over 50 years. Psychological Medicine, 38, 635-639.
- Warmerdam, L., van Straten, A., Twisk, J., Riper, H., & Cuijpers, P. (2008). Internet-based treatment for adults with depressive symptoms: randomized controlled trial. Journal of Medical Internet Research, 10(4), e44.
- Warmerdam, L., van Straten, A., Jongsma, J., Twisk, J., Cuijpers, P. (2010). Online cognitive behavioral therapy and problem-solving therapy for depressive symptoms: Exploring mechanisms of change. Journal of Behavior Therapy and Experimental Psychiatry, 41(1), 64-70.
- Gerhards, S. A., et al. (2010). Economic evaluation of online computerised cognitive-behavioural therapy without support for depression in primary care: randomised trial. British Journal of Psychiatry, 196, 310-318.
- Crutzen, R. et al (2011) Bringing loyalty to e-Health: theory validation using three internet-delivered interventions. Journal of Medical Internet Research, 13(3): e73
- Gerhards, S.A. et al (2011) Improving adherence and effectiveness of computerised cognitive behavioural therapy without support for depression: a qualitative study on patient experiences. Journal of Affective Disorders, 129: 117-25
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Last Updated: November 22nd 2012