Internet-administered cognitive behavior therapy for health problems: a systematic review
Open accessAbstract
Cognitive-behavioral interventions are the most extensively researched form of psychological treatment and are increasingly offered through the Internet. Internet-based interventions may save therapist time, reduce waiting-lists, cut traveling time, and reach populations with health problems who can not easily access other more traditional forms of treatments. We conducted a systematic review of twelve randomized controlled or comparative trials. Studies were identified through systematic searches in major bibliographical databases. Three studies focused on patients suffering from pain, three on headache, and six on other health problems. The effects found for Internet interventions targeting pain were comparable to the effects found for face-to-face treatments, and the same was true for interventions aimed at headache. The other interventions also showed some effects, although effects differed across target conditions. Internet-delivered cognitive-behavioral interventions are a promising addition and complement to existing treatments. The Internet will most likely assume a major role in the future delivery of cognitive-behavioral interventions to patients with health problems.
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Several barriers impede the provision of psychological treatment to older adults, some of which can be overcome by internet-based interventions, such as mobility limitations or stigma.
“Several barriers have been identified to impede the provision of psychological treatment to this population, some of which can be overcome by internet-based interventions, such as mobility limitations (Kersting et al., 2009) or stigma (e.g., Cuijpers et al. 2008).”
From Feasibility, acceptability, and preliminary efficacy of an internet-based CBT intervention for loneliness in older adults: A pilot RCT (2024) · cites this paper as Cuijpers et al. 2008
The Introduction says internet-based interventions may reduce the stigma of going to a psychologist or therapist, supporting the part of the sentence attributed to Cuijpers et al. The citing sentence applies this barrier to older adults, but the Discussion says none of the reviewed studies specifically targeted older adults. Page numbers were not supplied. (LLM, conf=0.85)
Experimental — accuracy not yet measuredOlder individuals are generally under-represented in the samples that provide efficacy data for iCBT programs.
“Reviews of iCBT for mental illness have indicated that older individuals are generally under-represented in the samples that provide efficacy data for these programs [5], [6].”
From A Naturalistic Study of the Acceptability and Effectiveness of Internet-Delivered Cognitive Behavioural Therapy for Psychiatric Disorders in Older Australians (2013) · cites this paper as [5]
The Results (‘The target populations’) state that none of the twelve iCBT interventions for health problems targeted older adults, and only three allowed people aged 70 or over to participate. This supports the concern about older adults being under-represented in the evidence base, but the review concerns health problems, not specifically mental illness, and does not quantify older adults’ representation in the samples. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe acceptability, effectiveness and uptake of iCBT treatment for mental disorders has not been established in older populations.
“However, the acceptability, effectiveness and uptake of iCBT treatment for mental disorders has not been established in older populations [5], [6].”
From A Naturalistic Study of the Acceptability and Effectiveness of Internet-Delivered Cognitive Behavioural Therapy for Psychiatric Disorders in Older Australians (2013) · cites this paper as [5]
The Results (‘The target populations’; page unavailable) say none of the reviewed interventions targeted older adults, and the Discussion calls for studies with older adults. But this review concerns health problems rather than mental disorders, and it does not specifically establish a gap in acceptability or uptake for older people with mental disorders. (LLM, conf=0.86)
Experimental — accuracy not yet measuredAn increasing number of studies on Internet-based interventions, many based on CBT (iCBT), indicate their efficacy in supporting use of constructive self-management strategies in individuals living with chronic illness.
“An increasing number of studies on Internet-based interventions, many based on CBT (iCBT), indicate their efficacy in supporting use of constructive self-management strategies in individuals living with chronic illness [12-15].”
Efficacious face-to-face interventions adapted for the Internet frequently retain effect sizes rivaling those of traditionally delivered interventions.
“Such adapted therapies frequently retain effect-sizes rivaling those of the more traditionally delivered interventions [41; 28; 19]”
From Internet-enhanced management of fibromyalgia: A randomized controlled trial (2010) · cites this paper as [19]
Several studies have shown effects similar to face-to-face CBT.
“several studies have shown effects similar to that of face-to-face CBT [11] , [12] and [13] .”
The findings from the present Cancer Coping Workbook study are consistent with findings from studies of other web-based psychological interventions, which appear to work about as well as in-person interventions for conditions such as pain, asthma, and improving health behaviors.
“The findings from the present Cancer Coping Workbook study are consistent with findings from studies of other web-based psychological interventions, which appear to work about as well as in-person interventions for conditions such as pain, asthma, and improving health behaviors (Cuijpers, 2008; Wantland, 2004).”
From An online stress management workbook for breast cancer (2014) · cites this paper as Cuijpers, 2008
Reviews of Internet-based interventions for patients with various chronic pain conditions indicate a positive effect on pain, but results on psychological outcomes have been inconsistent.
“Reviews of Internet-based interventions for patients with various chronic pain conditions indicate a positive effect on pain, but results on psychological outcomes have been inconsistent [14,15,62].”
Studies on Internet-based interventions and interventions using SMS to support self-management of chronic illness show promising results.
“Studies on Internet-based interventions and interventions using SMS to support self-management of chronic illness show promising results [60-62].”
Web-based interventions can be effective for promoting health and health-related behavior.
“Evidence exists to support the effectiveness of web-based interventions. Research has shown these interventions to be effective in different areas of health care [2-7].”
From Persuasive System Design Does Matter: a Systematic Review of Adherence to Web-based Interventions (2012) · cites this paper as [3]
Adapting empirically supported treatments into online delivery platforms makes them more accessible, particularly to those living in remote areas, with outcomes often rivaling those for in-clinic treatment.
“However, one increasingly used approach to overcoming these obstacles has been to adapt empirically supported treatments into online delivery platforms that make them more accessible, particularly to those living in remote areas,29,43,47 with outcomes often rivaling those for in-clinic treatment.10,14”
From Randomized Controlled Trial of Online Acceptance and Commitment Therapy for Fibromyalgia (2018) · cites this paper as [10]
Participation in Web-based treatments is more anonymous compared to face-to-face treatment.
“High accessibility may be of special benefit to employees because they will not lose work hours due to therapist visits outside the workplace and participation in Web-based treatments is more anonymous compared to face-to-face treatment.”
From Short-Term Effects of a Web-Based Guided Self-Help Intervention for Employees With Depressive Symptoms: Randomized Controlled Trial (2014) · cites this paper as [22]
Web-based treatments may reduce costs and can increase efficiency in mental health care because of advantages such as high accessibility, no waiting list, and minimal contact with a professional therapist.
“Web-based treatments may reduce costs and can increase efficiency in mental health care because of several advantages, such as high accessibility, no waiting list, and minimal contact with a professional therapist [22].”
From Short-Term Effects of a Web-Based Guided Self-Help Intervention for Employees With Depressive Symptoms: Randomized Controlled Trial (2014) · cites this paper as [22]
The results regarding depression are not in-line with the overall positive effects of Web-based interventions that are often found when they are compared to nonactive control groups.
“The results regarding depression are not in-line with the overall positive effects of Web-based interventions that are often found when they are compared to nonactive control groups [21,22,61].”
From Short-Term Effects of a Web-Based Guided Self-Help Intervention for Employees With Depressive Symptoms: Randomized Controlled Trial (2014) · cites this paper as [22]
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Randomized Controlled Trial of Online Acceptance and Commitment Therapy for Fibromyalgia
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Guided internet-based CBT for common mental disorders
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Self-citationPsychosocial interventions for preventing and treating depression in dialysis patients
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Self-citationCognitive–behavioral therapy: what benefits can it offer people with multiple sclerosis?
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Development of a new approach to guided self-help via the internet: the Swedish experience
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Self-citationEfficacy of a Mindfulness-Based Mobile Application: a Randomized Waiting-List Controlled Trial
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Self-citation
- Authors
- Cuijpers, P., van Straten, A., & Andersson, G.
- Affiliations
- Vrije Universiteit Amsterdam (NL)
- Linköping University (SE)
- Corresponding author
- Cuijpers, Pim
- Venue
- Journal of Behavioral Medicine
- Published
- 2007-12-29
- Volume
- 31
- Issue
- 2
- Pages
- 169-177
- ISSN
- 0160-7715 (ISSN-L)
- 1573-3521
- PMC
- PMC2346512
- OpenAlex
- W2151159941
- Semantic Scholar
- f802e34f4d89c71ef8064671fd50062678a09d2e
- Cited by
- 555
- References
- 57
- Citations by year
- 2026: 7 · 2025: 16 · 2024: 14 · 2023: 15 · 2022: 30 · 2021: 32 · 2020: 18 · 2019: 36 · 2018: 38 · 2017: 33 · 2016: 35 · 2015: 47 · 2014: 60 · 2013: 42 · 2012: 37
- FWCI
- 4.08
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Journal of Behavioral Medicine (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- VU Research Portal (submittedVersion, other-oa)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- online intervention, cognitive-behavioral intervention, pain, headache, health problems, access to psychological treatment
- MeSH terms
- Headache, Health Status, Humans, Migraine Disorders, Cognitive Behavioral Therapy, Internet, Pain Management
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