The effectiveness of unguided internet cognitive behavioural therapy for mixed anxiety and depression
Open accessAbstract
Clinician-guided internet-delivered cognitive behavioral therapy (iCBT) is an effective treatment for depression and anxiety disorders. However, few studies have examined the effectiveness of completely unguided iCBT. The current research investigated adherence to, and the effects of two brief unguided iCBT programs on depression and anxiety symptom severity, and psychological distress. Study 1 evaluated a four-lesson transdiagnostic iCBT program for anxiety and depression ( N = 927). Study 2 then evaluated a three-lesson version of the same program ( N = 5107) in order to determine whether reducing the duration of treatment would influence adherence and treatment effects. Cross-tabulations and independent t -tests were used to examine the extent to which users adhered and remitted with treatment. Linear mixed models were used to evaluate the effects of treatment in the entire sample, and stratified by gender and completer-type (e.g., users who completed some but not all lessons vs. those who completed all lessons of treatment). Among those who began treatment, 13.83% completed all four lessons in Study 1. Shortening the course to three lessons did not improve adherence (e.g., 13.11% in Study 2). In both studies, users, on average, experienced moderate to large effect size reductions in anxiety and depressive symptom severity, as well as psychological distress. This pattern of results was robust across gender and for those who did and did not complete treatment. Approximately two-thirds of those who completed treatment experienced remission. These data show that unguided iCBT programs, which have the capacity to attract large numbers of individuals with clinically significant symptoms of depression and anxiety, and psychological distress, can produce significant improvements in wellbeing.
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The treatment components shown to be effective when applied online are Acceptance and Commitment Therapy, Cognitive Behavioral Therapy, Mindfulness, and Behavioral Activation, also, multicomponent proposals.
“Specifically, the treatment components shown to be effective when applied online are Acceptance and Commitment Therapy (Thompson et al., 2021), Cognitive Behavioral Therapy (Morgan et al., 2017), Mindfulness (Spijkerman et al., 2016), and Behavioral Activation (Huguet et al., 2018), also, multicomponent proposals (Marcelle et al., 2019; Wijnen et al., 2023).”
From Internet-based self-administered intervention to reduce anxiety and depression symptomatology and improve well-being in 7 countries: protocol of a randomized control trial (2024) · cites this paper as Morgan et al., 2017
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- Authors
- Morgan, C., Mason, E., Newby, J. M., Mahoney, A. E. J., Hobbs, M. J., McAloon, J., & Andrews, G.
- Affiliations
- University of Technology Sydney (AU)
- UNSW Sydney (AU)
- Corresponding author
- Mahoney, Alison E.J.
- Venue
- Internet Interventions
- Publisher
- Elsevier BV
- Published
- 2017-12
- Volume
- 10
- Pages
- 47-53
- ISSN
- 2214-7829 (ISSN-L)
- PMC
- PMC6084910
- OpenAlex
- W2765134967
- Cited by
- 58
- References
- 54
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 6 · 2023: 9 · 2022: 6 · 2021: 9 · 2020: 6 · 2019: 9 · 2018: 1
- FWCI
- 5.00
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Internet Interventions (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UTS ePRESS (University of Technology Sydney) (submittedVersion)
- RUNE (Research UNE) (submittedVersion, cc-by-nc-nd)
- Funders
- Australian Government
- National Health and Medical Research Council (1037787)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- internet-based cognitive behavioral therapy, mixed anxiety-depressive disorder, transdiagnostic treatment, medication adherence, treatment completion, treatment duration, depression severity, anxiety symptom severity, psychological distress, remission, gender differences
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