Preference trial of internet-delivered cognitive behaviour therapy comparing standard weekly versus optional weekly therapist support
Open accessAbstract
Emerging evidence from research trials suggests that Internet-delivered cognitive behaviour therapy (ICBT) produces similar symptom improvements whether patients receive weekly therapist support (standard support) or therapist support only when requested (optional support). It remains unknown, however, how many patients receiving ICBT as part of routine clinical care would prefer optional support compared to standard support and how outcomes compare when patients select their preferred treatment option. In this uncontrolled trial, we investigated patient preference and outcomes for standard versus optional support among patients with depression and or anxiety who were offered an 8-week transdiagnostic ICBT intervention in routine care. Of 401 patients accepted for ICBT, 22% selected optional support and 78% selected standard support. At assessment, patients who selected optional support had lower symptoms of anxiety and panic than patients who selected standard support. At post-treatment, both groups achieved similar large improvements in symptoms of anxiety and depression, with improvements sustained at 3-month follow-up. Patients receiving optional support sent and received fewer messages compared to patients receiving standard support. This study demonstrates the potential of optional therapist support to meet the needs and preferences of patients and to also reduce therapist costs in routine care.
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Outcomes are comparable with varying support (once-weekly support compares to optional support, twice-weekly support, and one-business-day support).
“Furthermore, outcomes are comparable with varying support (i.e., once-weekly support compares to optional support, 17,18 twice-weekly support, 19 and one-business-day support 20 ).”
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- Authors
- Hadjistavropoulos, H. D., Schneider, L. H., Mehta, S., Karin, E., Dear, B. F., & Titov, N.
- Affiliations
- University of Regina (CA)
- Macquarie University (AU)
- Corresponding author
- Hadjistavropoulos, H.D.
- Venue
- Journal of Anxiety Disorders
- Publisher
- Elsevier BV
- Published
- 2019-04
- Volume
- 63
- Pages
- 51-60
- ISSN
- 0887-6185 (ISSN-L)
- OpenAlex
- W2916295451
- Cited by
- 46
- References
- 36
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 5 · 2023: 11 · 2022: 7 · 2021: 8 · 2020: 7 · 2019: 3
- FWCI
- 7.08
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Anxiety Disorders (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research (293379, 152917)
- Saskatchewan Health Research Foundation
- Rx&D Health Research Foundation
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- internet-based cognitive behavioral therapy, patient preferences, depression, anxiety, panic disorder, transdiagnostic treatment, routine clinical practice, symptom outcomes, message exchange
- MeSH terms
- Social Workers, Adult, Anxiety, Anxiety Disorders, Depression, Depressive Disorder, Female, Humans, Male, Panic, Time Factors, Cognitive Behavioral Therapy, Treatment Outcome, Internet, Patient Preference
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