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Therapist-delivered internet psychotherapy for depression in primary care: a randomised controlled trial
Abstract
Background Despite strong evidence for its effectiveness, cognitive-behavioural therapy (CBT) remains difficult to access. Computerised programs have been developed to improve accessibility, but whether these interventions are responsive to individual needs is unknown. We investigated the effectiveness of CBT delivered online in real time by a therapist for patients with depression in primary care.Methods In this multicentre, randomised controlled trial, 297 individuals with a score of 14 or more on the Beck depression inventory (BDI) and a confirmed diagnosis of depression were recruited from 55 general practices in Bristol, London, and Warwickshire, UK. Participants were randomly assigned, by a computer-generated code, to online CBT in addition to usual care (intervention; n=149) or to usual care from their general practitioner while on an 8-month waiting list for online CBT (control; n=148). Participants, researchers involved in recruitment, and therapists were masked in advance to allocation. The primary outcome was recovery from depression (BDI score <10) at 4 months. Analysis was by intention to treat. This trial is registered, number ISRCTN 45444578.Findings 113 participants in the intervention group and 97 in the control group completed 4-month follow-up. 43 (38%) patients recovered from depression (BDI score <10) in the intervention group versus 23 (24%) in the control group at 4 months (odds ratio 2.39, 95% CI 1.23-4.67; p=0.011), and 46 (42%) versus 26 (26%) at 8 months (2.07, 1.11-3.87; p=0.023).Interpretation CBT seems to be effective when delivered online in real time by a therapist, with benefits maintained over 8 months. This method of delivery could broaden access to CBT.Funding BUPA Foundation.
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“while internet treatment can be presented in real time [35], most treatment applications will not require that the work is performed at a particular time, and this is an advantage for both patients and clinicians.”
From The promise and pitfalls of the internet for cognitive behavioral therapy (2010) · cites this paper as [35]
In the citing paper
“Psychotherapy has also been provided effectively and with reasonable effect sizes via instant messaging (12).”
From Behavioral Intervention Technologies: Evidence review and recommendations for future research in mental health (2013) · cites this paper as [12]
In the citing paper
“Internet-enabled CBT has been shown to be clinically effective for the treatment of depression16 and is currently deployed within IAPT.”
From Quantifying the association between psychotherapy content and clinical outcomes using deep learning (2020) · cites this paper as [16]
In the citing paper
“Ten therapist-delivered sessions of CBT over the internet were effective in reducing depression at 4 and 8 months (equivalent to our short-term measures).71”
In the citing paper
“The attrition rates in this study were equal or lower compared with several similar studies on guided Web-based interventions for depression with long-term follow-up assessments [67,73,74].”
From Long-Term Results of a Web-Based Guided Self-Help Intervention for Employees With Depressive Symptoms: Randomized Controlled Trial (2014) · cites this paper as [73]
In the citing paper
“However, despite similar delivery context and study design, there are important differences between the therapist-supported intervention in the study by Kessler et al. [28] and the nonguided intervention in the study by de Graaf et al. [19].”
From Internet-based psychological treatments for depression (2012) · cites this paper as [28]
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A Study of Asynchronous Mobile-Enabled SMS Text Psychotherapy
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“The one RCT on text therapy to date investigated the outcomes for synchronous text therapy (e.g., Kessler et al. 22 ), a very closely related, but subtly distinct approach from that discussed here.”
InfluentialBuckman, J. E. J., Saunders, R., Cohen, Z. D., Barnett, P., Clarke, K., Ambler, G., DeRubeis, R. J., Gilbody, S. M., Hollon, S. D., Kendrick, T., et al. (2021) · Psychological Medicine · doi:10.1017/s0033291721001367 · Cited by 70
“IPCRESS (Kessler et al., 2009) 295 Y Adults scoring ⩾14 BDI-II and GP confirmed diagnosis of depression 34.”
Self-citationCrawford, A., Lewis, S., Nutt, D., Peters, T., Cowen, P., O'Donovan, M., Wiles, N., & Lewis, G. (2014) · Psychopharmacology · doi:10.1007/s00213-014-3467-8 · Cited by 64
“…the similar scores on depressive scales and similar response rates to antidepressant treatment seen in other UK depression trials (Ward et al. 2000; Kessler et al. 2009) and the US STAR*D study (Trivedi et al. 2006), the GENPOD sample is a representative of a typical sample of primary care…”
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“Kessler et al. (2009) discussed the results of an effectiveness study of CBT delivered though online chat sessions with therapists.”
BackgroundFactors associated with differential response to online cognitive behavioural therapy
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“This study is a secondary analysis of data obtained in the IPCRESS study, a randomised controlled trial conducted in UK primary care investigating the effectiveness of online CBT for depression compared with a waiting list control [ 3 ].”
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Internetbasierte Interventionen in der Behandlung psychischer Störungen
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It's time for disruptive innovation in psychotherapy
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“Data addressing the extended impact of iCBTare limited, although the initial findings are promising (Kessler et al., 2009; Kivi et al., 2014; Ruwaard et al., 2009).”
BackgroundDigital mental health interventions for depression
Himle, J. A., Weaver, A., Zhang, A., & Xiang, X. (2022) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2020.12.009 · Cited by 65
“Although five of the six studies of cCBT for depression included in Andrews et al. (2010) meta-analysis tested cCBT compared to a waitlist control condition, one of the six studies compared cCBT for depression to treatment as usual by a general practitioner (Kessler et al., 2009).”
ResultSheltered in cyberspace? Computer use among the unsheltered 'street' homeless
Eyrich-Garg, K. (2011) · Computers in Human Behavior · doi:10.1016/j.chb.2010.08.007 · Cited by 58
The effectiveness of internet chat groups in relapse prevention after inpatient psychotherapy
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“Depression is known to affect motivation and executive abilities [13], which may partially explain these experiences.”
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Who does not participate in telehealth trials and why? A cross-sectional survey
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“The use of technology-augmented care for mental health problems such as depression and anxiety are promising, using both internet, and text message based facilities (e.g. [9, 20]).”
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Examining the potential of virtual reality to deliver remote rehabilitation
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“characterized by a structured, 6- to 12-week CBTbased approach, with five of the studies involving a ‘live’ therapist either online [55, 64, 65, 81] or in additional face-to-face groups [60].”
BackgroundEvidence-Based Applications of Combination Psychotherapy and Pharmacotherapy for Depression
Dunlop, B. W. (2016) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.20150042 · Cited by 58
Two-way messaging therapy for depression and anxiety: longitudinal response trajectories
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“…(≥ 16 years) Mild to severe SHADE 97 Australia Kay-Lambkin [43] Adults without older adults (18-75 years) Mild to severe No name 297 UK Kessler [44] Adults (≥16 years) Mild to moderate Depressions-hjälpen 92 Sweden Kivi [45] Adults (≥16 years) Mild to severe Good Life Compass 39 Finland…”
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Hunkeler, E. M., Hargreaves, W. A., FIREMAN, B. H., Terdiman, J. F., Meresman, J. F., Porterfield, Y., Lee, J., Dea, R., Simon, G. E., Bauer, M. S., et al. (2012) · Psychiatric Services · doi:10.1176/appi.ps.005332011 · Cited by 46
Challenges for trainees in psychiatry and early career psychiatrists
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“Examples that are available in the UK include the Big White Wall, IESO Digital Health (14), Kooth, and Mood District.”
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Self-citationO’Driscoll, C., Buckman, J. E. J., Fried, E. I., Saunders, R., Cohen, Z. D., Ambler, G., DeRubeis, R. J., Gilbody, S. M., Hollon, S. D., Kendrick, T., et al. (2021) · BMC Medicine · doi:10.1186/s12916-021-01971-0 · Cited by 55
Self-citationKordy, H., Wolf, M., Aulich, K., Bürgy, M., Hegerl, U., Hüsing, J., Puschner, B., Rummel‐Kluge, C., Vedder, H., & Backenstraß, M. (2016) · Psychotherapy and Psychosomatics · doi:10.1159/000441951 · Cited by 44
Internet‐Based Psychotherapy for Adult Depression: What About the Mechanisms of Change?
Mogoaşe, C., Cobeanu, O., David, D., Giosan, C., & Szentágotai, A. (2016) · Journal of Clinical Psychology · doi:10.1002/jclp.22326 · Cited by 48
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“13 These extended data, including both depression and anxiety disorders, offer an example of translational research put into practice and successfully deployed at scale.”
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“Text-based correspondence generates a written document that could help both patients/clients and counselors/psychologists/psychiatrists/therapists (Kessler et al., 2009), and Goss and Anthony (2003) discovered that patients/clients had more influence over the tele-psychotherapy session so they…”
BackgroundSample size calculations for skewed distributions
Cundill, B., & Alexander, N. D. E. (2015) · BMC Medical Research Methodology · doi:10.1186/s12874-015-0023-0 · Cited by 49
Manualised cognitive–behavioural therapy in treating depression in advanced cancer: the CanTalk RCT
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Self-citationEriksson, M. C. M., Kivi, M., Hange, D., Petersson, E.-L., Ariai, N., Häggblad, P., Ågren, H., Spak, F., Lindblad, U., Johansson, B., et al. (2017) · Scandinavian Journal of Primary Health Care · doi:10.1080/02813432.2017.1333299 · Cited by 43
“In addition, in ICBT research, performed interventions are often diverse; including various types of software programs, computerized CBT on site at clinics, live-CBT online and unsupported ICBT, which complicates comparisons [5,6,12,13].”
BackgroundResultBlended CBT versus face-to-face CBT: a randomised non-inferiority trial
Mathiasen, K., Andersen, T. E., Riper, H. M., Kleiboer, A. M., & Roessler, K. K. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-1140-y · Cited by 40
Roberts, M., Jones, J., Garcia, L. M., & Techau, A. (2021) · Journal of Child and Adolescent Psychiatric Nursing · doi:10.1111/jcap.12354 · Cited by 44
Psicoterapia pela Internet: viável ou inviável?
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E-therapy and social work practice: Benefits, barriers, and training
Cwikel, J., & Friedmann, E. (2019) · International Social Work · doi:10.1177/0020872819847747 · Cited by 49
“Studies have shown that Internet-based interventions based on iCBT can be an effective method of service delivery for mothers facing symptoms of post-partum depression (PPD) (Danaher et al., 2013; King, 2009; Pugh et al., 2014, 2016).”
BackgroundThe barriers, benefits and training needs of clinicians delivering psychological therapy via video
Buckman, J. E. J., Saunders, R., Leibowitz, J., & Minton, R. (2021) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465821000187 · Cited by 46
Estimation of the prevalence of adverse drug reactions from social media
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The use of the Internet by people who die by suicide in England: A cross sectional study
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“In recent years the Internet's therapeutic potential has been harnessed with innovations such as the development of online cognitive behavioural therapy (CBT) (Kessler et al., 2009), user support forums, and improved communication between health professionals and patients”
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Commissioning mental health services
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“…included a treatment condition using synchronous or asynchronous online counseling have reported significant posttreatment and followup effects (Kessler et al., 2009; Vernmark et al., 2010), demonstrating the efficacy of delivering structured, online CBT treatments for depression (Richards &…”
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“This definition is also in line with previous trials on depression [29,30].”
ResultNavarro, P., Sheffield, J. K., Edirippulige, S., & Bambling, M. (2019) · JMIR Mental Health · doi:10.2196/15564 · Cited by 46
“This is curious, given evidence that these interventions can produce positive long-term outcomes for depression and anxiety presentations [42,68-70].”
BackgroundDwyer, A., Neto, A. D. A., Estival, D., Li, W., Lam‐Cassettari, C., & Antoniou, M. (2021) · JMIR Mental Health · doi:10.2196/19478 · Cited by 39
“Interviews with 24 patients with depression [54] were used to evaluate an online e-mental health treatment [34].”
BackgroundMethodExperiences of Counsellors Providing Online Chat Counselling to Young People
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“Some of the clinicians viewed online chat as a stepping stone to face-to-face services, despite evidence suggesting that long-term structured interventions can be effective using online chat (Kessler et al., 2009).”
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“Few studies have investigated the use of blended care combining internet-based psychotherapeutic modules and FtF sessions into 1 coherent treatment manual to treat adult depression [28-31].”
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Self-citationMontero‐Marín, J., Prado-Abril, J., Botella, C., Mayoral, F., Baños, R., Herrera‐Mercadal, P., Romero‐Sanchiz, P., Gili, M., Castro, A., Nogueira‐Arjona, R., et al. (2015) · Journal of Medical Internet Research · doi:10.2196/jmir.3985 · Cited by 38
“Web-based interventions may also resemble traditional psychotherapy with scheduled sessions [34], but a general characteristic is that patients are reached from a distance and that therapist time is reduced compared with face-to-face treatments [35].”
Online CBT Is Effective in Overcoming Cultural and Language Barriers in Patients With Depression
Alavi, N., Hirji, A., Sutton, C., & Naeem, F. (2016) · Journal of Psychiatric Practice · doi:10.1097/pra.0000000000000119 · Cited by 34
UK military doctors; stigma, mental health and help-seeking: a comparative cohort study
Jones, N., Whybrow, D., & Coetzee, R. H. (2018) · Journal of the Royal Army Medical Corps · doi:10.1136/jramc-2018-000928 · Cited by 34
Gur-Yaish, N., Zisberg, A., Sinoff, G., & Shadmi, E. (2013) · Aging & Mental Health · doi:10.1080/13607863.2012.758234 · Cited by 33
“The prevalence rate of self-reported depressive symptoms among community-dwelling older adults ranges from 15% to 30% (Anstey, Von Sanden, Sargent-Cox, & Luszcz, 2007), and is accompanied by a high prevalence of underdiagnosis and under-treatment (Kessler et al., 2009).”
BackgroundLu, G., Brazier, J., & Ades, A. (2013) · Value in Health · doi:10.1016/j.jval.2012.07.003 · Cited by 36
“[20] Kessler D, Lewis G, Kaur S, et al.”
BackgroundMethodOwen, J. E., Bantum, E. O., Criswell, K. R., Bazzo, J., Gorlick, A., & Stanton, A. L. (2013) · Journal of Behavioral Medicine · doi:10.1007/s10865-013-9509-6 · Cited by 32
“, 2009), and psychological functioning (Kessler et al., 2009; Lintvedt et al., 2012).”
BackgroundCerga-Pashoja, A., Doukani, A., Gega, L., Walke, J., & Araya, R. (2020) · Psychotherapy Research · doi:10.1080/10503307.2020.1720932 · Cited by 30
“Third, as therapist-delivered sessions, iCBT relies on the synchronous client-therapist communication via telephone, email or via web-based “chat-rooms” to replace or support face-to-face meetings (Kessler et al., 2009; Muller & Yardley, 2011).”
BackgroundSelf-citationEngel, L. B., Thal, S. B., & Bright, S. J. (2022) · Contemporary Drug Problems · doi:10.1177/00914509221121420 · Cited by 30
“The provision of social support through online peer counseling is being explored (Fukkink, 2011) and online therapeutic interventions have evidenced decreases in anxiety and depression (e.g., Cohen & Kerr, 1999; Kessler et al., 2009).”
Robinson, J., Hetrick, S. E., Cox, G., Bendall, S., Yung, A. R., Yuen, H. P., Templer, K., & Pirkis, J. (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-155 · Cited by 30
Major Depressive Disorder: New Clinical, Neurobiological, and Treatment Perspectives
Kupfer, D. J., Frank, E., & Phillips, M. L. (2014) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.12.2.217 · Cited by 30
Ekberg, S., Barnes, R., Kessler, D. S., Mirza, S., Montgomery, A. A., Malpass, A., & Shaw, A. R. G. (2014) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465814000241 · Cited by 31
“, 2001) was conducted as part of the original trial and confirmed that therapists competently adhered to CBT methods (Kessler et al., 2009).”
MethodInfluentialSelf-citationMaking Evidence-Based Psychotherapy More Accessible in Canada
Gratzer, D., & Goldbloom, D. S. (2016) · The Canadian Journal of Psychiatry · doi:10.1177/0706743716642416 · Cited by 37
“Thus, in public health care systems like Canada’s, these psychotherapies have limited availability.(7,8) In this journal, Dezetter et al.”
BackgroundCardi, V., Ambwani, S., Crosby, R. D., Macdonald, P., Todd, G., Park, S. J., Moss, S. A., Schmidt, U. H., & Treasure, J. L. (2015) · Trials · doi:10.1186/s13063-015-0701-6 · Cited by 31
Parry, G. D., Barkham, M., Brazier, J. E., Dent‐Brown, K., Hardy, G. E., Kendrick, T., Rick, J., Chambers, E., Chan, T., Connell, J., et al. (2011) · White Rose Research Online (University of Leeds, The University of Sheffield, University of York) · doi:10.13140/2.1.2983.0726 · Cited by 29
Flygare, A.-L., Engström, I., Hasselgren, M., Jansson-Fröjmark, M., Frejgrim, R., Andersson, G., & Holländare, F. (2019) · Internet Interventions · doi:10.1016/j.invent.2019.100303 · Cited by 26
“However, some studies on ICBT in health care settings have been carried out (Ruwaard et al., 2012; Watts et al., 2012; Williams and Andrews, 2013; Kessler et al., 2009; Hedman et al., 2014; Titov et al., 2015; Kivi et al., 2014; Johansson et al., 2019; Mathiasen et al., 2018; Hadjistavropoulos et al., 2016; Nordgreen…”
BackgroundMajor Depressive Disorder: New Clinical, Neurobiological, and Treatment Perspectives
Kupfer, D. J., Frank, E., & Phillips, M. L. (2016) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.140208 · Cited by 31
Severity of depression and response to antidepressants: GENPOD randomised controlled trial
Wiles, N., Mulligan, J., Peters, T. J., Cowen, P. J., Mason, V. L., Nutt, D., Sharp, D., Tallon, D., Thomas, L., O’Donovan, M. C., et al. (2011) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.110.091223 · Cited by 28
Self-citationThriveNYC: Delivering on Mental Health
Belkin, G. S., & McCray, C. I. (2019) · American Journal of Public Health · doi:10.2105/ajph.2019.305040 · Cited by 29
Online Cognitive Behavioral Therapy for Depressed Primary Care Patients: A Pilot Feasibility Project
Whiteside, U. S., Richards, J. A., Steinfeld, B. I., Simon, G. E., Caka, S., Tachibana, C., Stuckey, S. J., & Ludman, E. J. (2014) · The Permanente Journal · doi:10.7812/tpp/13-155 · Cited by 27
Internet interventions: Moving from efficacy to effectiveness
Andersson, G., Carlbring, P., & Cuijpers, P. J. (2010) · E-Journal of Applied Psychology · doi:10.7790/ejap.v5i2.169 · Cited by 27
“However, recently a depression trial was conducted in which online treatment was given in real time in a chat format (Kessler et al., 2009).”
BackgroundKernel-based features for predicting population health indices from geocoded social media data
Nguyen, T., Larsen, M. E., O’Dea, B., Nguyen, D. T., Yearwood, J. L., Phung, D., Venkatesh, S., & Christensen, H. M. (2017) · Decision Support Systems · doi:10.1016/j.dss.2017.06.010 · Cited by 27
Montero-Marín, J., Carrasco, J. M., Roca, M., Serrano-Blanco, A., Gili, M., Mayoral, F., Luciano, J. V., Lopez-del-Hoyo, Y., Olivan, B., Collazo, F., et al. (2013) · BMC Psychiatry · doi:10.1186/1471-244x-13-64 · Cited by 26
“Other computer-assisted intervention models are being tested in which treatment is delivered by a therapist in real time via the Internet, and the results of these tests are positive in terms of effectiveness and acceptability [19].”
BackgroundSelf-citationJunge, M. N., Lehr, D., Bockting, C., Berking, M., Riper, H. M., Cuijpers, P. J., & Ebert, D. D. (2014) · Internet Interventions · doi:10.1016/j.invent.2014.11.007 · Cited by 27
“This is in line with research indicating that (therapist-delivered) online CBT is less effective in less depressed patients (Button et al., 2012; Kessler et al., 2009).”
Stawarz, K., Preist, C., Tallon, D., Wiles, N., Kessler, D., Turner, K., Shafran, R., & Coyle, D. (2020) · JMIR Mental Health · doi:10.2196/15972 · Cited by 24
Self-citationHolst, A., Björkelund, C., Metsini, A., Madsen, J.-H., Hange, D., Petersson, E., Eriksson, M. C. M., Kivi, M., Andersson, P.-Å., & Svensson, M. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-019716 · Cited by 24
“78.(12) ICBT has been specified as the treatment of choice for mild depression by the National Board of Health and Welfare in Sweden and is one of the preferred treatments for moderate depression.”
Zhao, D., Lustria, M. L. A., & Hendrickse, J. (2017) · Patient Education and Counseling · doi:10.1016/j.pec.2017.01.004 · Cited by 27
Verdoux, H., Cortaredona, S., Dumesnil, H., Sebbah, R., & Verger, P. (2013) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-013-0717-8 · Cited by 24
“the increased awareness that access to psychotherapy should be improved for primary care patients [7, 22, 28, 34], little is known about how GPs prescribe psychother-”
BackgroundInfluentialOrienting to Emotion in Computer-Mediated Cognitive Behavioral Therapy
Ekberg, S., Shaw, A. R. G., Kessler, D. S., Malpass, A., & Barnes, R. (2016) · Research on Language and Social Interaction · doi:10.1080/08351813.2016.1199085 · Cited by 23
“This study involved 183 therapist-client dyads participating in a British randomized trial of computer-mediated CBT for depression (Kessler et al., 2009).”
Self-citationEvidence on Technology-Based Psychological Interventions in Diagnosed Depression: Systematic Review
Köhnen, M., Dreier, M., Seeralan, T., Kriston, L., Härter, M., Baumeister, H., & Liebherz, S. (2021) · JMIR Mental Health · doi:10.2196/21700 · Cited by 23
Faucher, P., Dries, A., Mousset, P. Y., Leboyer, M., Dore, J. M., & Béracochéa, D. (2022) · Beneficial Microbes · doi:10.3920/bm2021.0188 · Cited by 26
Internetbasierte psychologische Behandlung bei Depressionen
Klein, J. P., & Berger, T. (2013) · Verhaltenstherapie · doi:10.1159/000354046 · Cited by 23
“Diese Annahme wird auch durch 2 bereits erwähnte Studien unterstützt [Kessler et al., 2009; Ruward et al., 2012].”
BackgroundKordy, H., Backenstraß, M., Hüsing, J., Wolf, M., Aulich, K., Bürgy, M., Puschner, B., Rummel‐Kluge, C., & Vedder, H. (2013) · Contemporary Clinical Trials · doi:10.1016/j.cct.2013.08.005 · Cited by 22
“There is growing evidence that health services for depressive disorders can be effectively delivered online [21–30].”
BackgroundPhysical activity as a treatment for depression: the TREAD randomised trial protocol
Baxter, H., Winder, R. E., Chalder, M., Wright, C., Sherlock, S., Haase, A. M., Wiles, N., Montgomery, A. A., Taylor, A. H., Fox, K. R., et al. (2010) · Trials · doi:10.1186/1745-6215-11-105 · Cited by 23
Self-citationJakobsen, H., Andersson, G., Havik, O. E., & Nordgreen, T. (2016) · Internet Interventions · doi:10.1016/j.invent.2016.11.002 · Cited by 25
“Patient Health Questionnaire 9 (PHQ-9; Kroenke and Spitzer, 2002) comprises nine itemsmeasuring the frequency of depressive symptoms and anhedonia the past two weeks on a scale from 0 (not at all) to 3 (nearly every day).”
Background
Metadata
- Authors
- Kessler, D., Lewis, G., Kaur, S., Wiles, N., King, M., Weich, S., Sharp, D. J., Araya, R., Hollinghurst, S., & Peters, T. J.
- Affiliations
- National Institute for Health and Care Research (GB)
- University of Bristol (GB)
- The Royal Free Hospital (GB)
- University of Warwick (GB)
- Corresponding author
- Kessler, David
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2009-08
- Volume
- 374
- Issue
- 9690
- Pages
- 628-634
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2130951278
- Cited by
- 387
- References
- 22
- Citations by year
- 2026: 9 · 2025: 7 · 2024: 12 · 2023: 10 · 2022: 12 · 2021: 19 · 2020: 30 · 2019: 23 · 2018: 26 · 2017: 29 · 2016: 33 · 2015: 28 · 2014: 41 · 2013: 35 · 2012: 27
- FWCI
- 28.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Bristol Research (University of Bristol) (submittedVersion)
- Explore Bristol Research (submittedVersion)
- Funders
- National Institute for Health and Care Research (CL-2007-25-001)
- Bupa Foundation
- 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 therapy, cognitive behavioral therapy, depression, primary care, access to mental health care, recovery from depression
- MeSH terms
- Adult, Antidepressive Agents, Depressive Disorder, England, Female, Follow-Up Studies, Health Services Accessibility, Humans, Male, Psychiatric Status Rating Scales, Severity of Illness Index, Therapy, Computer-Assisted, Cognitive Behavioral Therapy, Effect Modifier, Epidemiologic, Linear Models, Logistic Models, Treatment Outcome, Internet, International Classification of Diseases
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