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Internet- and Mobile-Based Psychological Interventions: Applications, Efficacy, and Potential for Improving Mental Health: A Report of the EFPA E-Health Taskforce
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Abstract. The majority of mental health disorders remain untreated. Many limitations of traditional psychological interventions such as limited availability of evidence-based interventions and clinicians could potentially be overcome by providing Internet- and mobile-based psychological interventions (IMIs). This paper is a report of the Taskforce E-Health of the European Federation of Psychologists’ Association and will provide an introduction to the subject, discusses areas of application, and reviews the current evidence regarding the efficacy of IMIs for the prevention and treatment of mental disorders. Meta-analyses based on randomized trials clearly indicate that therapist-guided stand-alone IMIs can result in meaningful benefits for a range of indications including, for example, depression, anxiety, insomnia, or posttraumatic stress disorders. The clinical significance of results of purely self-guided interventions is for many disorders less clear, especially with regard to effects under routine care conditions. Studies on the prevention of mental health disorders (MHD) are promising. Blended concepts, combining traditional face-to-face approaches with Internet- and mobile-based elements might have the potential of increasing the effects of psychological interventions on the one hand or to reduce costs of mental health treatments on the other hand. We also discuss mechanisms of change and the role of the therapist in such approaches, contraindications, potential limitations, and risk involved with IMIs, briefly review the status of the implementation into routine health care across Europe, and discuss confidentiality as well as ethical aspects that need to be taken into account, when implementing IMIs. Internet- and mobile-based psychological interventions have high potential for improving mental health and should be implemented more widely in routine care.
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“Most online interventions are grounded in Cognitive Behavioral Therapy (CBT), with the majority of these using traditional CBT techniques (e.g. cognitive restructuring, progressive muscle relaxation, etc.; Ebert et al., 2018; Fleming et al., 2018).”
From A systematic review and meta-analysis of self-guided online acceptance and commitment therapy as a transdiagnostic self-help intervention (2023) · cites this paper as Ebert et al., 2018
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“They are effective in treating and preventing a broad range of disorders (19, 20), yet uptake remains low as students lack knowledge and experience with IMI but show positive attitudes towards apps (i.e., future expectations and less fear of risks) (21).”
From Mental health services for German university students: acceptance of intervention targets and preference for delivery modes (2024) · cites this paper as [19]
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In the citing paper
“A promising approach to address the challenge of low uptake of mental health services could be telehealth interventions which can be used flexibly in time and location and thus, facilitate health care access (Ebert et al., 2018; Snoswell et al., 2021).”
From How to promote usage of telehealth interventions for farmers' mental health? A qualitative study on supporting and hindering aspects for acceptance and satisfaction with a personalized telephone coaching for depression prevention (2023) · cites this paper as Ebert et al., 2018
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“While there is already substantial evidence in the area of digital interventions in the field of mental health, there is still much to learn about the needs and best way of providing digital interventions for people with medical conditions (Ebert et al., 2018).”
From Special issue on digital health interventions in chronic medical conditions: Editorial (2022) · cites this paper as Ebert et al., 2018
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“The research on IMIs has so far almost exclusively focused on stand-alone IMIs, i.e., online interventions that are used as an alternative to on-site treatment (8, 9).”
From Clinical and Cost-Effectiveness of PSYCHOnlineTHERAPY: Study Protocol of a Multicenter Blended Outpatient Psychotherapy Cluster Randomized Controlled Trial for Patients With Depressive and Anxiety Disorders (2021) · cites this paper as [8]
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“Using the internet to provide psychotherapeutic interventions may increase the coverage of usual care services [8,9] by providing highly accessible and scalable interventions reaching people who cannot be reached otherwise.”
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“IMIs have the potential to overcome barriers to help-seeking by offering anonymous, flexible, and easily accessible support whenever and wherever needed, thereby reducing feelings of shame and stigmatization (Ebert et al., 2018).”
From PandaMom – Feasibility and acceptability of an internet- and mobile-based intervention to enhance peripartum mental well-being and to prevent postpartum depression (2024) · cites this paper as Ebert et al., 2018
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“several trials suggesting near equivalent effects as compared to face-to-face therapy”
From A systematic review and meta-analysis of self-guided online acceptance and commitment therapy as a transdiagnostic self-help intervention (2023) · cites this paper as Ebert et al., 2018
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“Researchers on telehealth interventions have argued that remotely delivered health service might offer low-threshold access to (mental) health care (Ebert et al., 2018; Snoswell et al., 2021) and improves health care in underserved areas (Myers, 2019; Salize et al., 2007), which is supported for farming communities by our interviewees.”
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“Other studies revealed that digital health interventions, including smartphone apps, showed significant clinical improvements in depression and anxiety (19), and psychosis (20).”
From Digital Therapeutic Alliance With Fully Automated Mental Health Smartphone Apps: A Narrative Review (2022) · cites this paper as [19]
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“Internet and mobile-based interventions (IMIs) can help overcome barriers of face-to-face treatments.30–32”
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“Numerous clinical trials summarized in several meta-analyses have now shown the effectiveness of IMIs in the treatment of mental disorders (8), particularly well-studied in depressive disorders and anxiety disorders (10, 11).”
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“Internet- and mobile-based interventions (IMIs) can provide a means of making evidence-based psychotherapeutic interventions available in a timely manner, thereby contributing to reducing the shortage of care (8, 9).”
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“a recent narrative review of digital interventions reported large effect sizes for participants with major depressive disorder, anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder and small effect sizes for eating disorders or problematic alcohol use [23].”
From The therapeutic alliance in digital mental health interventions for serious mental illnesses: narrative review (2020) · cites this paper as [23]
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“In addition, supported digital interventions have comparably smaller attrition rates and greater engagement, as demonstrated in systematic reviews [23,85].”
From The therapeutic alliance in digital mental health interventions for serious mental illnesses: narrative review (2020) · cites this paper as [23]
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Web-basierte Rehabilitationsnachsorge nach stationärer psychosomatischer Therapie (W-RENA)
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Cochran, G., Stitzer, M. L., Campbell, A. N. C., Hu, M., Vandrey, R. G., & Nunes, E. V. (2015) · Addictive Behaviors · doi:10.1016/j.addbeh.2015.02.002 · Cited by 28
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„Occupational eMental Health“ in der Lehrergesundheit
Lehr, D., Heber, E., Sieland, B., Hillert, A., Funk, B., & Ebert, D. D. (2016) · Prävention und Gesundheitsförderung · doi:10.1007/s11553-016-0541-6 · Cited by 25
Self-citationThe efficiency model of support and the creation of digital apothecaries.
Muñoz, R. F. (2017) · Clinical Psychology: Science and Practice · doi:10.1111/cpsp.12174 · Cited by 25
Internetbasierte psychologische Behandlung bei Depressionen
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Nyenhuis, N., Zastrutzki, S., Jäger, B., & Kröner‐Herwig, B. (2012) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2012.724081 · Cited by 19
Lévesque, A., Campbell, A. N. C., Pavlicová, M., Hu, M., Walker, R., McClure, E. A., Ghitza, U. E., Bailey, G. L., Stitzer, M. L., & Nunes, E. V. (2016) · Addictive Behaviors · doi:10.1016/j.addbeh.2016.09.012 · Cited by 15
Online Intervention for Prevention of Major Depression—Reply
Ebert, D. D., Buntrock, C., & Cuijpers, P. J. (2016) · JAMA · doi:10.1001/jama.2016.9586 · Cited by 6
Self-citationHarper, K. M. (2019) · Carolina Digital Repository (University of North Carolina at Chapel Hill) · doi:10.17615/j997-0s97 · Cited by 3
Portable technology in mental healthcare
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Research works printed but not linked: 8
- Ebert D. D., 2017, JAMA Psychiatry, 1, 205
- Ebert D. D., 2016, Diabetic Medicine, 46, 2679
- Enander J., 2016, BMJ, 352
- Kleiboer A., 2016, Trials, 17
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- Olthuis J. V., 2015, The Cochrane Database of Systematic Reviews, 3, CD011565
- 10.1111/cpsp.12173 · DOI · Paper page
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Harrer, M., Adam, S. H., Baumeister, H., Cuijpers, P., Karyotaki, E., Auerbach, R. P., Kessler, R. C., Bruffaerts, R., Berking, M., & Ebert, D. D. (2019) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.1759 · Cited by 445
Self-citationDigital interventions for the treatment of depression: a meta-analytic review
Moshe, I., Terhorst, Y., Philippi, P., Domhardt, M., Cuijpers, P., Cristea, I., Pulkki-Råback, L., Baumeister, H., & Sander, L. B. (2021) · Psychological Bulletin · doi:10.1037/bul0000334 · Cited by 390
Self-citationStandalone smartphone apps for mental health—a systematic review and meta-analysis
Weisel, K. K., Fuhrmann, L. M., Berking, M., Baumeister, H., Cuijpers, P., & Ebert, D. D. (2019) · npj Digital Medicine · doi:10.1038/s41746-019-0188-8 · Cited by 447
Self-citationEbert, D. D., Mortier, P., Kaehlke, F., Bruffaerts, R., Baumeister, H., Auerbach, R. P., Alonso, J., Vilagut, G., Martínez, K. U., Lochner, C., et al. (2019) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.1782 · Cited by 407
Self-citationJosephine, K., Josefine, L., Philipp, D., David, E., & Harald, B. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.07.021 · Cited by 341
Metadata
- Authors
- Ebert, D. D., Van Daele, T., Nordgreen, T., Karekla, M., Compare, A., Zarbo, C., Brugnera, A., Øverland, S., Trebbi, G., Jensen, K. L., Kaehlke, F., & Baumeister, H.
- Affiliations
- Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
- Department of Applied Psychology, Thomas More University of Applied Sciences, Antwerp, Belgium
- Haukeland University Hospital (NO)
- University of Cyprus (CY)
- University of Bergamo (IT)
- SuperEgo AS, Trondheim, Norway
- Trebbipsicologie, Luxembourg & Societé Luxembourgeoise de Psychologie SLP, Luxembourg
- Private Practice, Skagen, Denmark
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
- Universität Ulm (DE)
- ORCID
- Venue
- European Psychologist
- Publisher
- Hogrefe Publishing Group
- Published
- 2018-05
- Volume
- 23
- Issue
- 2
- Pages
- 167-187
- ISSN
- 1016-9040 (ISSN-L)
- 1878-531X
- OpenAlex
- W2803511537
- Cited by
- 437
- References
- 179
- Citations by year
- 2026: 34 · 2025: 56 · 2024: 64 · 2023: 54 · 2022: 65 · 2021: 58 · 2020: 55 · 2019: 38 · 2018: 12
- FWCI
- 51.39
- Type
- journal article
- Language
- en
- Open access
- Locations
- European Psychologist (publishedVersion)
- Bournemouth University Research Online (Bournemouth University) (acceptedVersion)
- Bournemouth University Research Online (Bournemouth University) (submittedVersion)
- Aisberg (University of Bergamo) (submittedVersion)
- BOA (University of Milano-Bicocca) (submittedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- online psychological intervention, e-mental health, depression, anxiety, insomnia, post-traumatic stress disorder, mental disorder prevention, blended intervention, therapist-guided intervention, self-guided intervention, mechanisms of change, confidentiality, implementation in routine care, treatment costs
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