Clinician-Assisted Internet-Based Treatment is Effective for Depression: Randomized Controlled Trial
Abstract
Objective The aim of the present study was to determine the efficacy of an Internet-based clinician-assisted computerized cognitive behavioural treatment (CaCCBT) programme for depression. Method Forty-five individuals meeting diagnostic criteria for depression were randomly assigned to the Sadness programme or to a waitlist control group. In the clinician-assisted Sadness programme, participants complete six online lessons, weekly homework assignments, receive weekly email contact from a clinical psychologist, and contribute to a moderated online discussion forum with other participants. An intention-to-treat model was used for data analyses. Results A total of 20 (74%) treatment group participants completed all lessons within the 8 week programme, and post-treatment data were collected from 18/27 treatment group and 17/18 waitlist group participants. Treatment group participants reported significantly reduced symptoms of depression as measured by the Beck Depression Inventory-second edition and the Patient Health Questionnaire-Nine Item. Treatment group participants each received an average of eight email contacts (111 min of therapist time]. Mean within- and between-group effect sizes (Cohen's d) across the two measures of depressive symptoms were 0.98 and 0.75, respectively. Participants found the treatment programme acceptable and satisfactory. Conclusions These results replicate those from the pilot trial reported by Perini et al. and are consistent with literature indi…
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Other studies on the combination of online sessions and personal support only investigated support through e-mail or instant messaging.
“Other studies on the combination of online sessions and personal support only investigated support through e-mail, or instant messaging (e.g. [19,36-38]).”
Pretreatment contact is often in the form of a structured diagnostic interview and probably results in more reliable diagnostic categories for inclusion in a trial.
“This pretreatment contact is often in the form of a structured diagnostic interview [20,21], and probably results in more reliable diagnostic categories for inclusion in a trial.”
From Internet-based psychological treatments for depression (2012) · cites this paper as [20]
Cognitive restructuring, a form of reappraisal, is one of the most common components in Web-based treatments for depression.
“Cognitive restructuring, a form of reappraisal, is one of the most common components in Web-based treatments for depression [24-27].”
From Efficacy of a web-based, crowdsourced peer-to-peer cognitive reappraisal platform for depression: Randomized controlled trial (2015) · cites this paper as [25]
Eighteen studies state that encouraging adherence is a task for the counselor.
“it is remarkable that 18 state that encouraging adherence is a task for the counselor [45-62]”
From Persuasive System Design Does Matter: a Systematic Review of Adherence to Web-based Interventions (2012) · cites this paper as [52]
Cites
The PHQ-9: Validity of a brief depression severity measure
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009606.x · Cited by 44,910 · see citing works
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)
American Psychiatric Association (2000) · doi:10.1176/appi.books.9780890423349 · Cited by 11,069 · see citing works
KESSLER, R. C., ANDREWS, G., COLPE, L. J., HIRIPI, E., MROCZEK, D. K., NORMAND, S.-L. T., WALTERS, E. E., & ZASLAVSKY, A. M. (2002) · Psychological Medicine · doi:10.1017/s0033291702006074 · Cited by 10,327 · see citing works
Self-citationInternet-based cognitive behaviour therapy for symptoms of depression and anxiety: A meta-analysis
SPEK, V., CUIJPERS, P., NYKLÍČEK, I., RIPER, H., KEYZER, J., & POP, V. (2007) · Psychological Medicine · doi:10.1017/s0033291706008944 · Cited by 1,586 · see citing works
Monitoring Depression Treatment Outcomes With the Patient Health Questionnaire-9
L??we, B., Un??tzer, J., Callahan, C. M., Perkins, A. J., & Kroenke, K. (2004) · Medical Care · doi:10.1097/00005650-200412000-00006 · Cited by 1,354 · see citing works
Gilbody, S., Richards, D., Brealey, S., & Hewitt, C. (2007) · Journal of General Internal Medicine · doi:10.1007/s11606-007-0333-y · Cited by 1,290 · see citing works
Andrews, G., Henderson, S., & Hall, W. (2001) · British Journal of Psychiatry · doi:10.1192/bjp.178.2.145 · Cited by 933 · see citing works
Self-citationDelivering interventions for depression by using the internet: randomised controlled trial
Christensen, H. (2004) · BMJ · doi:10.1136/bmj.37945.566632.ee · Cited by 928 · see citing works
Internet-based self-help for depression: randomised controlled trial
Andersson, G., Bergström, J., Holländare, F., Carlbring, P., Kaldo, V., & Ekselius, L. (2005) · British Journal of Psychiatry · doi:10.1192/bjp.187.5.456 · Cited by 529 · cited 2× · see citing works
“Research indicates that Internet-based CaCCBT programmes with email or telephone contact can result in clinically significant improvements in patients with depression [10,15], social phobia [Titov N et al: unpublished data, 2009; 16 21] and panic disorder [22 26], at a level similar to that provided by face-to-face cl…”
BackgroundResultPROUDFOOT, J., GOLDBERG, D., MANN, A., EVERITT, B., MARKS, I., & GRAY, J. A. (2003) · Psychological Medicine · doi:10.1017/s0033291702007225 · Cited by 389 · see citing works
Andersson, G., Carlbring, P., Holmström, A., Sparthan, E., Furmark, T., Nilsson-Ihrfelt, E., Buhrman, M., & Ekselius, L. (2006) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.74.4.677 · Cited by 382 · see citing works
Clarke, G., Eubanks, D., Reid, E., Kelleher, C., O'Connor, E., DeBar, L. L., Lynch, F., Nunley, S., & Gullion, C. (2005) · Journal of Medical Internet Research · doi:10.2196/jmir.7.2.e16 · Cited by 372 · see citing works
Treatment of panic disorder: live therapy vs. self-help via the Internet
Carlbring, P., Nilsson-Ihrfelt, E., Waara, J., Kollenstam, C., Buhrman, M., Kaldo, V., Söderberg, M., Ekselius, L., & Andersson, G. (2005) · Behaviour Research and Therapy · doi:10.1016/j.brat.2004.10.002 · Cited by 372 · see citing works
Is internet-based CBT for panic disorder and agoraphobia as effective as face-to-face CBT?
Kiropoulos, L. A., Klein, B., Austin, D. W., Gilson, K., Pier, C., Mitchell, J., & Ciechomski, L. (2008) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2008.01.008 · Cited by 290 · see citing works
Clarke, G., Reid, E., Eubanks, D., O'Connor, E., DeBar, L. L., Kelleher, C., Lynch, F., & Nunley, S. (2002) · Journal of Medical Internet Research · doi:10.2196/jmir.4.3.e14 · Cited by 256 · see citing works
Efficacy of internet therapy for panic disorder
Klein, B., Richards, J. C., & Austin, D. W. (2006) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2005.07.001 · Cited by 236 · see citing works
Titov, N., Andrews, G., Choi, I., Schwencke, G., & Mahoney, A. (2008) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670802512107 · Cited by 221 · see citing works
Self-citationMarks, I. M., Cavanagh, K., & Gega, L. (2007) · Psychology Press eBooks · doi:10.4324/9780203962152 · Cited by 167 · see citing works
Shyness 2: Treating Social Phobia Online: Replication and Extension
Titov, N., Andrews, G., & Schwencke, G. (2008) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670802119820 · Cited by 133 · see citing works
Self-citationStatus of computerized cognitive behavioural therapy for adults
Titov, N. (2007) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670601109873 · Cited by 120 · cited 2× · see citing works
“Delegating such tasks to a computer system that then presents evidence-based information in an engaging manner with absolute fidelity can free clinicians to spend time on more sophisticated and specialized components of therapy [5,6,8,9].”
BackgroundSelf-citationShyness programme: Longer term benefits, cost-effectiveness, and acceptability
Titov, N., Andrews, G., Johnston, L., Schwencke, G., & Choi, I. (2009) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670802534424 · Cited by 88 · see citing works
Self-citationShandley, K., Austin, D. W., Klein, B., Pier, C., Schattner, P., Pierce, D., & Wade, V. (2008) · Journal of Medical Internet Research · doi:10.2196/jmir.1033 · Cited by 84 · see citing works
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Computer-based psychological treatments for depression: A systematic review and meta-analysis
Richards, D., & Richardson, T. (2012) · Clinical Psychology Review · doi:10.1016/j.cpr.2012.02.004 · Cited by 1,442 · see citing works
“…their objective was to establish the ef-fi cacy of a computer-based, clinician-assisted, intervention for depression (Andersson et al., 2005; Perini, Titov, & Andrews, 2009; Ruwaard et al., 2009), others examined the ef fi cacy of unsupported computer-based interventions (Clarke et al.,…”
BackgroundAndrews, G., Cuijpers, P., Craske, M. G., McEvoy, P., & Titov, N. (2010) · PLoS ONE · doi:10.1371/journal.pone.0013196 · Cited by 1,311 · see citing works
“In the first [24] 70% had sought prior help and 51% were currently taking medication for their depression.”
BackgroundSelf-citationPersuasive System Design Does Matter: a Systematic Review of Adherence to Web-based Interventions
Kelders, S. M., Kok, R. N., Ossebaard, H. C., & Van Gemert-Pijnen, J. E. (2012) · Journal of Medical Internet Research · doi:10.2196/jmir.2104 · Cited by 1,308 · see citing works
Advantages and limitations of Internet-based interventions for common mental disorders
Andersson, G., & Titov, N. (2014) · World Psychiatry · doi:10.1002/wps.20083 · Cited by 1,160 · see citing works
Self-citationAndrews, G., Basu, A., Cuijpers, P., Craske, M. G., McEvoy, P., English, C. L., & Newby, J. M. (2018) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2018.01.001 · Cited by 922 · see citing works
Self-citationKaryotaki, E., Efthimiou, O., Miguel, C., Maas genannt Bermpohl, F., Furukawa, T. A., Cuijpers, P., Individual Patient Data Meta-Analyses for Depression (IPDMA-DE) Collaboration, Riper, H., Patel, V., Mira, A., et al. (2021) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2020.4364 · Cited by 866 · see citing works
Self-citationHedman, E., Ljótsson, B., & Lindefors, N. (2012) · Expert Review of Pharmacoeconomics & Outcomes Research · doi:10.1586/erp.12.67 · Cited by 672 · see citing works
Internet-Delivered Psychological Treatments
Andersson, G. (2016) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-021815-093006 · Cited by 595 · see citing works
Cuijpers, P., Cristea, I. A., Karyotaki, E., Reijnders, M., & Huibers, M. J. H. (2016) · World Psychiatry · doi:10.1002/wps.20346 · Cited by 572 · see citing works
Internet-based psychological treatments for depression
Johansson, R., & Andersson, G. (2012) · Expert Review of Neurotherapeutics · doi:10.1586/ern.12.63 · Cited by 509 · see citing works
Digital 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 · see citing works
E-Mental Health: A Rapid Review of the Literature
Lal, S., & Adair, C. E. (2014) · Psychiatric Services · doi:10.1176/appi.ps.201300009 · Cited by 417 · see citing works
van Ballegooijen, W., Cuijpers, P., van Straten, A., Karyotaki, E., Andersson, G., Smit, J. H., & Riper, H. (2014) · PLoS ONE · doi:10.1371/journal.pone.0100674 · Cited by 409 · see citing works
Titov, N., Andrews, G., Davies, M., McIntyre, K., Robinson, E., & Solley, K. (2010) · PLoS ONE · doi:10.1371/journal.pone.0010939 · Cited by 406 · see citing works
“The present CONSORT-Revised compliant randomized controlled trial (RCT) [30] examined the clinical efficacy and acceptability of clinician- and technician-assisted iCBT using the Sadness program [12,13] for people with a DSM-IV [31] diagnosis of depression.”
MethodSelf-citationBerger, T., Hämmerli, K., Gubser, N., Andersson, G., & Caspar, F. (2011) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2011.616531 · Cited by 383 · see citing works
“The findings for the guided selfhelp group replicate other studies on guided internet-based treatments for depression in which large within- and medium-to-large between-group effect sizes on depression measures are typical (Andersson et al., 2005; Perini et al., 2009; Titov et al., 2010; Vernmark et al., 2010).”
BackgroundResultJosephine, 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 · see citing works
Arnberg, F. K., Linton, S. J., Hultcrantz, M., Heintz, E., & Jonsson, U. (2014) · PLoS ONE · doi:10.1371/journal.pone.0098118 · Cited by 330 · see citing works
Titov, N., Dear, B. F., McMillan, D., Anderson, T., Zou, J., & Sunderland, M. (2011) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2010.550059 · Cited by 342 · see citing works
“These RCTs employed the same recruitment process, inclusion criteria, and treatment materials and are described in detail elsewhere (Perini et al., 2009; Titov et al., 2010).”
MethodSelf-citationCBT for depression: a pilot RCT comparing mobile phone vs. computer
Watts, S., Mackenzie, A., Thomas, C., Griskaitis, A., Mewton, L., Williams, A., & Andrews, G. (2013) · BMC Psychiatry · doi:10.1186/1471-244x-13-49 · Cited by 329 · see citing works
Self-citationKaryotaki, E., Ebert, D. D., Donkin, L., Riper, H., Twisk, J., Burger, S., Rozental, A., Lange, A., Williams, A. D., Zarski, A. C., et al. (2018) · Clinical Psychology Review · doi:10.1016/j.cpr.2018.06.007 · Cited by 303 · see citing works
Self-citationGriffiths, K. M., Farrer, L., & Christensen, H. (2010) · Medical Journal of Australia · doi:10.5694/j.1326-5377.2010.tb03685.x · Cited by 303 · see citing works
Transdiagnostic internet treatment for anxiety and depression: a randomised controlled trial
Titov, N., Dear, B. F., Schwencke, G., Andrews, G., Johnston, L., Craske, M. G., & McEvoy, P. (2011) · Behaviour Research and Therapy · doi:10.1016/j.brat.2011.03.007 · Cited by 285 · see citing works
Self-citationClinician-Assisted Internet-Based Treatment is Effective for Panic: A Randomized Controlled Trial
Wims, E., Titov, N., Andrews, G., & Choi, I. (2010) · Australian & New Zealand Journal of Psychiatry · doi:10.3109/00048671003614171 · Cited by 290 · see citing works
Self-citationRobinson, E., Titov, N., Andrews, G., McIntyre, K., Schwencke, G., & Solley, K. (2010) · PLoS ONE · doi:10.1371/journal.pone.0010942 · Cited by 277 · see citing works
Self-citationvan der Vaart, R., Witting, M., Riper, H., Kooistra, L., Bohlmeijer, E. T., & van Gemert-Pijnen, L. J. (2014) · BMC Psychiatry · doi:10.1186/s12888-014-0355-z · Cited by 273 · see citing works
Attitudes towards digital treatment for depression: A European stakeholder survey
Topooco, N., Riper, H., Araya, R., Berking, M., Brunn, M., Chevreul, K., Cieslak, R., Ebert, D. D., Etchmendy, E., Herrero, R., et al. (2017) · Internet Interventions · doi:10.1016/j.invent.2017.01.001 · Cited by 262 · see citing works
Hedman, E., Ljótsson, B., Kaldo, V., Hesser, H., El Alaoui, S., Kraepelien, M., Andersson, E., Rück, C., Svanborg, C., Andersson, G., et al. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.10.023 · Cited by 224 · see citing works
Van Ameringen, M., Turna, J., Khalesi, Z., Pullia, K., & Patterson, B. (2017) · Depression and Anxiety · doi:10.1002/da.22657 · Cited by 234 · see citing works
Vernmark, K., Lenndin, J., Bjärehed, J., Carlsson, M., Karlsson, J., Öberg, J., Carlbring, P., Eriksson, T., & Andersson, G. (2010) · Behaviour Research and Therapy · doi:10.1016/j.brat.2010.01.005 · Cited by 226 · see citing works
Morris, R. R., Schueller, S. M., & Picard, R. W. (2015) · Journal of Medical Internet Research · doi:10.2196/jmir.4167 · Cited by 206 · see citing works
“The primary therapeutic approach behind Panoply draws from CBT.”
InfluentialO'Mahen, H. A., Richards, D. A., Woodford, J., Wilkinson, E., McGinley, J., Taylor, R. S., & Warren, F. C. (2014) · Psychological Medicine · doi:10.1017/s0033291713002092 · Cited by 201 · see citing works
“Online cognitive behavioural therapy (CBT) for depression has been demonstrated in a number of randomized controlled trials (e.g. Christensen et al. 2004; Warmerdam et al. 2008; Meyer et al. 2009; Perini et al. 2009) and systematic reviews (e.”
MethodComputer-Assisted Cognitive-Behavior Therapy for Depression: A Systematic Review and Meta-Analysis
Wright, J. H., Owen, J. J., Richards, D., Eells, T. D., Richardson, T., Brown, G. K., Barrett, M., Rasku, M. A., Polser, G., & Thase, M. E. (2019) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.18r12188 · Cited by 200 · see citing works
“…0.020 −0.009 0.543 1.894 .058 Warmerdam et al 2008 0.543 0.153 0.024 0.243 0.844 3.545 .000 Clarke et al 2009 0.228 0.171 0.029 −0.107 0.562 1.333 .183 Perini et al 2009 0.614 0.311 0.097 0.004 1.223 1.974 .048 Ruwaard et al 2009 0.831 0.296 0.087 0.252 1.410 2.812 .005 Titov et al 2010a 1.262…”
InfluentialTransdiagnostic Internet treatment for anxiety disorders: A randomized controlled trial
Titov, N., Andrews, G., Johnston, L., Robinson, E., & Spence, J. (2010) · Behaviour Research and Therapy · doi:10.1016/j.brat.2010.05.014 · Cited by 196 · see citing works
Self-citationHilvert-Bruce, Z., Rossouw, P. J., Wong, N., Sunderland, M., & Andrews, G. (2012) · Behaviour Research and Therapy · doi:10.1016/j.brat.2012.04.001 · Cited by 193 · see citing works
Self-citationPsychotherapy for subclinical depression: meta-analysis
Cuijpers, P., Koole, S. L., van Dijke, A., Roca, M., Li, J., & Reynolds, C. F. (2014) · British Journal of Psychiatry · doi:10.1192/bjp.bp.113.138784 · Cited by 193 · see citing works
Blom, K., Jernelöv, S., Kraepelien, M., Bergdahl, M. O., Jungmarker, K., Ankartjärn, L., Lindefors, N., & Kaldo, V. (2015) · SLEEP · doi:10.5665/sleep.4412 · Cited by 197 · see citing works
Newby, J. M., Mackenzie, A., Williams, A. D., McIntyre, K., Watts, S., Wong, N., & Andrews, G. (2013) · Psychological Medicine · doi:10.1017/s0033291713000111 · Cited by 181 · see citing works
“2011), and for the primary disorders (Perini et al. 2009).”
Self-citationChoi, I., Zou, J., Titov, N., Dear, B. F., Li, S., Johnston, L., Andrews, G., & Hunt, C. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.11.003 · Cited by 180 · see citing works
“05, which was the minimum expected based on similar studies (Perini et al., 2009; Titov et al., 2010a).”
BackgroundMethodResultInfluentialSelf-citationSpanhel, K., Balci, S., Feldhahn, F., Bengel, J., Baumeister, H., & Sander, L. B. (2021) · npj Digital Medicine · doi:10.1038/s41746-021-00498-1 · Cited by 178 · see citing works
Butow, P., Price, M., Shaw, J., Turner, J., Clayton, J., Grimison, P., Rankin, N., & Kirsten, L. (2015) · Psycho-Oncology · doi:10.1002/pon.3920 · Cited by 178 · see citing works
“As effective as face-to-face care for mild to moderate anxiety and depression [73,74].”
BackgroundInfluentialCombining Imagination and Reason in the Treatment of Depression
Williams, A. D., Blackwell, S., Mackenzie, A., Holmes, E., & Andrews, G. (2013) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0033247 · Cited by 177 · see citing works
Self-citationLintvedt, O. K., Griffiths, K. M., Sørensen, K., Østvik, A. R., Wang, C. E. A., Eisemann, M., & Waterloo, K. (2013) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.770 · Cited by 157 · see citing works
Internet-delivered psychotherapy for depression in adults
Titov, N. (2011) · Current Opinion in Psychiatry · doi:10.1097/yco.0b013e32833ed18f · Cited by 158 · see citing works
Self-citationProviding Human Support for the Use of Digital Mental Health Interventions: Systematic Meta-review
Werntz, A., Amado, S., Jasman, M., Ervin, A., & Rhodes, J. E. (2023) · Journal of Medical Internet Research · doi:10.2196/42864 · Cited by 158 · see citing works
“The most common solution to attrition and low engagement is to provide users with personalized feedback [19] and human support designed to personalize DMHIs through supportive text messages, phone calls, personalized feedback, monitoring, and troubleshooting [34-37].”
Mohr, D., Duffecy, J., Ho, J., Kwasny, M., Cai, X., Burns, M., & Begale, M. (2013) · PLoS ONE · doi:10.1371/journal.pone.0070086 · Cited by 156 · see citing works
“three of these trials did not include clinical counseling, while many trials examining coached web-based interactions do include clinical coaching [10,30].”
BackgroundEbert, D. D., Donkin, L., Andersson, G., Andrews, G., Berger, T., Carlbring, P., Rozenthal, A., Choi, I., Laferton, J. A. C., Johansson, R., et al. (2016) · Psychological Medicine · doi:10.1017/s0033291716001562 · Cited by 154 · see citing works
“…identified from the database search, primary data was obtained from 14 (Andersson et al. 2005; van Straten et al. 2008; Warmerdam et al. 2008; Perini et al. 2009; Ruwaard et al. 2009; Vernmark et al. 2010; Titov et al. 2010; Berger et al. 2011; van Bastelaar et al. 2011; Choi et al. 2012;…”
BackgroundMethodSelf-citationHøifødt, R. S., Lillevoll, K. R., Griffiths, K. M., Wilsgaard, T., Eisemann, M., Waterloo, K., & Kolstrup, N. (2013) · Journal of Medical Internet Research · doi:10.2196/jmir.2714 · Cited by 154 · see citing works
“The adherence rate in the present study is comparable to that observed in other online guided interventions, in which adherence varied between 55% and 75% [13,14,23,30,99].”
BackgroundResultBaikie, K. A., Geerligs, L., & Wilhelm, K. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.11.032 · Cited by 150 · see citing works
Johnston, L., Titov, N., Andrews, G., Spence, J., & Dear, B. F. (2011) · PLoS ONE · doi:10.1371/journal.pone.0028079 · Cited by 150 · see citing works
Self-citationWilliams, A. D., & Andrews, G. (2013) · PLoS ONE · doi:10.1371/journal.pone.0057447 · Cited by 149 · see citing works
Self-citationTitov, N., Andrews, G., Robinson, E., Schwencke, G., Johnston, L., Solley, K., & Choi, I. (2009) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670903179269 · Cited by 147 · see citing works
“We have demonstrated the clinical efficacy of clinician-assisted (CaCCBT) programmes in randomized controlled trials (RCTs) or open studies in patients with depression [16,17], social phobia [18 25], and in a recent trial in patients with panic disorder [26].”
MethodSelf-citationFarrer, L., Christensen, H., Griffiths, K. M., & Mackinnon, A. (2011) · PLoS ONE · doi:10.1371/journal.pone.0028099 · Cited by 140 · see citing works
“Effects were also larger than any previous reported effect sizes across 11 RCTs comparing Internet interventions to waitlist, treatment as usual or placebo control conditions for depression [6,15,17,38,39, 40,41,42,43,44,45].”
ResultCuijpers, P., Cristea, I. A., Ebert, D. D., Koot, H. M., Auerbach, R. P., Bruffaerts, R., & Kessler, R. C. (2016) · Depression and Anxiety · doi:10.1002/da.22461 · Cited by 137 · see citing works
Sztein, D. M., Koransky, C. E., Fegan, L., & Himelhoch, S. (2018) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x17717402 · Cited by 135 · see citing works
Online interventions for depression and anxiety – a systematic review
Saddichha, S., Al-Desouki, M., Lamia, A., Linden, I. A., & Krausz, M. (2014) · Health Psychology and Behavioral Medicine · doi:10.1080/21642850.2014.945934 · Cited by 133 · see citing works
“…analysis, and subsequent applications of components commonly used in CBT for depression including behavior activation and cognitive restructuring Perini et al. (2009) Forty-five individuals with DSM IV depressive disorder were randomized into either the treatment group (Sadness Program) or…”
BackgroundMethodInfluentialSo, M., Yamaguchi, S., Hashimoto, S., Sado, M., Furukawa, T. A., & McCrone, P. (2013) · BMC Psychiatry · doi:10.1186/1471-244x-13-113 · Cited by 129 · see citing works
“Perini (2009) [42] community guided iCBT, 8 45 PHQ-9, BDI-ii SDS WL 8 weeks 27% replaced by pretreatment scores Australia”
BackgroundMomMoodBooster Web-Based Intervention for Postpartum Depression: Feasibility Trial Results
Danaher, B. G., Milgrom, J., Seeley, J. R., Stuart, S., Schembri, C., Tyler, M. S., Ericksen, J., Lester, W., Gemmill, A. W., Kosty, D. B., et al. (2013) · Journal of Medical Internet Research · doi:10.2196/jmir.2876 · Cited by 124 · see citing works
Randomized Controlled Trial of Web-Based Treatment of Social Phobia Without Clinician Guidance
Titov, N., Andrews, G., Choi, I., Schwencke, G., & Johnston, L. (2009) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670903179160 · Cited by 122 · see citing works
Self-citationRelational Agents in Clinical Psychiatry
Bickmore, T., & Gruber, A. (2010) · Harvard Review of Psychiatry · doi:10.3109/10673221003707538 · Cited by 112 · see citing works
Guided internet-based CBT for common mental disorders
Andersson, G., Carlbring, P., Ljótsson, B., & Hedman, E. (2013) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-013-9237-9 · Cited by 119 · see citing works
“Controlled trials have been conducted in for example Australia (Perini et al. 2009; Titov et al. 2010), The Netherlands (Ruwaard et al.”
BackgroundMethodTitov, N., Andrews, G., Schwencke, G., Solley, K., Johnston, L., & Robinson, E. (2009) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670903179228 · Cited by 112 · see citing works
“The clinical efficacy or effectiveness of clinicianassisted CCBT programmes has been consistently demonstrated in randomized controlled trials (RCTs) in patients with depression [3,4], panic disorder [5 9], and social phobia [10 12].”
BackgroundSelf-citationWeb-Based Intervention Programs for Depression: A Scoping Review and Evaluation
Renton, T., Tang, H., Ennis, N., Cusimano, M. D., Bhalerao, S., Schweizer, T. A., & Topolovec-Vranic, J. (2014) · Journal of Medical Internet Research · doi:10.2196/jmir.3147 · Cited by 116 · see citing works
“Examining the existing literature, completion rates in RCTs of Web-delivered treatments for depression have primarily ranged from 55%-67% [49-54] with rates as low as 20% [55].”
Holländare, F., Johnsson, S., Randestad, M., Tillfors, M., Carlbring, P., Andersson, G., & Engström, I. (2011) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2011.01698.x · Cited by 111 · see citing works
The association between adherence and outcome in an Internet intervention for depression
Fuhr, K., Schröder, J., Berger, T., Moritz, S., Meyer, B., Lutz, W., Hohagen, F., Hautzinger, M., & Klein, J. P. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.12.028 · Cited by 97 · see citing works
Step-by-Step: a new WHO digital mental health intervention for depression
Carswell, K., Harper-Shehadeh, M., Watts, S., van’t Hof, E., Abi Ramia, J., Heim, E., Wenger, A., & van Ommeren, M. (2018) · mHealth · doi:10.21037/mhealth.2018.08.01 · Cited by 104 · see citing works
Boumparis, N., Karyotaki, E., Kleiboer, A., Hofmann, S. G., & Cuijpers, P. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.05.019 · Cited by 105 · see citing works
An open trial of a brief transdiagnostic internet treatment for anxiety and depression
Dear, B. F., Titov, N., Schwencke, G., Andrews, G., Johnston, L., Craske, M. G., & McEvoy, P. (2011) · Behaviour Research and Therapy · doi:10.1016/j.brat.2011.09.007 · Cited by 107 · see citing works
Self-citationDores, A. R., Geraldo, A., Carvalho, I. P., & Barbosa, F. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17207663 · Cited by 106 · see citing works
Newby, J., Robins, L., Wilhelm, K., Smith, J., Fletcher, T., Gillis, I., Ma, T., Finch, A., Campbell, L., & Andrews, G. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.7274 · Cited by 102 · see citing works
“Benchmarked against previous studies of iCBT for depressive and anxiety disorders in the general population, these effect sizes are larger than those seen in patients who do not have chronic physical diseases [43].”
ResultSelf-citationEffectiveness of Web-based Psychological Interventions for Depression: A Meta-analysis
Cowpertwait, L., & Clarke, D. (2013) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-012-9416-z · Cited by 101 · see citing works
Wildeboer, G., Kelders, S. M., & van Gemert-Pijnen, J. E. W. C. (2016) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2016.04.005 · Cited by 98 · see citing works
Titov, N., Andrews, G., Kemp, A., & Robinson, E. (2010) · PLoS ONE · doi:10.1371/journal.pone.0010885 · Cited by 97 · see citing works
Self-citationComputer-Assisted Cognitive-Behavior Therapy and Mobile Apps for Depression and Anxiety
Wright, J. H., Mishkind, M., Eells, T. D., & Chan, S. R. (2019) · Current Psychiatry Reports · doi:10.1007/s11920-019-1031-2 · Cited by 93 · see citing works
Forbes, A., Keleher, M. R., Venditto, M., & DiBiasi, F. (2023) · Journal of Medical Internet Research · doi:10.2196/43727 · Cited by 94 · see citing works
“Many studies provided coach feedback to participants after each lesson [72,75,77,99,106,108,111,122,124,130,135,141,144,145,154,155,157,158].”
Ospina-Pinillos, L., Davenport, T., Diaz, A. M., Navarro-Mancilla, A., Scott, E., & Hickie, I. (2019) · Journal of Medical Internet Research · doi:10.2196/14127 · Cited by 92 · see citing works
“Although positive results are seen from the use of self-directed electronic health interventions, increased effectiveness has been reported if they are used as part of a stepped-care model [28], with the support of a trained health professional [29] or as an adjunct to face-to-face treatment [30].”
User Acceptance of Computerized Cognitive Behavioral Therapy for Depression: Systematic Review
Rost, T., Stein, J., Löbner, M., Kersting, A., Luck-Sikorski, C., & Riedel-Heller, S. G. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.7662 · Cited by 91 · see citing works
“%) reported a very high level of acceptance [23,26,36,43,45,47-49], 17 studies (59”
BackgroundMahoney, A. E. J., Mackenzie, A., Williams, A. D., Smith, J., & Andrews, G. (2014) · Behaviour Research and Therapy · doi:10.1016/j.brat.2014.09.012 · Cited by 90 · see citing works
Self-citationChallenges and opportunities in internet-mediated telemental health.
Yuen, E. K., Goetter, E. M., Herbert, J. D., & Forman, E. M. (2012) · Professional Psychology: Research and Practice · doi:10.1037/a0025524 · Cited by 89 · see citing works
Mental health related Internet use among psychiatric patients: a cross-sectional analysis
Kalckreuth, S., Trefflich, F., & Rummel-Kluge, C. (2014) · BMC Psychiatry · doi:10.1186/s12888-014-0368-7 · Cited by 86 · see citing works
“So far, promising results have been shown for the effective web-based treatment of many common psychiatric disorders [10,11] particularly for depression [12-21] and anxiety disorders [22-24].”
BackgroundSunderland, M., Wong, N., Hilvert-Bruce, Z., & Andrews, G. (2012) · Behaviour Research and Therapy · doi:10.1016/j.brat.2012.03.005 · Cited by 84 · see citing works
Proudfoot, J. G., Jayawant, A., Whitton, A. E., Parker, G. B., Manicavasagar, V. L., Smith, M., & Nicholas, J. (2012) · BMC Psychiatry · doi:10.1186/1471-244x-12-196 · Cited by 82 · see citing works
“Such interventions are typically offered as stand-alone programs or with support from mental health professionals, with evidence indicating superior outcomes, greater compliance and decreased rates of attrition in supported, compared to unsupported programs [36-38].”
BackgroundThe effect of psychotherapy for depression on improvements in social functioning: a meta-analysis
Renner, F., Cuijpers, P., & Huibers, M. J. H. (2014) · Psychological Medicine · doi:10.1017/s0033291713003152 · Cited by 82 · see citing works
“Thirty-one studies met our inclusion criteria, reported social functioning at post-test, and were included in the meta-analyses comparing the effects of psychotherapy (versus control group) on social functioning.”
BackgroundAmir, N., & Taylor, C. T. (2012) · Behavior Therapy · doi:10.1016/j.beth.2010.12.008 · Cited by 76 · see citing works
Lungu, A., Jun, J. J., Azarmanesh, O., Leykin, Y., & Chen, C. E.-J. (2020) · Journal of Medical Internet Research · doi:10.2196/18723 · Cited by 75 · see citing works
Andrews, G., & Williams, A. D. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2014.05.006 · Cited by 80 · see citing works
“In Table 3 we present their schema and responses in respect to one of the exemplar course, the www.thiswayup.org.au/clinic course for depression (Perini et al., 2008; 2009, Titov et al., 2010) and present a case example for the scalability of iCBT.”
BackgroundSelf-citationMoock, J. (2014) · Frontiers in Public Health · doi:10.3389/fpubh.2014.00065 · Cited by 79 · see citing works
The impact of psychological distress tolerance in the treatment of depression
Williams, A. D., Thompson, J., & Andrews, G. (2013) · Behaviour Research and Therapy · doi:10.1016/j.brat.2013.05.005 · Cited by 77 · see citing works
Self-citationNewby, J. M., Mewton, L., & Andrews, G. (2017) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2016.06.002 · Cited by 75 · see citing works
“However, these adherence rates are much lower than the rates we find in RCTs of the same programs (between 70 and 89%) (Newby et al., 2013; Perini et al., 2009; Robinson et al., 2010), which is not surprising given that adherence to iCBT is reduced when programs are completed with little to no guidance from clinicians.”
BackgroundResultSelf-citationSchueller, S. M., Tomasino, K. N., & Mohr, D. C. (2017) · Clinical Psychology: Science and Practice · doi:10.1037/h0101740 · Cited by 70 · see citing works
A qualitative exploration of Internet-based treatment for comorbid depression and alcohol misuse
Darvell, M. J., Kavanagh, D. J., & Connolly, J. M. (2015) · Internet Interventions · doi:10.1016/j.invent.2015.03.003 · Cited by 69 · see citing works
“Web-based cognitive-behavioural therapy programs have been found efficacious in treating sub-threshold (Perini et al., 2009; Spek et al., 2007, 2008) and moderate (Andersson et al.”
BackgroundEthical and legal considerations for internet-based psychotherapy
Dever Fitzgerald, T., Hunter, P. V., Hadjistavropoulos, T., & Koocher, G. P. (2010) · Cognitive Behaviour Therapy · doi:10.1080/16506071003636046 · Cited by 69 · see citing works
Milgrom, J., Danaher, B., Seeley, J., Holt, C. J., Holt, C., Ericksen, J., Tyler, M. S., Gau, J. M., & Gemmill, A. W. (2020) · Journal of Medical Internet Research · doi:10.2196/17185 · Cited by 69 · see citing works
“For depression and anxiety in particular, the efficacy of internet-based treatment has been demonstrated relative to control conditions in populations with elevated symptoms and increasingly in clinically diagnosed groups [25,29-34].”
Ahern, E., Kinsella, S., & Semkovska, M. (2018) · Expert review of pharmacoeconomics & outcomes research · doi:10.1080/14737167.2018.1407245 · Cited by 68 · see citing works
Danaher, B. G., Milgrom, J., Seeley, J. R., Stuart, S., Schembri, C., Tyler, M. S., Ericksen, J., Lester, W., Gemmill, A. W., & Lewinsohn, P. (2012) · JMIR Research Protocols · doi:10.2196/resprot.2329 · Cited by 67 · see citing works
“Guided human support (ranging from a technician-level coach to a more highly skilled therapist) has been shown to increase adherence to online mental health treatments [57,58] and a number of Web-based mental health interventions have used telephones or other mediums to deliver this [20,37,59,60].”
Kenter, R., Cuijpers, P., Beekman, A., & van Straten, A. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.4861 · Cited by 66 · see citing works
“The low adherence to this intervention is a cause for concern because it is far lower than generally found in Internet-based interventions for depression [12,34-36].”
Johansen, M. A., Henriksen, E. K. K., Horsch, A., Schuster, T., & Berntsen, G. (2012) · Journal of Medical Internet Research · doi:10.2196/jmir.2214 · Cited by 54 · see citing works
“We suggest not focusing so much on symptom and its synonyms as search words, since they were lacking in many of these studies, but to include specific search strings such as Interapy [85,86], Internet-based therapy [86,87], Internet-based treatment [86,88-91], and online therapeutic relationship [86].”
BackgroundMewton, L., Smith, J., Rossouw, P., & Andrews, G. (2014) · Psychology Research and Behavior Management · doi:10.2147/prbm.s40879 · Cited by 57 · see citing works
Self-citationAn Online Recovery Plan Program: Can Peer Coaching Increase Participation?
Simon, G. E., Ludman, E. J., Goodale, L. C., Dykstra, D. M., Stone, E., Cutsogeorge, D., Operskalski, B., Savarino, J., & Pabiniak, C. (2011) · Psychiatric Services · doi:10.1176/ps.62.6.pss6206_0666 · Cited by 62 · see citing works
Rosso, I. M., Killgore, W. D. S., Olson, E. A., Webb, C. A., Fukunaga, R., Auerbach, R. P., Gogel, H., Buchholz, J. L., & Rauch, S. L. (2016) · Depression and Anxiety · doi:10.1002/da.22590 · Cited by 65 · see citing works
“This study used a modified version of the Sadness Program, a technician-assisted iCBT program developed at the UNSW (Perini et al., 2009; Titov et al., 2010).”
BackgroundMethodMcferran, K., Hense, C., Koike, A., & Rickwood, D. (2018) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104518767231 · Cited by 59 · see citing works
- Authors
- Perini, S., Titov, N., & Andrews, G.
- Affiliations
- St Vincent's Hospital Sydney (AU)
- UNSW Sydney (AU)
- Corresponding author
- Titov, Nickolai
- Venue
- Australian & New Zealand Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2009-01-01
- Volume
- 43
- Issue
- 6
- Pages
- 571-578
- ISSN
- 0004-8674 (ISSN-L)
- 1440-1614
- OpenAlex
- W4239050078
- Cited by
- 231
- References
- 36
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 6 · 2023: 9 · 2022: 5 · 2021: 10 · 2020: 9 · 2019: 11 · 2018: 8 · 2017: 18 · 2016: 20 · 2015: 17 · 2014: 24 · 2013: 26 · 2012: 19
- FWCI
- 24.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Australian & New Zealand Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of New South Wales
- 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
- depression, online therapy, online forums, treatment acceptability, common mental disorders, treatment efficacy
- MeSH terms
- Major Depressive Disorder, Female, Humans, Male, Middle Aged, Motivation, Professional-Patient Relations, Surveys and Questionnaires, Cognitive Behavioral Therapy, Patient Satisfaction, Internet, Professional Role, Diagnostic and Statistical Manual of Mental Disorders
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