The DOI matches its Crossref record; 51 of the 51 references it cites were found in a registry or an index.
Efficacy of cognitive behavioural therapy delivered over the Internet for depressive symptoms: A systematic review and meta-analysis
Abstract
Introduction: Cognitive behavioural therapy has been shown to improve depressive symptoms in adults with mild to moderate depression. To overcome many of the barriers associated with delivering this treatment, attempts have been made to deliver cognitive behavioural therapy via the Internet. The objective of this meta-analysis is to assess whether Internet-based cognitive behavioural therapy delivered to adults with depressive symptoms leads to a reduction in these symptoms as compared to those who receive no therapy. Methods: In September 2015, the Cochrane, PubMed and PsycInfo databases were searched; studies were also found through bibliography searches. Studies were included if they were randomized controlled trials published in English between 2005–2015 conducted with adults >18 years of age experiencing mild to moderate depression where study subjects received Internet-based cognitive behavioural therapy, and the control group was placed on a wait-list. The search yielded 257 articles; 14 of these were included in the meta-analysis. Results: Internet delivered cognitive behavioural therapy had a medium effect on reducing depressive symptoms at the end of the study period (standardized mean difference: 0.74, confidence interval: 0.62–0.86, p < 0.001). Internet-delivered cognitive behavioural therapy also has a large sustained effect in maintaining reduction of depressive symptoms in follow-up measures done 3–6 months after the conclusion of the therapy (standardized mean difference: 0.83, confidence interval: 0.69–0.99, p < 0.001). There was no publication bias and low heterogeneity. Discussion: Cognitive behavioural therapy delivered over the Internet leads to immediate and sustained reduction in depressive symptoms; thus, it may be a good treatment modality for individuals unable or unwilling to access traditional face-to-face therapy.
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“Well-established evidence shows that interventions fully or partially delivered through the Internet (especially those based on Cognitive Behavioural Therapy (CBT)) are effective in treating different psychological disorders [8,9,10]”
Citations
Cites
Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series
(2008) · doi:10.1002/9780470712184 · Cited by 25,048
The empirical status of cognitive-behavioral therapy: A review of meta-analyses
Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006) · Clinical Psychology Review · doi:10.1016/j.cpr.2005.07.003 · Cited by 3,215
Epidemiology of women and depression
Kessler, R. (2003) · Journal of Affective Disorders · doi:10.1016/s0165-0327(02)00426-3 · Cited by 2,006
Internet-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
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
Internet-Based and Other Computerized Psychological Treatments for Adult Depression: A Meta-Analysis
Andersson, G., & Cuijpers, P. (2009) · Cognitive Behaviour Therapy · doi:10.1080/16506070903318960 · Cited by 1,368
Andrews, G., Cuijpers, P., Craske, M. G., McEvoy, P., & Titov, N. (2010) · PLoS ONE · doi:10.1371/journal.pone.0013196 · Cited by 1,311
Barak, A., Hen, L., Boniel-Nissim, M., & Shapira, N. (2008) · Journal of Technology in Human Services · doi:10.1080/15228830802094429 · Cited by 1,283
Adherence in Internet Interventions for Anxiety and Depression
Christensen, H., Griffiths, K. M., & Farrer, L. (2009) · Journal of Medical Internet Research · doi:10.2196/jmir.1194 · Cited by 1,133
A meta-analysis of the effects of cognitive therapy in depressed patients
Gloaguen, V., Cottraux, J., Cucherat, M., & Blackburn, I.-M. (1998) · Journal of Affective Disorders · doi:10.1016/s0165-0327(97)00199-7 · Cited by 809
Cited by
Sorted by citations
Items 101–134 of 134
Digitale Ansätze bei Depression und Angst
Landgrebe, M., & Zwanzger, P. (2023) · InFo Neurologie + Psychiatrie · doi:10.1007/s15005-022-3122-6 · Cited by 2
Park, S., Kim, Y., & Oh, E. G. (2018) · Journal of Korean Academy of Psychiatric and Mental Health Nursing · doi:10.12934/jkpmhn.2018.27.3.227 · Cited by 2
Behavior Change in Community Contexts
Trickett, E. J., & Paterson, S. E. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.028 · Cited by 2
“I'm Not the Only One With Depression”
Aubry, C., Rider, A., Russell, S., Moyer, S. W., & Kinser, P. A. (2021) · The Journal of Perinatal & Neonatal Nursing · doi:10.1097/jpn.0000000000000530 · Cited by 2
“Because of recent calls for inexpensive and scalable interventions, in-person group-based delivery methods are increasingly being phased out in favor of technology-based delivery.(6) However, it is unclear whether the mechanism or potency of in-person groupbased psychological therapies may be lost when delivered via t…”
BackgroundFernández-Regueras, D., Elvira, A. C., & Guerrero-Escagedo, M. C. (2023) · Behavioral Psychology/Psicología Conductual · doi:10.51668/bp.8323306s · Cited by 2
“…telepsicológicas que utilizan terapias cognitivo-conductuales (TCC), son cuantiosos los datos de investigación, a lo largo de los años, que las avalan para diferentes problemáticas, recogidos en revisiones sistemáticas y metaanálisis (entre ellas, Grist y Cavanagh, 2013; Sztein et al ., 2018).”
BackgroundOnly on Invitation? How the Recruitment Strategy Determines Who Is Treated Online
Zagorscak, P., Bohn, J., Heinrich, M., Kampisiou, C., & Knaevelsrud, C. (2019) · Verhaltenstherapie · doi:10.1159/000503407 · Cited by 2
“Several meta-analyses have shown that various forms of IBI can effectively reduce depressive symptoms [e.g., Karyotaki et al., 2017, 2018; Königbauer et al., 2017; Sztein et al., 2018].”
BackgroundCost-Effectiveness Evaluations of Behavior Change Interventions
Wang, T., Downes, M., Byrnes, J., & Scuffham, P. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.026 · Cited by 1
Gingras-Lacroix, G., Guilmette, D., Tremblay, G., Ferlatte, O., Brodeur, N., Labra, Ó., Houle, J., Roy, P., & Dionne, É. (2023) · Santé mentale au Québec · doi:10.7202/1106396ar · Cited by 1
Simpson, K. M., McHardy, R. J. W., Zhou, J. W., Levasseur-Puhach, S., Côté, C. M., Braun, M., Clement, F. M., MacKinnon, A., Nickel, N. C., Afifi, T. O., et al. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-06964-4 · Cited by 4
Wei, S., Cheng, S. J., Li, J., Choi, E. P. H., & Wong, W. C. W. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1612755 · Cited by 1
Effect of telemonitoring on self-care behaviors among community-dwelling adults with heart failure
Nick, J. M., Petersen, A. B., & Roberts, L. R. (2019) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-d-18-00016 · Cited by 1
Telemedizin in der Psychiatrie
van den Berg, N., Grabe, H. J., Stentzel, U., & Hoffmann, W. U. (2020) · Springer eBooks · doi:10.1007/978-3-662-60611-7_15 · Cited by 1
Joyce, K. M., Rioux, C., MacKinnon, A., Katz, L., Reynolds, K., Kelly, L. E., Klassen, T. P., Afifi, T. O., Mushquash, A. R., Clement, F. M., et al. (2022) · PsyArXiv (OSF Preprints) · doi:10.31234/osf.io/czt8h · Cited by 1
Werntz, A. J., Amado, S., Jasman, M., Ervin, A., & Rhodes, J. E. (2022) · doi:10.2196/preprints.42864 · Cited by 1
Mamukashvili-Delau, M., Koburger, N., Dietrich, S., & Rummel‐Kluge, C. (2022) · Research Square · doi:10.21203/rs.3.rs-1816188/v1 · Cited by 1
Online programs for depression
Batterham, P. J., Calear, A. L., & Kurz, E. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-817933-8.00012-8
Hagger, M. S., Cameron, L. D., Hamilton, K., Hankonen, N. E., & Lintunen, T. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.047
Azizul, M. D. A., Jaafar, W. M. W., Khir, A. M., & Amin, S. M. A. (2022) · International Journal of Academic Research in Business and Social Sciences · doi:10.6007/ijarbss/v12-i6/13895
“Several therapies such as acceptance and commitment therapy (ACT) (Herbert et al., 2017), cognitive behavioural therapy (CBT) (Sztein et al., 2018) and parenting interventions have a robust evidence base (Comer et al., 2015).”
BackgroundMindfulness-based Cognitive Behavioral Therapy during Pandemic: mHealth Application
Hanna, B. S. H., & Hanna, A. (2022) · International Journal for Digital Society · doi:10.20533/ijds.2040.2570.2022.0218
Joyce, K. M., Rioux, C., MacKinnon, A., Katz, L. Y., Reynolds, K., Kelly, L. E., Klassen, T. P., Afifi, T. O., Mushquash, A. R., Clement, F. M., et al. (2022) · Research Square · doi:10.21203/rs.3.rs-2235864/v1
Impact Of Physical Activity And Health Education On The Development Of Depression
Kulbat, A., Karwańska, A., Kulbat, M., Brzychczy, P., Majcher, M., Górska, D., Sierpień, M., Majcher, M., Świercz, K., & Pikulicka, A. (2023) · Journal of Education Health and Sport · doi:10.12775/jehs.2023.13.04.021
The Potential Power of Virtual Group CBT
Vanderkruik, R. C. (2023) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.23com14882
Li, S., Gao, S., Shi, X., Guo, Y., & Xu, T. (2023) · Research Square · doi:10.21203/rs.3.rs-3479766/v1
Tang, S., Mahoney, A., Dobinson, K. A., & Shiner, C. T. (2025) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2025.2465737
“CBT can be delivered either in-person or online (internet-based CBT, or iCBT), with the latter having been demonstrated to be both efficacious and effective in treating a variety of mental health conditions, including depression and anxiety (Sztein et al., 2018).”
García, N. B., Torres, J. M., Galvis-Pérez, Y., Martínez, S. M., & Gómez, G. F. V. (2025) · Gerencia y Políticas de Salud · doi:10.11144/javeriana.rgps24.dacp · Cited by 1
Joyce, K. M., Rioux, C., MacKinnon, A., Katz, L. Y., Reynolds, K., Kelly, L. E. S., Klassen, T. P., Afifi, T. O., Mushquash, A. R., Clement, F. M., et al. (2023) · Figshare · doi:10.6084/m9.figshare.22620301
Gallegos-Carrillo, K., Ramírez‐Palacios, P., Chávez‐Iñiguez, A., Cupertino, A. P., Cartujano‐Barrera, F., & Rodríguez-Bolaños, R. (2026) · Tobacco Induced Diseases · doi:10.18332/tid/213755 · Cited by 1
“With the shift from face-to-face to digital interventions, growing evidence supports the effectiveness of internet-based programs in treating psychological disorders 10 .”
Ophir, Y. (2026) · Current Psychology · doi:10.1007/s12144-025-08920-7 · Cited by 1
“…now supports the effectiveness of online interventions that incorporate cognitive-behavioral strategies (Barak et al., 2014; Mallen et al., 2005; Sztein et al., 2018), particularly for depression (Andrews et al., 2010; Kambeitz-Ilankovic et al., 2022; Kessler et al., 2009; Lange et al., 2003).”
Sala, M., Roos, C., Ascarrunz, D., Stern, C. M., Bricker, J., Feldman, J. M., Levinson, C., Aslan, M., Hay, J. L., & Kober, H. (2026) · JMIR Research Protocols · doi:10.2196/91761
“Digital MBIs and CBTs were already shown to be efficacious for several other psychiatric disorders [27-30].”
Kikuchi, S., Sakata, M., Imai, H., Sozu, T., Oe, Y., Ito, Y., Horikoshi, M., Kubota, E., Kamiya, T., Akechi, T., et al. (2026) · BMC Gastroenterology · doi:10.1186/s12876-026-04681-0
“Delivering resource-limited healthcare services via the internet may save time and money for both therapists and participants [18].”
Dipeolu, A. O., Li, H., Shivers, C. H., Rodriguez, S., Galindo), S. C. T. (., & Benavidez, B. R. (2026) · Journal of Prevention & Intervention in the Community · doi:10.1080/10852352.2026.2660523
Parks, J., Xiang, P., Patel, R., McBride, K., Costantino, H., Mirza, S., & Borsos, K. (2026) · Journal of Managed Care & Specialty Pharmacy · doi:10.18553/jmcp.2026.32.6.691
Counsellors' Experiences of Care and Challenge in Anonymous Gambling Helplines
Huang, M. Z., Li, J., Teng, S. H., Mao, Y., Zhong, S., Zhou, X., & Wang, K. Y. (2026) · Proceedings of the ACM on Interactive Mobile Wearable and Ubiquitous Technologies · doi:10.1145/3810206
Zainal, N. H. (2024) · OSF Preprints (OSF Preprints)
Metadata
- Authors
- Sztein, D. M., Koransky, C. E., Fegan, L., & Himelhoch, S.
- Affiliations
- University of Maryland, Baltimore (US)
- Corresponding author
- Sztein, Dina M
- ORCID
- Himelhoch, Seth
- Venue
- Journal of Telemedicine and Telecare
- Publisher
- SAGE Publications
- Published
- 2017-07-11
- Volume
- 24
- Issue
- 8
- Pages
- 527-539
- ISSN
- 1357-633X (ISSN-L)
- 1758-1109
- OpenAlex
- W2776959657
- Semantic Scholar
- 7e2fbea7bc194e627a1c6fce6a9a8acc65d3e710
- Cited by
- 135
- References
- 51
- Citations by year
- 2026: 8 · 2025: 5 · 2024: 6 · 2023: 19 · 2022: 14 · 2021: 17 · 2020: 55 · 2019: 6 · 2018: 5
- FWCI
- 2.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Telemedicine and Telecare (publishedVersion)
- PubMed (publishedVersion)
- 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, depressive symptoms, mild to moderate depression, online therapy, treatment efficacy, sustained treatment effects, access to mental health care
- MeSH terms
- Adult, Depression, Depressive Disorder, Female, Humans, Male, Middle Aged, Waiting Lists, Cognitive Behavioral Therapy, Internet, PubMed
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