Digital IAPT: the effectiveness & cost-effectiveness of internet-delivered interventions for depression and anxiety disorders in the Improving Access to Psychological Therapies programme: study protocol for a randomised control trial
Open accessAbstract
BACKGROUND: Depression and anxiety are common mental health disorders worldwide. The UK's Improving Access to Psychological Therapies (IAPT) programme is part of the National Health Service (NHS) designed to provide a stepped care approach to treating people with anxiety and depressive disorders. Cognitive Behavioural Therapy (CBT) is widely used, with computerised and internet-delivered cognitive behavioural therapy (cCBT and iCBT, respectively) being a suitable IAPT approved treatment alternative for step 2, low- intensity treatment. iCBT has accumulated a large empirical base for treating depression and anxiety disorders. However, the cost-effectiveness and impact of these interventions in the longer-term is not routinely assessed by IAPT services. The current study aims to evaluate the clinical and cost-effectiveness of internet-delivered interventions for symptoms of depression and anxiety disorders in IAPT. METHODS: The study is a parallel-groups, randomised controlled trial examining the effectiveness and cost-effectiveness of iCBT interventions for depression and anxiety disorders, against a waitlist control group. The iCBT treatments are of 8 weeks duration and will be supported by regular post-session feedback by Psychological Wellbeing Practitioners. Assessments will be conducted at baseline, during, and at the end of the 8-week treatment and at 3, 6, 9, and 12-month follow-up. A diagnostic interview will be employed at baseline and 3-month follow-up. Participants in the waitlist control group will complete measures at baseline and week 8, at which point they will receive access to the treatment. All adult users of the Berkshire NHS Trust IAPT Talking Therapies Step 2 services will be approached to participate and measured against set eligibility criteria. Primary outcome measures will assess anxiety and depressive symptoms using the GAD-7 and PHQ-9, respectively. Secondary outcome measures will allow for the evaluation of long-term outcomes, mediators and moderators of outcome, and cost-effectiveness of treatment. Analysis will be conducted on a per protocol and intention-to-treat basis. DISCUSSION: This study seeks to evaluate the immediate and longer-term impact, as well as the cost effectiveness of internet-delivered interventions for depression and anxiety. This study will contribute to the already established literature on internet-delivered interventions worldwide. The study has the potential to show how iCBT can enhance service provision, and the findings will likely be generalisable to other health services. TRIAL REGISTRATION: Current Controlled Trials ISRCTN ISRCTN91967124. DOI: https://doi.org/10.1186/ISRCTN91967124 . Web: http://www.isrctn.com/ISRCTN91967124 . Clinicaltrials.gov : NCT03188575. Trial registration date: June 8, 2017 (prospectively registered).
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Programmes have also been tailored using media-rich interactive content incorporating engaging strategies to improve user experience.
“Programmes have also been tailored using media-rich interactive content incorporating engaging strategies to improve user experience (Richards et al ., 2018).”
From A qualitative study of patients’ experiences and acceptance of computerised cognitive behavioural therapy in primary care, Scotland (2021) · cites this paper as Richards et al., 2018
The Methods (Study setting; page unavailable) describe media-rich interactive programmes with quizzes, videos, activities and personal stories, as well as modules customised for different anxiety presentations. These passages support the content and tailoring described, but do not state that those features improved user experience; the Methods (Measures; page unavailable) say patient experience will be assessed. (LLM, conf=0.82)
Experimental — accuracy not yet measuredThe attrition rate in iCBT trials is 25%.
“Considering the 25% attrition (Richards et al., 2018)”
From A randomised controlled trial comparing internet-delivered cognitive behavioural therapy (iCBT) with and without main carer access versus treatment-as-usual for depression and anxiety among breast cancer survivors: Study protocol (2021) · cites this paper as Richards et al., 2018
In Methods > Study setting (Sample size; page unavailable), the protocol adds a 25% sample-size uplift to account for attrition. It does not report an observed 25% attrition rate in iCBT trials, so the cited figure supports a planning allowance, not the claim as stated. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007) · Behavior Research Methods · doi:10.3758/bf03193146 · Cited by 65,971 · see citing works
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
A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1092 · Cited by 31,765 · see citing works
(1998) · The Journal of Clinical Psychiatry · Cited by 19,139 · see citing works
CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials
the CONSORT Group, Schulz, K. F., Altman, D. G., & Moher, D. (2010) · BMC Medicine · doi:10.1186/1741-7015-8-18 · Cited by 13,371 · see citing works
Gross, J. J., & John, O. P. (2003) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.85.2.348 · Cited by 11,929 · cited 1× · see citing works
“Emotion Regulation Questionnaire (ERQ) [59] The ERQ is a 10-item scale that assesses individual differences in the habitual use of two emotion regulation strategies: cognitive reappraisal and expressive suppression.”
Background(1998) · PubMed · Cited by 10,216 · see citing works
Spitzer, R. L. (1999) · JAMA · doi:10.1001/jama.282.18.1737 · Cited by 9,802 · see citing works
Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)
Herdman, M., Gudex, C., Lloyd, A., Janssen, M., Kind, P., Parkin, D., Bonsel, G., & Badia, X. (2011) · Quality of Life Research · doi:10.1007/s11136-011-9903-x · Cited by 9,795 · cited 1× · see citing works
“EuroQoL Five Dimension Five Level Version (EQ-5D5 L) [54] This measure is used to assess a person’s perception of their general health state and obtain a measure of quality adjusted life years (QALYs).”
MethodSPIRIT 2013 Statement: Defining Standard Protocol Items for Clinical Trials
Chan, A.-W., Tetzlaff, J. M., Altman, D. G., Laupacis, A., Gøtzsche, P. C., Krleža-Jerić, K., Hróbjartsson, A., Mann, H., Dickersin, K., Berlin, J. A., et al. (2013) · Annals of Internal Medicine · doi:10.7326/0003-4819-158-3-201302050-00583 · Cited by 7,363 · see citing works
Whiteford, H. A., Degenhardt, L., Rehm, J., Baxter, A. J., Ferrari, A. J., Erskine, H. E., Charlson, F. J., Norman, R. E., Flaxman, A. D., Johns, N., et al. (2013) · The Lancet · doi:10.1016/s0140-6736(13)61611-6 · Cited by 6,006 · see citing works
Development and validation of the Penn State Worry Questionnaire
Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990) · Behaviour Research and Therapy · doi:10.1016/0005-7967(90)90135-6 · Cited by 5,099 · see citing works
The Work and Social Adjustment Scale: a simple measure of impairment in functioning
Mundt, J. C., Marks, I. M., Shear, M. K., & Greist, J. M. (2002) · British Journal of Psychiatry · doi:10.1192/bjp.180.5.461 · Cited by 2,515 · see citing works
Mediators and Mechanisms of Change in Psychotherapy Research
Kazdin, A. E. (2007) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.3.022806.091432 · Cited by 2,504 · cited 1× · see citing works
“Understanding the factors that account for therapeutic changes is a key factor in providing the best patient care and assists in the pathway toward improving psychological treatments [30].”
BackgroundPsychometric properties of the credibility/expectancy questionnaire
Devilly, G. J., & Borkovec, T. D. (2000) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/s0005-7916(00)00012-4 · Cited by 2,295 · cited 1× · see citing works
“Expectancy/credibility questionnaire This is a one question item that assesses the clients level of credibility with the intervention and is based on the work in this area [61].”
Eysenbach, G., & CONSORT-EHEALTH Group (2011) · Journal of Medical Internet Research · doi:10.2196/jmir.1923 · Cited by 1,863 · see citing works
The American Psychiatric Association (APA)
Strentz, T. (2017) · CRC Press eBooks · doi:10.1201/9781315150581-3 · Cited by 1,855 · see citing works
The Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work
Wampold, B. E. (2015) · doi:10.4324/9780203582015 · Cited by 1,773 · see citing works
Collaborative care for patients with depression and chronic illnesses
Katon, W. J., Lin, E. H. B., Von Korff, M., Ciechanowski, P., Ludman, E. J., Young, B., Peterson, D., Rutter, C. M., McGregor, M., & McCulloch, D. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa1003955 · Cited by 1,697 · see citing works
Psychometric properties of the Social Phobia Inventory (SPIN): New self-rating scale
Connor, K. M., Davidson, J. R. T., Churchill, L. E., Sherwood, A., Weisler, R. H., & Foa, E. (2000) · British Journal of Psychiatry · doi:10.1192/bjp.176.4.379 · Cited by 1,624 · see citing works
The economic cost of brain disorders in Europe
Olesen, J., Gustavsson, A., Svensson, M., Wittchen, H., & Jönsson, B. (2012) · European Journal of Neurology · doi:10.1111/j.1468-1331.2011.03590.x · Cited by 1,560 · see citing works
Treatment gap in mental health care.
Abramowitz, M. Z., Greenberg, D., & Levav, I. (2008) · PubMed · Cited by 1,482 · see citing works
The treatment gap in mental health care.
(2004) · Europe PMC (PubMed Central) · Cited by 1,419 · see citing works
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 · see citing works
SALKOVSKIS, P. M., RIMES, K. A., WARWICK, H. M. C., & CLARK, D. M. (2002) · Psychological Medicine · doi:10.1017/s0033291702005822 · Cited by 1,351 · see citing works
Bower, P., & Gilbody, S. (2005) · British Journal of Psychiatry · doi:10.1192/bjp.186.1.11 · Cited by 1,084 · see citing works
A Guide to Treatments that Work
Nathan, P. E., & Gorman, J. M. (2007) · Oxford University Press eBooks · doi:10.1093/med/9780195304145.001.0001 · Cited by 1,082 · see citing works
Multicenter Collaborative Panic Disorder Severity Scale
Shear, M. K., Brown, T. A., Barlow, D. H., Money, R., Sholomskas, D. E., Woods, S. W., Gorman, J. M., & Papp, L. A. (1997) · American Journal of Psychiatry · doi:10.1176/ajp.154.11.1571 · Cited by 1,001 · see citing works
Psychometric properties of the Penn State Worry Questionnaire in a clinical anxiety disorders sample
Brown, T. A., Antony, M. M., & Barlow, D. H. (1992) · Behaviour Research and Therapy · doi:10.1016/0005-7967(92)90093-v · Cited by 812 · see citing works
McHugh, R. K., Whitton, S. W., Peckham, A. D., Welge, J. A., & Otto, M. W. (2013) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.12r07757 · Cited by 800 · see citing works
Costing psychiatric interventions.
Beecham, J. K., & Knapp, M. R. J. (1992) · Kent Academic Repository (University of Kent) · Cited by 710 · see citing works
Clark, D. M. (2011) · International Review of Psychiatry · doi:10.3109/09540261.2011.606803 · Cited by 699 · see citing works
Slade, M., & Thornicroft, G. (2025) · doi:10.1093/med/9780198898818.003.0007 · Cited by 679 · see citing works
Health care costs associated with depressive and anxiety disorders in primary care
(1995) · American Journal of Psychiatry · doi:10.1176/ajp.152.3.352 · Cited by 555 · see citing works
Latimer, N. R. (2013) · Medical Decision Making · doi:10.1177/0272989x12472398 · Cited by 539 · see citing works
The Penn State Worry Questionnaire: Psychometric properties and associated characteristics.
Plaza, S. M., & Borkovec, T. D. (1994) · Cited by 523 · see citing works
Worrying: Perspectives on theory, assessment and treatment
Carmin, C. N. (1995) · Clinical Psychology Review · doi:10.1016/0272-7358(95)90175-2 · Cited by 500 · see citing works
Increased Medical Costs of a Population-Based Sample of Depressed Elderly Patients
Katon, W. J., Lin, E. H. B., Russo, J. E., & Unützer, J. (2003) · Archives of General Psychiatry · doi:10.1001/archpsyc.60.9.897 · Cited by 500 · see citing works
Evans-Lacko, S., & Knapp, M. (2016) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-016-1278-4 · Cited by 390 · see citing works
McCrone, P., Knapp, M., Proudfoot, J., Ryden, C., Cavanagh, K., Shapiro, D. A., Ilson, S., Gray, J. A., Goldberg, D., Mann, A., et al. (2004) · British Journal of Psychiatry · doi:10.1192/bjp.185.1.55 · Cited by 371 · see citing works
International review of psychiatry
Silva, J. A. C. E., Nadelson, C. C., & Mak, F. L. (1993) · American Psychiatric Press eBooks · Cited by 358 · see citing works
High prevalence of mental disorders in primary care
Ansseau, M., Dierick, M., Buntinkx, F., Cnockaert, P., De Smedt, J., Van Den Haute, M., & Vander Mijnsbrugge, D. (2004) · Journal of Affective Disorders · doi:10.1016/s0165-0327(02)00219-7 · Cited by 352 · see citing works
Economic evaluations of Internet interventions for mental health: a systematic review
Donker, T., Blankers, M., Hedman, E., Ljótsson, B., Petrie, K., & Christensen, H. (2015) · Psychological Medicine · doi:10.1017/s0033291715001427 · Cited by 316 · cited 1× · see citing works
“A recent systematic review of economic evaluations of internet-delivered interventions for mental health highlighted that interventions for depression and anxiety demonstrated cost-effectiveness compared to unguided interventions, waiting list controls, treatment as usual, group CBT, and telephone counselling [29].”
BackgroundKeetharuth, A. D., Brazier, J. E., Connell, J., Bjørner, J. B., Carlton, J., Buck, E. T., Ricketts, T., McKendrick, K., Browne, J. P., Croudace, T. J., et al. (2018) · The British Journal of Psychiatry · doi:10.1192/bjp.2017.10 · Cited by 269 · see citing works
The Short Health Anxiety Inventory: A systematic review and meta-analysis
Alberts, N. M., Hadjistavropoulos, H. D., Jones, S. L., & Sharpe, D. (2013) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2012.10.009 · Cited by 267 · see citing works
A new scale to assess the therapeutic relationship in community mental health care: STAR
McGuire-Snieckus, R., McCabe, R., Catty, J., Hansson, L. I., & Priebe, S. (2006) · Psychological Medicine · doi:10.1017/s0033291706009299 · Cited by 267 · see citing works
Mitte, K. (2005) · Psychological Bulletin · doi:10.1037/0033-2909.131.5.785 · Cited by 239 · see citing works
Cuijpers, P., van Straten, A., van Oppen, P., & Andersson, G. (2008) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v69n1102 · Cited by 219 · see citing works
Unit Costs of Health & Social Care 2020
Curtis, L. A., & Burns, A. (2020) · Kent Academic Repository (University of Kent) · doi:10.22024/unikent/01.02.84818 · Cited by 156 · see citing works
Improving access to psychological therapies: Phase IV prospective cohort study
Richards, D. A., & Suckling, R. (2009) · British Journal of Clinical Psychology · doi:10.1348/014466509x405178 · Cited by 154 · see citing works
Self-citationLow intensity CBT interventions: a revolution in mental health care
Bennett–Levy, J., Richards, D. A., & Farrand, P. A. (2010) · Oxford University Press eBooks · doi:10.1093/med:psych/9780199590117.003.0001 · Cited by 148 · see citing works
McManus, S., Bebbington, P., Jenkins, R., & Brugha, T. S. (2016) · Cited by 140 · see citing works
Contemporary cognitive therapy : theory, research, and practice
Leahy, R. L. (2004) · Guilford Press eBooks · Cited by 136 · see citing works
Morbilidad psiquiátrica en pacientes mayores de 18 años
King, M. (n.d.) · DOAJ (DOAJ: Directory of Open Access Journals) · Cited by 112 · see citing works
Richards, D., Richardson, T., Timulak, L., & McElvaney, J. (2015) · Internet Interventions · doi:10.1016/j.invent.2015.07.003 · Cited by 111 · see citing works
Positive beliefs about rumination in depression—a replication and extension
Watkins, E. R., & Moulds, M. L. (2005) · Personality and Individual Differences · doi:10.1016/j.paid.2004.12.006 · Cited by 109 · see citing works
Richards, D., Timulak, L., O'Brien, E., Hayes, C., Vigano, N., Sharry, J., & Doherty, G. (2015) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.10.005 · Cited by 109 · see citing works
Wuyek, L. A., Antony, M., & McCabe, R. (2011) · Clinical Psychology and Psychotherapy · doi:10.1002/cpp.703 · Cited by 67 · see citing works
Wells, M. J., Owen, J. J., McCray, L. W., Bishop, L. B., Eells, T. D., Brown, G. K., Richards, D., Thase, M. E., & Wright, J. H. (2018) · The Primary Care Companion For CNS Disorders · doi:10.4088/pcc.17r02196 · Cited by 46 · see citing works
Self-citationInternet‐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 45 · see citing works
Oxford Guide to Low Intensity CBT Interventions
(2015) · Oxford Clinical Psychology · doi:10.1093/med:psych/9780199590117.001.0001 · Cited by 40 · see citing works
Terides, M. D., Dear, B. F., Karin, E., Jones, M. P., Gandy, M., Fogliati, V. J., Kayrouz, R., Staples, L., & Titov, N. (2016) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2016.1149876 · Cited by 20 · see citing works
Development and validation of the recovering quality of life (ReQoL) outcome measures
Keetharuth, A. D., Brazier, J. E., Connell, J., Carlton, J., Taylor Buck, E., Ricketts, T., & Barkham, M. (2024) · Figshare · doi:10.15131/shef.data.25218911 · Cited by 12 · see citing works
Mental Health Analysis Profiles (MhAPs): England
Hewlett, E., & Horner, K. (2015) · OECD health working papers · doi:10.1787/5jrxr7vj1g9v-en · Cited by 5 · see citing works
Flagged first, then by citations
4 of the 68 references couldn’t be matched to a known paper.
Research works printed but not linked: 2
- [15]Hersen M Sturmey P Handbook of evidence-based practice in clinical psychology, volume 2, adult disorders 2012 Hoboken, New Jersey John Wiley & Sons
- [21]Bennett-Levy J Richards DA Farrand P Christensen H Griffiths KM Kavanagh DJ Low intensity CBT interventions 2010 Oxford Oxford University Press
Cited by
Sorted by citations
An overview of and recommendations for more accessible digital mental health services
Lattie, E. G., Stiles-Shields, C., & Graham, A. K. (2022) · Nature Reviews Psychology · doi:10.1038/s44159-021-00003-1 · Cited by 446 · see citing works
Richards, D., Enrique, A., Eilert, N., Franklin, M., Palacios, J., Duffy, D., Earley, C., Chapman, J., Jell, G., Sollesse, S., et al. (2020) · npj Digital Medicine · doi:10.1038/s41746-020-0293-8 · Cited by 154 · see citing works
Self-citationMa, T., Jin, H., Kwok, L., Sun, Z., Liong, M., & Zhang, H. (2021) · Neurobiology of Stress · doi:10.1016/j.ynstr.2021.100294 · Cited by 153 · see citing works
Chien, I., Enrique, A., Palacios, J., Regan, T., Keegan, D., Carter, D., Tschiatschek, S., Nori, A., Thieme, A., Richards, D., et al. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.10791 · Cited by 111 · 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
(2019) · Europe PMC (PubMed Central) · Cited by 72 · see citing works
Business as usual? Psychological support at a distance.
Payne, L., Flannery, H., Kambakara Gedara, C., Daniilidi, X., Hitchcock, M., Lambert, D., Taylor, C., & Christie, D. (2020) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104520937378 · Cited by 65 · see citing works
“However, careful thought needs to be given to the practical considerations of offering e-therapies to clients experiencing more severe symptoms, including managing risk (Bower et al., 2013; Richards et al., 2018).”
BackgroundCarhart-Harris, R. L., Wagner, A. C., Agrawal, M., Kettner, H., Rosenbaum, J. F., Gazzaley, A., Nutt, D. J., & Erritzoe, D. (2022) · Journal of Psychopharmacology · doi:10.1177/02698811211008567 · Cited by 51 · see citing works
Duffy, D., Enrique, A., Connell, S., Connolly, C., & Richards, D. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00902 · Cited by 49 · see citing works
Agyapong-Opoku, G., Agyapong, B., Obuobi-Donkor, G., & Eboreime, E. (2023) · Behavioral Sciences · doi:10.3390/bs13121002 · Cited by 59 · see citing works
Franklin, M. K., Enrique, Á., Palacios, J. E., & Richards, D. (2021) · Quality of Life Research · doi:10.1007/s11136-021-02833-1 · Cited by 43 · see citing works
Thew, G. R. (2020) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x20000033 · Cited by 36 · see citing works
Catarino, A., Harper, S., Malcolm, R., Stainthorpe, A., Warren, G., Margoum, M., Hooper, J., Blackwell, A. D., & Welchman, A. E. (2023) · Nature Mental Health · doi:10.1038/s44220-023-00106-z · Cited by 36 · see citing works
Fitzsimmons‐Craft, E. E., Taylor, C. B., Newman, M. G., Zainal, N. H., Rojas-Ashe, E. E., Lipson, S. K., Firebaugh, M., Ceglarek, P. J. D., Topooco, N., Jacobson, N. C., et al. (2021) · Contemporary Clinical Trials · doi:10.1016/j.cct.2021.106320 · Cited by 35 · see citing works
Enrique, Á., Mooney, O., Salamanca-Sanabria, A., Lee, C. T., Farrell, S., & Richards, D. (2020) · JMIR Formative Research · doi:10.2196/20167 · Cited by 29 · see citing works
Ma, J., Chen, Y., Wang, Z., Wang, R., & Dong, Y. (2023) · Journal of Functional Foods · doi:10.1016/j.jff.2023.105710 · Cited by 24 · see citing works
Jardine, J., Earley, C., Richards, D., Timulák, L., Palacios, J. E., Duffy, D. J., Tierney, K., & Doherty, G. J. (2020) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3313831.3376254 · Cited by 22 · see citing works
Chibanda, D. (2018) · International Review of Psychiatry · doi:10.1080/09540261.2018.1564648 · Cited by 21 · see citing works
Franklin, M. K., Hunter, R. M., Enrique, Á., Palacios, J. E., & Richards, D. (2022) · Value in Health · doi:10.1016/j.jval.2021.11.1358 · Cited by 17 · see citing works
Palacios, J. E., Enrique, Á., Mooney, O., Farrell, S., Earley, C., Duffy, D. J., Eilert, N., Harty, S., Timulák, L., & Richards, D. (2022) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2743 · Cited by 16 · see citing works
Enrique, Á., Eilert, N., Wogan, R., Earley, C., Duffy, D. J., Palacios, J. E., Timulák, L., & Richards, D. (2021) · Cognitive Therapy and Research · doi:10.1007/s10608-020-10200-6 · Cited by 15 · see citing works
Flygare, O., Lundström, L., Andersson, E., Mataix‐Cols, D., & Rück, C. (2022) · British Journal of Clinical Psychology · doi:10.1111/bjc.12365 · Cited by 15 · see citing works
Hamer, O., Kuroski, J. A., Bray, E. P., Harris, C., Blundell, A., Schneider, E., & Watkins, C. L. (2024) · BMJ Open · doi:10.1136/bmjopen-2023-082973 · Cited by 17 · see citing works
Effectiveness of iFightDepression ® online guided self-help tool in depression: A pilot study
Varga, A., Czeglédi, E., Tóth, M. D., & Purebl, G. (2022) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x221084584 · Cited by 13 · see citing works
Rothman, B., Slomkowski, M., Speier, A., Rush, A. J., Trivedi, M. H., Lawson, E., Fahmy, M., Carpenter, D., Chen, D., & Forbes, A. (2024) · JMIR Research Protocols · doi:10.2196/56960 · Cited by 12 · see citing works
Kraepelien, M., Blom, K., Lindefors, N., Johansson, R., & Kaldo, V. (2019) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2351 · Cited by 12 · see citing works
Eilert, N., Timulak, L., Duffy, D., Earley, C., Enrique, A., Kennedy, P., McCormack, C., Palacios, J., Wogan, R., & Richards, D. (2022) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2619 · Cited by 11 · see citing works
Franklin, M., & Alava, M. H. (2023) · Quality of Life Research · doi:10.1007/s11136-023-03443-9 · Cited by 6 · see citing works
Cumpanasoiu, D. C., Enrique, Á., Palacios, J. E., Duffy, D. J., McNamara, S., & Richards, D. (2022) · JMIR mhealth and uhealth · doi:10.2196/41815 · Cited by 9 · see citing works
Onnis, L., Kinchin, I., Pryce, J., Ennals, P., Petrucci, J., & Tsey, K. (2020) · Frontiers in Public Health · doi:10.3389/fpubh.2020.585933 · Cited by 9 · see citing works
Steen, S. (2018) · Journal of Health Psychology · doi:10.1177/1359105318803751 · Cited by 8 · see citing works
Akkol-Solakoglu, S., Hevey, D., & Richards, D. (2021) · Internet Interventions · doi:10.1016/j.invent.2021.100367 · Cited by 8 · see citing works
Sigurðardóttir, S., Helgadóttir, F. D., Menzies, R. E., Sighvatsson, M. B., & Menzies, R. G. (2022) · Internet Interventions · doi:10.1016/j.invent.2022.100535 · Cited by 8 · see citing works
Fonseca, M. B., MacKenna, B., Mehrkar, A., Collaborative, T. O., Walters, C. E., Hickman, G., Pearson, J., Fisher, L., Inglesby, P., Bacon, S., et al. (2023) · JMIR Public Health and Surveillance · doi:10.2196/46485 · Cited by 7 · see citing works
Eilert, N., Wogan, R., Adegoke, A., Earley, C., Duffy, D. J., Enrique, Á., Palacios, J. E., Timulák, L., & Richards, D. (2022) · Journal of Clinical Psychology · doi:10.1002/jclp.23403 · Cited by 7 · see citing works
Du, E., Quayle, E., & Macleod, H. (2021) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x21000210 · Cited by 5 · see citing works
“Programmes have also been tailored using media-rich interactive content incorporating engaging strategies to improve user experience (Richards et al., 2018).”
MRAYYAN, M. T., Khait, A. F. A., Al‐Mrayat, Y. D., Alkhawaldeh, J. M., Alfayoumi, I. H., Algunmeeyn, A., Kutah, O. A., Abunab, H. Y., Hamdan, M. S., & Alhabashneh, H. (2024) · Journal of Health Psychology · doi:10.1177/13591053241249634 · Cited by 5 · see citing works
Silverman, A. L., Ferguson, I., Bullis, J. R., Bajwa, H., Mei, S., & Beard, C. (2025) · Journal of Mood and Anxiety Disorders · doi:10.1016/j.xjmad.2025.100106 · Cited by 5 · see citing works
Wu, Z., Luo, F., Wang, S., hu, X., & Chen, M. (2025) · JMIR Cancer · doi:10.2196/64754 · Cited by 4 · see citing works
Aguilera, A., Avalos, M. R. A., Rosales, K., Reyes, Y., Hernandez-Ramos, R., Ramos, G., Garcia, E. R., Hoang, T., Ochoa‐Frongia, L., Fortuna, L. R., et al. (2023) · Contemporary Clinical Trials · doi:10.1016/j.cct.2023.107422 · Cited by 4 · see citing works
Addressing depression and behavioral health needs through a digital program at scale
Sharif-Sidi, Z., Shen, C. P., Wong, W., Hanson, R., Miller, L. A., Fickel, K., Green, E., Burns, J., Dunn, C., Somai, M. M., et al. (2021) · Healthcare · doi:10.1016/j.hjdsi.2021.100521 · Cited by 3 · see citing works
Sampson, E. (2023) · Journal of Psychosocial Nursing and Mental Health Services · doi:10.3928/02793695-20230424-01 · Cited by 2 · see citing works
How Online Counselling Is Utilised, Evaluated, and Received
Agathokleous, G., & Taiwo, A. O. (2021) · Advances in psychology, mental health, and behavioral studies (APMHBS) book series · doi:10.4018/978-1-7998-7991-6.ch011 · Cited by 2 · see citing works
Hong, W. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15041371 · Cited by 1 · see citing works
Klettke, E. E., Holmes, M. D., Meyer, T. D., & Jones, G. H. (2023) · Personalized Medicine in Psychiatry · doi:10.1016/j.pmip.2023.100112 · Cited by 1 · see citing works
Agathokleous, G. (2020) · Wolverhampton Intellectual Repository and E-Theses (University of Wolverhampton) · Cited by 1 · see citing works
Cognitive Behavioral Therapy in the Republic of Ireland
Butcher, G. J., & Chigwedere, C. (2022) · Springer eBooks · doi:10.1007/978-3-030-82555-3_18
Hariz, A. J., Chevreul, K., Daval, L., Husson, M., Alberti, C., & Michel, M. (2025) · Value in Health · doi:10.1016/j.jval.2025.01.023
Price, J. A. B., McCall, H. C., Demyen, S. A., Spencer, S., Katz, B. M., Clairmont, A. P., & Hadjistavropoulos, H. D. (2025) · Journal of Medical Internet Research · doi:10.2196/72321
Kuczynski, A. M., & Areán, P. A. (2026) · Current Treatment Options in Psychiatry · doi:10.1007/s40501-026-00380-5
Huynh, K. L., Silverman, A. L., Beard, C., & Bullis, J. R. (2026) · Cognitive Therapy and Research · doi:10.1007/s10608-026-10763-w
Public Health and Socioeconomic Dimensions of Major Depressive Disorder
Naderian, R. (2026) · IGI Global eBooks · doi:10.4018/979-8-2600-4270-0.ch009
- Authors
- Richards, D., Duffy, D., Blackburn, B., Earley, C., Enrique, A., Palacios, J., Franklin, M., Clarke, G., Sollesse, S., Connell, S., & Timulak, L.
- Affiliations
- Trinity College Dublin (IE)
- SilverCloud (Ireland) (IE)
- University of Sheffield (GB)
- National Health Service (GB)
- Corresponding author
- Richards, Derek
- ORCID
- Venue
- BMC Psychiatry
- Published
- 2018-03-02
- Volume
- 18
- Issue
- 1
- Pages
- 59-59
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC5833053
- OpenAlex
- W2789518990
- Cited by
- 52
- References
- 68
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 3 · 2023: 9 · 2022: 9 · 2021: 10 · 2020: 9 · 2019: 2 · 2018: 2
- FWCI
- 7.25
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- Arrow@dit (Dublin Institute of Technology) (submittedVersion, cc-by-nc-sa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Trinity's Access to Research Output (TARA) (Trinity College Dublin) (submittedVersion)
- 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
- internet-based cognitive behavioral therapy, depression, anxiety disorders, Improving Access to Psychological Therapies, stepped care, cost-effectiveness, waitlist control, long-term outcomes, GAD-7, PHQ-9, NHS mental health services, generalizability
- MeSH terms
- Adult, Anxiety Disorders, Cost-Benefit Analysis, Depressive Disorder, Female, Follow-Up Studies, Health Services Accessibility, Humans, Male, Pregnancy, Surveys and Questionnaires, Therapy, Computer-Assisted, Waiting Lists, Cognitive Behavioral Therapy, Treatment Outcome, Internet
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
