Effectiveness of a Transdiagnostic guided internet-delivered protocol for emotional disorders versus treatment as usual in specialized care: randomized controlled trial
Open accessPublished version of a preprint
Abstract
BACKGROUND: Anxiety disorders and depression (emotional disorders) are highly prevalent mental disorders. Extensive empirical evidence supports the efficacy of cognitive behavioral therapy (CBT) for the treatment of these disorders. However, there are still some barriers related to their dissemination and implementation, which make it difficult for patients to receive these treatments, especially in public health care settings where resources are limited. Recent advances in improving CBT dissemination encompass different perspectives. One is the transdiagnostic approach, which offers treatment protocols that can be used for a range of emotional disorders. Another approach is the use of the internet to reach a larger number of people who could benefit from CBT. OBJECTIVE: This study aimed to analyze the effectiveness and acceptability of a transdiagnostic internet-delivered protocol (EmotionRegulation) with human and automated guidance in patients from public specialized mental health care settings. METHODS: A 2-armed randomized controlled trial (RCT) was conducted to compare the effectiveness of EmotionRegulation with treatment as usual (TAU) in specialized mental health care. In all, 214 participants were randomly assigned to receive either EmotionRegulation (n=106) or TAU (n=108). Measurement assessments were conducted at pre- and postintervention and at a 3-month follow-up. RESULTS: The results revealed the superiority of EmotionRegulation over TAU on measures of depression (d=0.41), anxiety (d=0.35), and health-related quality of life (d=-0.45) at posttreatment, and these gains were maintained at the 3-month follow-up. Furthermore, the results for expectations and opinions showed that EmotionRegulation was well accepted by participants. CONCLUSIONS: EmotionRegulation was more effective than TAU for the treatment of emotional disorders in the Spanish public mental health system. The implications of this RCT, limitations, and suggestions for future research are discussed. TRIAL REGISTRATION: ClinicalTrials.gov NCT02345668; https://clinicaltrials.gov/ct2/show/NCT02345668.
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?
The transdiagnostic protocol has already been shown to be effective in a self-applied format in previous trials.
“This transdiagnostic protocol has already been shown to be effective in a self-applied format in previous trials (Díaz-García et al., 2021a; González-Robles et al., 2020)”
From Feasibility, acceptability, and preliminary efficacy of a blended transdiagnostic group CBT for the treatment of emotional disorders (2025) · cites this paper as González-Robles et al., 2020
The Methods (Treatments; page unavailable) describe EmotionRegulation as a transdiagnostic internet-delivered protocol, and the Results (Effectiveness of EmotionRegulation on Primary and Secondary Outcome Measures; page unavailable) report lower anxiety and depression scores than treatment as usual. However, the Methods also specify weekly therapist calls and automated support. This paper therefore supports effectiveness in a guided online format, but does not establish effectiveness in an unguided self-applied format. (LLM, conf=0.84)
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.
The citation lists haven’t been fetched yet
References 122 · Cited by 40
Research works printed but not linked: 3
- [74]American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders. Fourth Edition 2000 Washington, DC American Psychiatric Association
- [98]Hair J Black W Babin B Anderson R Multivariate Data Analysis: With Readings. Seventh Edition 2014 River, NJ Pearson-Prentice Hall International Edition
- [102]Cohen J Statistical Power Analysis for the Behavioral Sciences. Second Edition 1988 12 Hillsdale, NJ Erlbaum
- Authors
- González-Robles, A., Díaz-García, A., García-Palacios, A., Roca, P., Ramos-Quiroga, J. A., & Botella, C.
- Affiliations
- Universitat Jaume I (ES)
- Universidad Complutense de Madrid (ES)
- Corresponding author
- González-Robles, Alberto
- ORCID
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2020-07-07
- Volume
- 22
- Issue
- 7
- Pages
- e18220
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC7381075
- OpenAlex
- W3041067516
- Cited by
- 40
- References
- 122
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 10 · 2023: 8 · 2022: 6 · 2021: 5 · 2020: 2
- FWCI
- 4.75
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Internet Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
- Dipòsit Digital de Documents de la UAB (Universitat Autònoma de Barcelona) (submittedVersion, cc-by)
- Zaguan (University of Zaragoza Repository) (submittedVersion, cc-by)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Repositori UJI (Universitat Jaume I) (submittedVersion, cc-by-sa)
- Funders
- Ministerio de Educación, Cultura y Deporte (FPU13, CB06/03/0052, P1-1B2014-43, FPU13/00576)
- Universitat Jaume I (P1.1B2014-43, CB06/03/0052, FPU13/00576)
- Instituto de Salud Carlos III (FPU13/00576, CB06 03/0052, CB06/03, P1-1B2014-43)
- 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 › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- transdiagnostic treatment, internet-based cognitive behavioral therapy, anxiety disorders, depression, emotional disorders, public mental health services, treatment dissemination, health-related quality of life, treatment acceptability, specialized mental health care
- MeSH terms
- Adolescent, Adult, Aged, Clinical Protocols, Female, Humans, Male, Middle Aged, Quality of Life, Cognitive Behavioral Therapy, Treatment Outcome, Mood Disorders, Internet, Young Adult
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
