Computerised cognitive behaviour therapy for depression and anxiety update: a systematic review and economic evaluation
Open accessAbstract
OBJECTIVES: To evaluate computerised cognitive behaviour therapy (CCBT) for the treatment of anxiety, depression, phobias, panic and obsessive-compulsive behaviour (OCD). The software packages to be considered include Beating the Blues (BtB), Overcoming Depression: a five areas approach, FearFighter (FF), Cope and BT Steps. Other packages or programmes incorporating CCBT were also considered. DATA SOURCES: Electronic databases from 1966 to March 2004. Evidence submitted by sponsors for CCBT products. REVIEW METHODS: A systematic review was a review of the literature and the evidence submitted by sponsors for each of the products. A series of cost-effectiveness models was developed and run by the project team for the five CCBT products across the three mental health conditions. RESULTS: Twenty studies were identified in the clinical effectiveness review. The analysis of these results showed some evidence that CCBT is as effective as therapist-led cognitive behaviour therapy (TCBT) for the treatment of depression/anxiety and phobia/panic and is more effective than treatment as usual (TAU) in the treatment of depression/anxiety. CCBT also appears to reduce therapist time compared with TCBT. When reviewing cost-effectiveness studies, only one published economic evaluation of CCBT was found. This was an economic evaluation of the depression software BtB alongside a randomised controlled trial (RCT), which found that BtB was cost-effective against TAU in terms of cost per quality-adjusted life-year (QALY) (less than 2000 pounds), however it contained weaknesses that were then addressed in the cost-effectiveness model developed for the study. The results of the model for the depression software packages in terms of incremental cost per QALY compared with TAU and the chance of being cost-effective at 30,000 pounds per QALY were for BtB 1801 pounds and 86.8%, for Cope 7139 pounds and 62.6% and for Overcoming Depression 5391 pounds and 54.4%. The strength of the BtB software being that it has been evaluated in the context of an RCT with a control group. The subgroup analysis found no differences across the severity groupings. For phobia/panic software, the model showed an incremental cost per QALY of FF over relaxation was 2380 pounds. Its position compared with TCBT is less clear. When modelling OCD packages, using the practice-level licence cost meant that BT Steps was dominated by TCBT, which had significantly better outcomes and was cheaper. However, the cheaper PCT licence resulted in the incremental cost-effectiveness of BT Steps over relaxation being 15,581 pounds and TCBT over BT Steps being 22,484 pounds. CONCLUSIONS: The study findings are subject to substantial uncertainties around the organisational level for purchasing these products and the likely throughput. This is in addition to concerns with the quality of evidence on response to therapy, longer term outcomes and quality of life. The position of CCBT within a stepped care programme needs to be identified, as well as its relationship to other efforts to increase access to CBT and psychological therapies. Research is needed to compare CCBT with other therapies that reduce therapist time, in particular bibliotherapy and to explore the use of CCBT via the Internet. Independent research is needed, particularly RCTs, that examine areas such as patient preference and therapist involvement within primary care.
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The use of the Internet is a feasible solution for the accessibility problem in psychotherapy.
“The use of the Internet has been shown to be a feasible solution for the accessibility problem (18, 19).”
From Exploring the relationship between the acceptability of an internet-based intervention for depression in primary care and clinical outcomes: Secondary analysis of a randomized controlled trial (2019) · cites this paper as [18]
The ‘Computers in mental healthcare’ section says treatment can be delivered via the Internet and that computer-based therapy can potentially improve access, including for people unable to access care. But the ‘Cost impact’ section describes the evidence as limited and Internet-only packages as potentially useful, so the paper does not establish that Internet delivery has been shown to solve the accessibility problem. (LLM, conf=0.86)
Experimental — accuracy not yet measuredOf the three commercially-produced computerised packages for depression available to the NHS considered in the 2006 HTA review, only Beating The Blues, an adult intervention best suited to those aged 25 and over, had been evaluated in a randomised controlled trial by its developers.
“With respect to depression, three commercially-produced computerised packages available to the National Health Service (NHS) were considered—Beating The Blues, Cope and Overcoming Depression. Of these, only one adult intervention, Beating The Blues, best suited to those aged 25 and over, had been evaluated in a randomised controlled trial by its developers.13”
From Computerised cognitive behaviour therapy for depression in adolescents: Study protocol for a feasibility randomised controlled trial (2014) · cites this paper as [14]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredExisting research into CCBT has mainly been conducted with adults with depression and was most recently summarised in a 2006 HTA review of clinical and cost-effectiveness.
“Existing research into CCBT, which has mainly been conducted with adults with depression, has most recently been summarised in a 2006 HTA review of clinical and cost-effectiveness.14”
From Computerised cognitive behaviour therapy for depression in adolescents: Study protocol for a feasibility randomised controlled trial (2014) · cites this paper as [14]
The paper is a 2006 review of CCBT clinical effectiveness and cost-effectiveness, and its included studies cover predominantly adult populations. But the ‘mainly adults with depression’ characterization is not established by our copy: the ‘Quantity and quality of research available’ section identifies trials of depression/anxiety and phobia/panic, with OCD considered separately. The paper also cannot establish that it was the most recent review when the citing sentence was written. (LLM, conf=0.83)
Experimental — accuracy not yet measuredEvidence-based rationales for the content and ratio of combined online and face-to-face sessions are lacking.
“Evidence-based rationales for the content and ratio of the combined online and face-to-face sessions are, therefore, lacking [7,21].”
Online psychological treatments for depression are often as effective as face-to-face psychological treatments.
“Recent systematic reviews and meta-analyses have shown that online psychological treatments for depression often are as effective as face-to-face psychological treatments [3,6,7].”
Beating the Blues is judged to be effective.
“Beating the Blues is judged to be effective [8-11]”
From Meta-review of the effectiveness of computerised CBT in treating depression (2011) · cites this paper as [9]
The cost of Beating the Blues per quality-adjusted life-year is estimated to be £1250.
“the cost of one package, Beating the Blues, per quality-adjusted life-year is estimated to be £1250.”
From Meta-review of the effectiveness of computerised CBT in treating depression (2011) · cites this paper as [9]
According to Kaltenthaler et al [9], there is only one published paper on cost effectiveness of cCBT.
“This estimate comes from what, according to Kaltenthaler et al [9], is the only published paper on cost effectiveness of cCBT.”
From Meta-review of the effectiveness of computerised CBT in treating depression (2011) · cites this paper as [9]
Reviews have concluded that ODIN had moderate or no significant effect.
“ODIN had moderate or no significant effect [9,11,14,18]”
From Meta-review of the effectiveness of computerised CBT in treating depression (2011) · cites this paper as [9]
Reviews have concluded that MoodGYM was effective in reducing symptoms of depression.
“reviews have concluded that MoodGYM was effective in reducing symptoms of depression [9,11,13,14,18,19]”
From Meta-review of the effectiveness of computerised CBT in treating depression (2011) · cites this paper as [9]
There is not enough data with good quality to support Overcoming Depression.
“there is not enough data with good quality to support Overcoming Depression [8-11]”
From Meta-review of the effectiveness of computerised CBT in treating depression (2011) · cites this paper as [9]
cCBT has been shown to reduce therapist time.
“cCBT has been shown to reduce therapist time [8,9]”
From Meta-review of the effectiveness of computerised CBT in treating depression (2011) · cites this paper as [9]
For depression and anxiety disorders, cCBT has been found to be no less effective than therapist-led cognitive behaviour therapy (TCBT).
“their results broadly agree that, for depression and anxiety disorders, cCBT has been found to be no less effective than therapist-led cognitive behaviour therapy (TCBT) [8-10].”
From Meta-review of the effectiveness of computerised CBT in treating depression (2011) · cites this paper as [9]
cCBT is more effective than 'treatment as usual'.
“be more effective than 'treatment as usual' [8-10]”
From Meta-review of the effectiveness of computerised CBT in treating depression (2011) · cites this paper as [9]
Most studies on depression-related packages were tested by non-comparative trials rather than by comparison with alternative approaches.
“As highlighted by Kaltenthaler et al [9], most studies on depression-related packages were tested by non-comparative trials (i.e. according to improvement in individual measures against their baseline) rather than by comparison with alternative approaches.”
From Meta-review of the effectiveness of computerised CBT in treating depression (2011) · cites this paper as [9]
Kaltenthaler et al. undertook two reviews for the National Institute of Health Research Health Technology Assessment Board; these comprised a wide range of computerised interventions based on CBT, and were also the basis for two other publications.
“Kaltenthaler et al. [8,9] undertook two reviews for the National Institute of Health Research Health Technology Assessment Board; these comprised a wide range of computerised interventions based on CBT, and were also the basis for two other publications [10,11].”
From Meta-review of the effectiveness of computerised CBT in treating depression (2011) · cites this paper as [9]
Interventions based on CCBT have been shown to be acceptable, effective, and cost-effective across a range of mental health problems including mild to moderate depression, anxiety, obsessive-compulsive disorder, and phobias.
“Interventions based on CCBT have been shown to be acceptable, effective, and cost-effective across a range of mental health problems including mild to moderate depression, anxiety, obsessive-compulsive disorder, and phobias [48-54].”
From Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress (2012) · cites this paper as [48]
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Bowler, J. O., Mackintosh, B., Dunn, B. D., Mathews, A., Dalgleish, T., & Hoppitt, L. (2012) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0029932 · Cited by 164 · see citing works
“…these more economic approaches have been shown to be just as effective as therapist-led care for social phobia, generalized anxiety, and mild to moderate depression, despite their self-help format (Andersson et al., 2009; Kaltenthaler et al., 2006; Nordgreen et al., 2012; Proudfoot et al., 2004).”
BackgroundMental Health Policy and Practice Across Europe
Knapp, M. R. J., McDaid, D., Mossialos, E. A., & Thornicroft, G. (2006) · Research Portal (King's College London) · Cited by 159 · see citing works
Warmerdam, L., Smit, F., van Straten, A., Riper, H., & Cuijpers, P. (2010) · Journal of Medical Internet Research · doi:10.2196/jmir.1436 · Cited by 158 · see citing works
Chen, Y., Jowett, S. M., Barton, P. M., Malottki, K., Hyde, C., Gibbs, J. S. R., Pepke-Zaba, J., Fry-Smith, A., Roberts, J., & Moore, D. (2009) · Health Technology Assessment · doi:10.3310/hta13490 · Cited by 147 · see citing works
Gerhards, S. A. H., Abma, T. A., Arntz, A., de Graaf, L. E., Evers, S. M. A. A., Huibers, M. J. H., & Widdershoven, G. A. M. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.09.012 · Cited by 141 · see citing works
Andronis, L., Barton, P. M., & Bryan, S. (2009) · Health Technology Assessment · doi:10.3310/hta13290 · Cited by 139 · see citing works
Towards a chatbot for digital counselling
Cameron, G., Cameron, D., Megaw, G., Bond, R., Mulvenna, M. D., O’Neill, S. M., Armour, C., & McTear, M. (2017) · Electronic workshops in computing · doi:10.14236/ewic/hci2017.24 · Cited by 138 · see citing works
Little, P., Turner, S., Rumsby, K., Warner, G., Moore, M., Lowes, J., Smith, H., Hawke, C., Turner, D., Leydon, G., et al. (2009) · Health Technology Assessment · doi:10.3310/hta13190 · Cited by 137 · see citing works
Gerhards, S. A. H., de Graaf, L. E., Jacobs, L. E., Severens, J. L., Huibers, M. J. H., Arntz, A., Riper, H., Widdershoven, G., Metsemakers, J. F. M., & Evers, S. M. A. A. (2010) · British Journal of Psychiatry · doi:10.1192/bjp.bp.109.065748 · Cited by 135 · see citing works
Skapinakis, P., Caldwell, D. M., Hollingworth, W., Bryden, P. A., Fineberg, N. A., Salkovskis, P. M., Welton, N. J., Baxter, H., Kessler, D. S., Churchill, R. C., et al. (2016) · Health Technology Assessment · doi:10.3310/hta20430 · Cited by 133 · see citing works
Meta-review of the effectiveness of computerised CBT in treating depression
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Brazier, J. E., Tumur, I., Holmes, M. C., Ferriter, M., Parry, G. D., Dent-Brown, K., & Paisley, S. (2006) · Health Technology Assessment · doi:10.3310/hta10350 · Cited by 131 · see citing works
Self-citationSo, 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
“In addition to long follow-up outcomes, it also has not been meta-analysed until our study about whether CCBT can contribute to functional improvement, even though this outcome is critically important in view of evaluating cost-utility, which is referred to as a distinctive advantage of CCBT [15].”
BackgroundA randomized controlled trial of the cool teens CD-ROM computerized program for adolescent anxiety
Wuthrich, V. M., Rapee, R. M., Cunningham, M. J., Lyneham, H. J., Hudson, J. L., & Schniering, C. A. (2012) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2011.12.002 · Cited by 124 · see citing works
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Schlegl, S., Bürger, C., Schmidt, L., Herbst, N., & Voderholzer, U. (2015) · Journal of Medical Internet Research · doi:10.2196/jmir.3554 · Cited by 123 · see citing works
“More pragmatic RCTs in naturalistic settings should be performed to evaluate effectiveness and cost-effectiveness of TBIs within a stepped-care program [130].”
McCloud, T. L., Jones, R., Lewis, G., Bell, V., & Tsakanikos, E. (2020) · JMIR mhealth and uhealth · doi:10.2196/15418 · Cited by 122 · see citing works
Spence, S. H., Donovan, C. L., March, S., Gamble, A., Anderson, R., Prosser, S., Kercher, A., & Kenardy, J. (2008) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s135246580800444x · Cited by 120 · see citing works
Effectiveness of Online Collaborative Care for Treating Mood and Anxiety Disorders in Primary Care
Rollman, B. L., Belnap, B. H., Abebe, K. Z., Spring, M. B., Rotondi, A. J., Rothenberger, S. D., & Karp, J. F. (2017) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2017.3379 · Cited by 118 · see citing works
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Muñoz, R. F., Chavira, D. A., Himle, J. A., Koerner, K., Muroff, J. R., Reynolds, J., Rose, R. D., Ruzek, J. I., Teachman, B. A., & Schueller, S. M. (2018) · mHealth · doi:10.21037/mhealth.2018.05.04 · Cited by 117 · see citing works
Gilbody, S., Brabyn, S., Lovell, K., Kessler, D., Devlin, T., Smith, L., Araya, R., Barkham, M., Bower, P., Cooper, C., et al. (2017) · British Journal of Psychiatry · doi:10.1192/bjp.bp.116.192435 · Cited by 116 · see citing works
Cost-effectiveness of psychological treatments for post-traumatic stress disorder in adults
Mavranezouli, I., Megnin-Viggars, O., Grey, N., Bhutani, G., Leach, J., Daly, C., Dias, S., Welton, N. J., Katona, C., El-Leithy, S., et al. (2020) · PLOS ONE · doi:10.1371/journal.pone.0232245 · Cited by 115 · see citing works
Wilks, C. R., Lungu, A., Ang, S. Y., Matsumiya, B., Yin, Q., & Linehan, M. M. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.02.053 · Cited by 114 · see citing works
Development of a new approach to guided self-help via the internet: the Swedish experience
Andersson, G., Bergström, J., Buhrman, M., Carlbring, P., Holländare, F., Kaldo, V., Nilsson-Ihrfelt, E., Paxling, B., Ström, L., & Waara, J. (2008) · Journal of Technology in Human Services · doi:10.1080/15228830802094627 · Cited by 114 · see citing works
Mayo-Wilson, E., & Montgomery, P. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005330.pub4 · Cited by 112 · see citing works
Interventions for enhancing consumers' online health literacy
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A systematic review of presumed consent systems for deceased organ donation
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Herrero, R., Mira, A., Cormo, G., Etchemendy, E., Baños, R., García‐Palacios, A., Ebert, D. D., Franke, M., Berger, T., Schaub, M. P., et al. (2018) · Internet Interventions · doi:10.1016/j.invent.2018.03.005 · Cited by 105 · see citing works
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Performance of screening tests for child physical abuse in accident and emergency departments
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Stallard, P. N., Richardson, T. H., & Velleman, S. C. (2010) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465810000421 · Cited by 102 · see citing works
Hind, D., O’Cathain, A., Cooper, C. L., Parry, G. D., Isaac, C. L., Rose, A., Martin, L., & Sharrack, B. (2010) · Psychology & Health · doi:10.1080/08870440902842739 · Cited by 101 · see citing works
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Grist, R., & Cavanagh, K. (2013) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-013-9243-y · Cited by 100 · see citing works
VenUS II: a randomised controlled trial of larval therapy in the management of leg ulcers
Dumville, J. C., Worthy, G., Soares, M. O., Bland, J., Cullum, N. A., Dowson, C. G., Iglesias, C., McCaughan, D., Mitchell, J., Nelson, E. A., et al. (2009) · Health Technology Assessment · doi:10.3310/hta13550 · Cited by 100 · see citing works
Mowatt, G., Houston, J. G., Hernández, R. A., de Verteuil, R., Fraser, C. M., Cuthbertson, B. H., & Vale, L. D. (2009) · Health Technology Assessment · doi:10.3310/hta13070 · Cited by 94 · see citing works
Cooke, M. R., Marsh, J. L., Clark, M., Nakash, R., Jarvis, R., Hutton, J. L., Szczepura, A. K., Wilson, S., & Lamb, S. E. (2009) · Health Technology Assessment · doi:10.3310/hta13130 · Cited by 91 · see citing works
Bond, M., Pitt, M., Akoh, J. A., Moxham, T., Hoyle, M., & Anderson, R. (2009) · Health Technology Assessment · doi:10.3310/hta13380 · Cited by 91 · see citing works
Vitamin K to prevent fractures in older women: systematic review and economic evaluation
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Mouthaan, J., Sijbrandij, M., de Vries, G.-J., Reitsma, J. B., van de Schoot, R., Goslings, J. C., Luitse, J. S., Bakker, F. C., Gersons, B. P., & Olff, M. (2013) · Journal of Medical Internet Research · doi:10.2196/jmir.2460 · Cited by 90 · see citing works
Burch, J., Epstein, D. M., Baba-Akbari, A., Weatherly, H. L. A., Fox, D., Golder, S., Jayne, D. G., Drummond, M., & Woolacott, N. F. (2008) · Health Technology Assessment · doi:10.3310/hta12080 · Cited by 90 · see citing works
Littlewood, E., Duarte, A., Hewitt, C. E., Knowles, S. E., Palmer, S., Walker, S., Andersen, P., Araya, R., Barkham, M., Bower, P., et al. (2015) · Health Technology Assessment · doi:10.3310/hta191010 · Cited by 94 · see citing works
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Evaluating the promise of health IT to enhance/expand the reach of mental health services
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“While a few trials currently under way compare HIT-enabled interventions to traditional treatments [53] and/or include economic analyses [54,55], much more research is needed in this area of study.”
Virtues, ecological momentary assessment/intervention and smartphone technology
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Talboom-Kamp, E. P. W. A., Verdijk, N. A., Kasteleyn, M. J., Numans, M. E., & Chavannes, N. H. (2018) · Clinical eHealth · doi:10.1016/j.ceh.2018.01.001 · Cited by 86 · see citing works
Mikocka-Walus, A., Bampton, P., Hetzel, D., Hughes, P., Esterman, A., & Andrews, J. M. (2015) · BMC Gastroenterology · doi:10.1186/s12876-015-0278-2 · Cited by 86 · see citing works
Hummel, S., Simpson, E., Hemingway, P., Stevenson, M., & Rees, A. (2010) · Health Technology Assessment · doi:10.3310/hta14470 · Cited by 86 · see citing works
de Graaf, L. E., Huibers, M. J. H., Riper, H., Gerhards, S. A. H., & Arntz, A. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2008.12.009 · Cited by 86 · see citing works
Pilgrim, H., Lloyd-Jones, M., & Rees, A. (2009) · Health Technology Assessment · doi:10.3310/hta13100 · Cited by 85 · see citing works
Van Gemert-Pijnen, J. E., Kelders, S. M., & Bohlmeijer, E. T. (2014) · Journal of Medical Internet Research · doi:10.2196/jmir.2991 · Cited by 84 · see citing works
Kiluk, B. D., Sugarman, D. E., Nich, C., Gibbons, C. J., Martino, S., Rounsaville, B. J., & Carroll, K. M. (2011) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2011.10101443 · Cited by 84 · see citing works
Abeles, P., Verduyn, C., Robinson, A., Smith, P., Yule, W., & Proudfoot, J. (2009) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465808005067 · Cited by 82 · see citing works
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Only connect: The working alliance in computer-based cognitive behavioral therapy
Kiluk, B. D., Serafini, K., Frankforter, T., Nich, C., & Carroll, K. M. (2014) · Behaviour Research and Therapy · doi:10.1016/j.brat.2014.10.003 · Cited by 80 · see citing works
“…dissemination of evidence-based therapies, such as cognitive behavioral therapy (CBT), have spurred development of numerous technology-based interventions (see reviews, Cuijpers et al., 2009; Kaltenthaler et al., 2006; Marks et al., 2009; Richardson, Stallard, & Velleman, 2010; Spek et al., 2007).”
BackgroundCounselling for mental health and psychosocial problems in primary care
Bower, P., Knowles, S. E., Coventry, P. A., & Rowland, N. (2011) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001025.pub3 · Cited by 77 · see citing works
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Telemedicine support shortens length of stay after fast-track hip replacement
Vesterby, M., Pedersen, P. U., Laursen, M., Mikkelsen, S. S., Larsen, J. R., Søballé, K., & Jørgensen, L. B. (2016) · Acta Orthopaedica · doi:10.1080/17453674.2016.1256939 · Cited by 74 · see citing works
- Authors
- Kaltenthaler, E., Brazier, J., De Nigris, E., Tumur, I., Ferriter, M., Beverley, C., Parry, G., Rooney, G., & Sutcliffe, P.
- Affiliations
- University of Sheffield (GB)
- Rampton Hospital (GB)
- Venue
- Health Technology Assessment
- Published
- 2006-09
- Volume
- 10
- Issue
- 33
- Pages
- iii, xi-xiv, 1
- ISSN
- 1366-5278 (ISSN-L)
- 2046-4924
- OpenAlex
- W2033257301
- Cited by
- 357
- References
- 184
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 2 · 2023: 7 · 2022: 5 · 2021: 10 · 2020: 10 · 2019: 11 · 2018: 14 · 2017: 16 · 2016: 28 · 2015: 22 · 2014: 27 · 2013: 26 · 2012: 17
- FWCI
- 4.24
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Health Technology Assessment (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (submittedVersion)
- Funders
- Health Technology Assessment programme (04/01/01)
- 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 › Psychological Treatments and Assessments
- Keywords
- depression, anxiety, phobia, panic disorder, obsessive-compulsive disorder, COPE, cost-effectiveness, quality-adjusted life years, clinical effectiveness, economic evaluation model, treatment as usual comparison
- MeSH terms
- Anxiety Disorders, Cost-Benefit Analysis, Depression, United Kingdom, Humans, State Medicine, Therapy, Computer-Assisted, Cognitive Behavioral Therapy, Models, Econometric
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