The DOI matches its Crossref record; 55 of the 55 references it cites were found in a registry or an index.
The efficacy of internet interventions for depression and anxiety disorders: a review of randomised controlled trials
Abstract
OBJECTIVE: To review the outcomes, nature and quality of published randomised controlled trials of preventive and treatment internet interventions for depression and anxiety disorders, and to document the availability of effective interventions. DATA SOURCES: Previous reviews of internet interventions for mental health and related conditions were updated using an extension of the original methodology. All studies included in the original reviews and more recent eligible trials (published before June 2009) were included, together with any trials identified from a search of the health intervention web portal Beacon and the Journal of Medical Internet Research. STUDY SELECTION: A total of 29 reports describing 26 trials satisfied the inclusion criteria. DATA SYNTHESIS: All trials employed a cognitive behaviour therapy intervention program. Of the 26 trials, 23 demonstrated some evidence of effectiveness relative to controls. Effect size differences ranged from 0.42 to 0.65 for depression interventions involving participants with clinically significant symptoms of depression, and 0.29 to 1.74 for anxiety interventions involving participants with a diagnosed anxiety disorder. Of the five effective English-language programs, three are available to the public without charge and two can be accessed at a small cost through health practitioner referral. CONCLUSION: Internet interventions for depression and anxiety disorders offer promise for use as self-help applications for consumers or as an adjunct to usual care.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
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?
In the citing paper
“Online interventions addressing anxiety and depression in the general population have demonstrated similar levels of efficacy to face-to-face interventions in both the general population and cancer patients (Griffiths, Farrer, & Christensen, 2010;Jacobsen & Jim, 2008).”
From e-TC: Development and pilot testing of a web-based intervention to reduce anxiety and depression in survivors of testicular cancer (2017) · cites this paper as Griffiths, Farrer, & Christensen, 2010
In the citing paper
“Internet-based and computer-aided treatments have been shown to be effective in treating a wide range of psychological problems, and have effect sizes (ES) comparable to those found for more traditional types of psychological treatments [21-32].”
From Feasibility of a personal health technology-based psychological intervention for men with stress and mood problems: Randomized controlled pilot trial (2013) · cites this paper as [27]
In the citing paper
“However, the acceptability, effectiveness and uptake of iCBT treatment for mental disorders has not been established in older populations [5], [6].”
In the citing paper
“Reviews of iCBT for mental illness have indicated that older individuals are generally under-represented in the samples that provide efficacy data for these programs [5], [6].”
In the citing paper
“Reviews of randomised controlled trials (RCTs) of internet interventions with therapist assistance for depressive and anxiety disorders have found reductions in symptoms, relevant cognitions and improvement in patients’ mental health literacy [37–39].”
From Study protocol for a randomised controlled trial of internet-based cognitive-behavioural therapy for obsessive-compulsive disorder (2014) · cites this paper as [37]
In the citing paper
“These effects were somewhat smaller than those reported in other recent reviews [17, 19–22] and also smaller than the large effect sizes for Internet-based ACT (0.80 and 0.87) in the study of Fledderus et al. [40] and for Internet-based CBT for anxiety complaints in older adults (1.43) in the study of Dear et al. [26].”
In the citing paper
“Current psychotherapies for anxiety can be delivered online using a website, 47,48”
From Effectiveness of mobile technologies delivering Ecological Momentary Interventions for stress and anxiety: A systematic review (2016) · cites this paper as [48]
In the citing paper
“Four other reviews [15-18] had a wider scope than cCBT for depression.”
From Meta-review of the effectiveness of computerised CBT in treating depression (2011) · cites this paper as [15]
In the citing paper
“Four reviews did not name the packages they examined [12,15-17].”
From Meta-review of the effectiveness of computerised CBT in treating depression (2011) · cites this paper as [15]
In the citing paper
“However, few studies have compared supported and unsupported interventions in the same trial [11] and so the issue of whether support adds unequivocal benefit has not yet been resolved.”
From Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial (2011) · cites this paper as [11]
In the citing paper
“A range of software applications available on the web have also delivered effective CBT to depressed samples [11], reduced depression in school settings [12] and in general practice environments [13], [14], either with or without support from mental health professionals, paraprofessionals or teachers [11].”
From Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial (2011) · cites this paper as [11]
In the citing paper
“A range of software applications available on the web have also delivered effective CBT to depressed samples [11], reduced depression in school settings [12] and in general practice environments [13], [14], either with or without support from mental health professionals, paraprofessionals or teachers [11].”
From Internet-Based CBT for Depression with and without Telephone Tracking in a National Helpline: Randomised Controlled Trial (2011) · cites this paper as [11]
Citations
Cites
(2008) · Cited by 3,790
Assessing Risk of Bias in Included Studies
Higgins, J. P., & Altman, D. G. (2008) · Cochrane Handbook for Systematic Reviews of Interventions · doi:10.1002/9780470712184.ch8 · Cited by 3,396
Selective publication of antidepressant trials and its influence on apparent efficacy
Turner, E. H., Matthews, A. M., Linardatos, E., Tell, R. A., & Rosenthal, R. (2008) · New England Journal of Medicine · doi:10.1056/nejmsa065779 · Cited by 2,435
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
Delivering interventions for depression by using the internet: randomised controlled trial
Christensen, H. (2004) · BMJ · doi:10.1136/bmj.37945.566632.ee · Cited by 928
Self-citationGriffiths, K. M., Christensen, H., Jorm, A. F., Evans, K., & Groves, C. (2004) · British Journal of Psychiatry · doi:10.1192/bjp.185.4.342 · Cited by 789
Self-citationLange, A., Rietdijk, D., Hudcovicova, M., van de Ven, J.-P., Schrieken, B., & Emmelkamp, P. M. G. (2003) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.71.5.901 · Cited by 495
Shortfall in mental health service utilisation
Andrews, G., Issakidis, C., & Carter, G. (2001) · British Journal of Psychiatry · doi:10.1192/bjp.179.5.417 · Cited by 420
GELLATLY, J., BOWER, P., HENNESSY, S., RICHARDS, D., GILBODY, S., & LOVELL, K. (2007) · Psychological Medicine · doi:10.1017/s0033291707000062 · Cited by 419
Knaevelsrud, C., & Maercker, A. (2007) · BMC Psychiatry · doi:10.1186/1471-244x-7-13 · Cited by 398
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
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
Meyer, B., Berger, T., Caspar, F., Beevers, C. G., Andersson, G., & Weiss, M. (2009) · Journal of Medical Internet Research · doi:10.2196/jmir.1151 · Cited by 363
Kaltenthaler, E., Brazier, J., De Nigris, E., Tumur, I., Ferriter, M., Beverley, C., Parry, G., Rooney, G., & Sutcliffe, P. (2006) · Health Technology Assessment · doi:10.3310/hta10330 · Cited by 357
Psychological treatment of social anxiety disorder: a meta-analysis
Acarturk, C., Cuijpers, P., van Straten, A., & de Graaf, R. (2009) · Psychological Medicine · doi:10.1017/s0033291708003590 · Cited by 333
March, S., Spence, S. H., & Donovan, C. L. (2009) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsn099 · Cited by 315
SPEK, V., NYKLÍČEK, I., SMITS, N., CUIJPERS, P., RIPER, H., KEYZER, J., & POP, V. (2007) · Psychological Medicine · doi:10.1017/s0033291707000542 · Cited by 307
Carlbring, P., Gunnarsdóttir, M., Hedensjö, L., Andersson, G., Ekselius, L., & Furmark, T. (2007) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.105.020107 · Cited by 299
van Straten, A., Cuijpers, P., & Smits, N. (2008) · Journal of Medical Internet Research · doi:10.2196/jmir.954 · Cited by 297
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
Clinician-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
Treatment of panic disorder via the internet: A randomized trial of a self-help program
Carlbring, P., Westling, B. E., Ljungstrand, P., Ekselius, L., & Andersson, G. (2001) · Behavior Therapy · doi:10.1016/s0005-7894(01)80019-8 · Cited by 262
Carlbring, P., Bohman, S., Brunt, S., Buhrman, M., Westling, B. E., Ekselius, L., & Andersson, G. (2006) · American Journal of Psychiatry · doi:10.1176/ajp.2006.163.12.2119 · Cited by 262
Spence, S. H., Holmes, J. M., March, S., & Lipp, O. V. (2006) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.74.3.614 · Cited by 261
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
Internet-Based Treatment for Adults with Depressive Symptoms: Randomized Controlled Trial
Warmerdam, L., van Straten, A., Twisk, J., Riper, H., & Cuijpers, P. (2008) · Journal of Medical Internet Research · doi:10.2196/jmir.1094 · Cited by 255
Online randomized controlled trial of brief and full cognitive behaviour therapy for depression
CHRISTENSEN, H., GRIFFITHS, K. M., MACKINNON, A. J., & BRITTLIFFE, K. (2006) · Psychological Medicine · doi:10.1017/s0033291706008695 · Cited by 249
Self-citationInterapy. Treatment of posttraumatic stress through the Internet: a controlled trial
Lange, A., van de Ven, J.-P., Schrieken, B., & Emmelkamp, P. M. G. (2001) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/s0005-7916(01)00023-4 · Cited by 245
Psychological treatment of depression: A meta-analytic database of randomized studies
Cuijpers, P. J., van Straten, A., Warmerdam, L., & Andersson, G. (2008) · BMC Psychiatry · doi:10.1186/1471-244x-8-36 · Cited by 241
Internet-Based Mental Health Interventions
Ybarra, M. L., & Eaton, W. W. (2005) · Mental Health Services Research · doi:10.1007/s11020-005-3779-8 · Cited by 241
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
Clinician-Assisted Internet-Based Treatment is Effective for Depression: Randomized Controlled Trial
Perini, S., Titov, N., & Andrews, G. (2009) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670902873722 · Cited by 231
Titov, N., Andrews, G., Choi, I., Schwencke, G., & Mahoney, A. (2008) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670802512107 · Cited by 221
Haby, M. M., Donnelly, M., Corry, J., & Vos, T. (2006) · Australian and New Zealand journal of psychiatry (Print) · doi:10.1080/j.1440-1614.2006.01736.x · Cited by 220
Griffiths, K. M., & Christensen, H. (2006) · Clinical Psychologist · doi:10.1080/13284200500378696 · Cited by 210
Self-citationPsychotherapy mediated by remote communication technologies: a meta-analytic review
Bee, P. E., Bower, P., Lovell, K., Gilbody, S., Richards, D., Gask, L., & Roach, P. (2008) · BMC Psychiatry · doi:10.1186/1471-244x-8-60 · Cited by 189
Mackinnon, A. J., Griffiths, K. M., & Christensen, H. M. (2008) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.106.032078 · Cited by 182
Self-citationShyness 1: Distance Treatment of Social Phobia Over the Internet
Titov, N., Andrews, G., Schwencke, G., Drobny, J., & Einstein, D. (2008) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670802119762 · Cited by 180
The Effectiveness of Telemental Health Applications: A Review
Hailey, D., Roine, R., & Ohinmaa, A. (2008) · The Canadian Journal of Psychiatry · doi:10.1177/070674370805301109 · Cited by 176
A BRIEF INTERNET-BASED TREATMENT FOR PANIC DISORDER
Klein, B., & Richards, J. C. (2001) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465801001138 · Cited by 168
Self-help with minimal therapist contact for obsessive–compulsive disorder: a review
Mataix‐Cols, D., & Marks, I. M. (2005) · European Psychiatry · doi:10.1016/j.eurpsy.2005.07.003 · Cited by 146
Spek, V., Cuijpers, P., Nyklíček, I., Smits, N., Riper, H., Keyzer, J., & Pop, V. (2008) · Psychological Medicine · doi:10.1017/s0033291707002590 · Cited by 139
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
Hirai, M., & Clum, G. A. (2005) · Journal of Traumatic Stress · doi:10.1002/jts.20071 · Cited by 127
E-Therapy for Mental Health Problems: A Systematic Review
Postel, M. G., de Haan, H. A., & De Jong, C. A. J. (2008) · Telemedicine and e-Health · doi:10.1089/tmj.2007.0111 · Cited by 125
Internet‐Based Treatment for Panic Disorder: Does Frequency of Therapist Contact Make a Difference?
Klein, B., Austin, D., Pier, C., Kiropoulos, L., Shandley, K., Mitchell, J., Gilson, K., & Ciechomski, L. (2009) · Cognitive Behaviour Therapy · doi:10.1080/16506070802561132 · Cited by 123
A Web-Based Approach to Managing Stress and Mood Disorders in the Workforce
Billings, D. W., Cook, R. F., Hendrickson, A., & Dove, D. C. (2008) · Journal of Occupational & Environmental Medicine · doi:10.1097/jom.0b013e31816c435b · Cited by 117
Shandley, 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
Richards, J. C., Klein, B., & Austin, D. (2005) · Clinical Psychologist · doi:10.1080/13284200500378795 · Cited by 83
GEOGRAPHIC INEQUITY IN THE AVAILABILITY OF COGNITIVE BEHAVIOURAL THERAPY IN ENG LAND AND WALES
Shapiro, D. A., Cavanagh, K., & Lomas, H. (2003) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465803002066 · Cited by 75
Prevention of Depressive Symptoms Through the Use of Distance Technologies
Patten, S. B. (2003) · Psychiatric Services · doi:10.1176/appi.ps.54.3.396 · Cited by 69
Internet–based cognitive–behavioral self help for depression
Andersson, G. (2006) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.6.11.1637 · Cited by 46
Clickety-click: E-Mental Health Train on Track
Griffiths, K. M., Farrer, L. M., & Christensen, H. M. (2007) · Australasian Psychiatry · doi:10.1080/10398560601123716 · Cited by 39
Self-citatione‐hub: an online self‐help mental health service in the community
Bennett, K., Reynolds, J., Christensen, H. M., & Griffiths, K. M. (2010) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.2010.tb03694.x · Cited by 37
Self-citationIs internet treatment for depressive and anxiety disorders ready for prime time?
Andrews, G., & Titov, N. (2010) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.2010.tb03693.x · Cited by 37
Research works printed but not linked: 4
- Weightman AL, 2004, A systematic approach to identifying the evidence. Project Methodology 5. Health Evidence Bulletins Wales
- Christensen H, 2010, Beacon: a web portal listing high‐quality mental health websites for use by health professionals and the public, Med J Aust, 192, S40
- Lowe S, 2004, National allied health workforce report
- Australian Institute of Health and Welfare, 2005, Rural, regional and remote health: Indicators of health
Cited by
Sorted by citations
Baldwin, D. S., Anderson, I. M., Nutt, D. J., Allgulander, C., Bandelow, B., den Boer, J. A., Christmas, D. M., Davies, S., Fineberg, N., Lidbetter, N., et al. (2014) · Journal of Psychopharmacology · doi:10.1177/0269881114525674 · Cited by 676
“…review of 26 studies in individuals with depression or anxiety disorders suggest that internet-based interventions offer promise, in overall management [I (M)] (Griffiths et al., 2010); though there is a need to further investigate factors associated with beneficial outcomes (Andersson, 2012).”
BackgroundPhilippe, T. J., Sikder, N., Jackson, A., Koblanski, M. E., Liow, E., Pilarinos, A., & Vasarhelyi, K. (2022) · JMIR Mental Health · doi:10.2196/35159 · Cited by 436
A systematic review of online youth mental health promotion and prevention interventions
Clarke, A. M., Kuosmanen, T., & Barry, M. M. (2015) · Journal of Youth and Adolescence · doi:10.1007/s10964-014-0165-0 · Cited by 381
“…cognitive behavior therapy (cCBT) interventions targeting depression and anxiety symptoms in adults and reported small to medium effect sizes (e.g. Griffiths et al. 2010; Cuijpers et al. 2009; Spek et al. 2007), The effectiveness of online technologies in improving adolescent and emerging adult…”
BackgroundInfluentialE-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
Beatty, L., & Binnion, C. (2016) · International Journal of Behavioral Medicine · doi:10.1007/s12529-016-9556-9 · Cited by 347
“The benefits of online interventions include their ease of access, cost-efficiency, and ability to reach a wide range of users [4, 5, 8].”
Background
Metadata
- Authors
- Griffiths, K. M., Farrer, L., & Christensen, H.
- Affiliations
- Australian National University (AU)
- Corresponding author
- Griffiths, Kathleen M
- Venue
- Medical Journal of Australia
- Publisher
- Wiley
- Published
- 2010-06
- Volume
- 192
- Issue
- S11
- Pages
- S4-11
- ISSN
- 0025-729X (ISSN-L)
- 1326-5377
- OpenAlex
- W2181769958
- Cited by
- 303
- References
- 55
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 2 · 2023: 3 · 2022: 14 · 2021: 15 · 2020: 12 · 2019: 17 · 2018: 22 · 2017: 24 · 2016: 29 · 2015: 36 · 2014: 51 · 2013: 33 · 2012: 18
- FWCI
- 2.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- The Medical Journal of Australia (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Health and Medical Research Council
- 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 › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- online intervention, depression, anxiety disorders, cognitive behavioral therapy, self-help, treatment efficacy, preventive interventions
- MeSH terms
- Anxiety Disorders, Depressive Disorder, Humans, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Telemedicine, 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