Effects of internet-based cognitive behavioral therapy in routine care for adults in treatment for depression and anxiety: systematic review and meta-analysis

Anne Etzelmueller, Christiaan Vis, Eirini Karyotaki, Harald Baumeister, Nickolai Titov, Matthias Berking, Pim Cuijpers, Heleen Riper, David Daniel Ebert

    Research output: Contribution to journalArticlepeer-review

    9 Citations (Scopus)
    56 Downloads (Pure)

    Abstract

    BACKGROUND: Although there is evidence for the efficacy of internet-based cognitive behavioral therapy (iCBT), the generalizability of results to routine care is limited. OBJECTIVE: This study systematically reviews effectiveness studies of guided iCBT interventions for the treatment of depression or anxiety. METHODS: The acceptability (uptake, participants' characteristics, adherence, and satisfaction), effectiveness, and negative effects (deterioration) of nonrandomized pre-post designs conducted under routine care conditions were synthesized using systematic review and meta-analytic approaches. RESULTS: A total of 19 studies including 30 groups were included in the analysis. Despite high heterogeneity, individual effect sizes of investigated studies indicate clinically relevant changes, with effect sizes ranging from Hedges' g=0.42-1.88, with a pooled effect of 1.78 for depression and 0.94 for anxiety studies. Uptake, participants' characteristics, adherence, and satisfaction indicate a moderate to high acceptability of the interventions. The average deterioration across studies was 2.9%. CONCLUSIONS: This study provides evidence supporting the acceptability and effectiveness of guided iCBT for the treatment of depression and anxiety in routine care. Given the high heterogeneity between interventions and contexts, health care providers should select interventions that have been proven in randomized controlled clinical trials. The successful application of iCBT may be an effective way of increasing health care in multiple contexts.

    Original languageEnglish
    Article numbere18100
    Pages (from-to)1-27
    Number of pages27
    JournalJournal of Medical Internet Research
    Volume22
    Issue number8
    DOIs
    Publication statusPublished - 31 Aug 2020

    Bibliographical note

    Copyright the Author(s) 2020. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

    Keywords

    • internet-based interventions
    • depression
    • anxiety
    • effectiveness
    • acceptability
    • routine care

    Fingerprint Dive into the research topics of 'Effects of internet-based cognitive behavioral therapy in routine care for adults in treatment for depression and anxiety: systematic review and meta-analysis'. Together they form a unique fingerprint.

    Cite this