Internet-delivered psychological treatments: from innovation to implementation

Gerhard Andersson, Nickolai Titov, Blake F. Dear, Alexander Rozental, Per Carlbring

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Internet interventions, and in particular Internet-delivered cognitive behaviour therapy (ICBT), have existed for at least 20 years. Here we review the treatment approach and the evidence base, arguing that ICBT can be viewed as a vehicle for innovation. ICBT has been developed and tested for several psychiatric and somatic conditions, and direct comparative studies suggest that therapist-guided ICBT is more effective than a waiting list for anxiety disorders and depression, and tends to be as effective as face-to-face CBT. Studies on the possible harmful effects of ICBT are also reviewed: a significant minority of people do experience negative effects, although rates of deterioration appear similar to those reported for face-to-face treatments and lower than for control conditions. We further review studies on change mechanisms and conclude that few, if any, consistent moderators and mediators of change have been identified. A recent trend to focus on knowledge acquisition is considered, and a discussion on the possibilities and hurdles of implementing ICBT is presented. The latter includes findings suggesting that attitudes toward ICBT may not be as positive as when using modern information technology as an adjunct to face-to-face therapy (i.e., blended treatment). Finally, we discuss future directions, including the role played by technology and machine learning, blended treatment, adaptation of treatment for minorities and non-Western settings, other therapeutic approaches than ICBT (including Internet-delivered psychodynamic and interpersonal psychotherapy as well as acceptance and commitment therapy), emerging regulations, and the importance of reporting failed trials.

LanguageEnglish
Pages20-28
Number of pages9
JournalWorld Psychiatry
Volume18
Issue number1
DOIs
Publication statusPublished - Feb 2019

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Internet
Cognitive Therapy
Psychology
Acceptance and Commitment Therapy
Psychodynamic Psychotherapy
Technology
Waiting Lists
Anxiety Disorders
Psychiatry
Depression
Therapeutics

Keywords

  • internet interventions
  • cognitive behaviour therapy
  • innovation
  • anxiety disorders
  • depression
  • moderators and mediators
  • negative effects
  • blended treatment
  • implementation

Cite this

Andersson, Gerhard ; Titov, Nickolai ; Dear, Blake F. ; Rozental, Alexander ; Carlbring, Per. / Internet-delivered psychological treatments : from innovation to implementation. In: World Psychiatry. 2019 ; Vol. 18, No. 1. pp. 20-28.
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Internet-delivered psychological treatments : from innovation to implementation. / Andersson, Gerhard; Titov, Nickolai; Dear, Blake F.; Rozental, Alexander; Carlbring, Per.

In: World Psychiatry, Vol. 18, No. 1, 02.2019, p. 20-28.

Research output: Contribution to journalArticleResearchpeer-review

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