Journal Article

Effects of Internet-Based Cognitive Behavioral Therapy in Routine Care for Adults in Treatment for Depression and Anxiety: Systematic Review and Meta-Analysis

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

2020

Overview

Although there is evidence for the efficacy of internet-based cognitive behavioral therapy (iCBT), the generalizability of results to routine care is limited. This study systematically reviews effectiveness studies of guided iCBT interventions for the treatment of depression or anxiety. 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. 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%. 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.

• Publisher: Gunther Eysenbach MD MPH, Associate Professor,JMIR Publications
• Subject: Acceptability / Adult / Adults / Anxiety / Anxiety disorders / Anxiety Disorders - therapy / Behavior modification / Clinical medicine / Clinical research / Clinical trials / Cognition / Cognitive behavioral therapy / Cognitive Behavioral Therapy - methods / Cognitive-behavioral factors / Depression - therapy / Deterioration / Effectiveness / Efficacy / Female / Generalizability / Health care / Health care industry / Health services / Heterogeneity / Humans / Internet / Internet-Based Intervention - trends / Intervention / Male / Medical personnel / Medical treatment / Mental depression / Mental disorders / Mental health / Mental health services / Meta-analysis / Multimedia / Professionals / Psychotherapy / Review / Satisfaction / Systematic review / Treatment compliance / Treatment outcomes / Uptake / Young Adult