JMIR Publications

ABSTRACT

Background:

While 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 and/or anxiety.

Methods:

The acceptability (uptake, participant´s characteristics, adherence, and satisfaction), effec-tiveness and negative effects (deterioration) of non-randomized pre-post designs conducted under routine care conditions were synthesized using systematic review and meta-analytic approaches.

Results:

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 the anxiety studies. Uptake, participant characteristics, adherence and satisfaction indicate a moderate to high acceptability of the interventions. The average deterioration across studies was 3.1%.

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. Clinical Trial: This meta-analysis was registered at PROSPERO under the registration number CRD42018095704.