Internet-based or computerised cognitive behavioural therapy (iCBT or CCBT) programs.
Cognitive behavioural therapy (CBT) is the main psychological treatment approach available as computer or internet based programs.
About 85% of patients with depression have significant anxiety.
Depression and anxiety.
Treatment programs have been studied in patients with mild-to-moderate, moderate-to-severe and severe depression.
iCBT may be particularly useful for patients in rural and remote locations and for patients with mobility issues.
CBT may not be suitable for patients with additional disorders or conditions such as borderline personality disorder, antisocial personality disorder or substance dependence.
Practitioners should assess a patient’s risk of self-harm or suicide before recommending iCBT. More immediate and direct means of assistance may be necessary for some patients.
Practitioners should alert patients to report a lack of improvement or worsening of anxiety or depression.
There are several different iCBT programs available at no or low-to-moderate cost:
- The Australian National University (ANU) has a tool that rates various depression-related websites (some also cover anxiety). MoodGYM (see Consumer resources) has been developed by the ANU.
- Mindhealthconnect offers information about and access to online programs.
- eMHPrac provides has a list of programs, apps and services to support the management of mild-to-moderate depression and anxiety.
More information on specific sites is provided in the Consumer resources section.
CCBT or iCBT programs engage patients in structured programs of care. The content is similar to and based on therapist-provided CBT programs.
Programs vary in style, degree of complexity, content and involvement by clinician.
Tips and challenges
Internet intervention may offer help for many individuals without access to effective treatments.
Slow or unreliable internet access may limit availability of some programs. For these patients, access to programs could be offered in the general practice.
Bibliotherapy for depression on HANDI is an alternative for patients without internet access.
Each site offers clinician access and guidance.
NHMRC Level 1 evidence.