Resources for Internet-delivered cognitive behavioural therapy (CBT) in the literature and the real world
| Program name | Description | Geographic availability |
|---|---|---|
| In research trials | ||
| Cancer Coping Online | Available to patients with cancer to help them in coping with distress. The program has 6 modules and takes 6 weeks to complete. High patient satisfaction and relatively good adherence (due to weekly email reminders) was reported. In a pilot trial, 10 of 12 participants completed the full program, and patients stated that the program was easy to use. Patients reported reduction in negative affect, hopelessness and anxiety following completion.17 A full clinical trial has recently been completed.18 | NA |
| A-CHESS | Developed by the Addiction–Comprehensive Health Enhancement Support System as an application (app) that provides support, monitoring and information to patients with alcohol dependence. A-CHESS is part of a behavioural approach for treating this addiction. The app allows patients to stay in contact with counsellors to help maintain sobriety. In an unmasked RCT, use of the app was associated with significant reductions in heavy alcohol consumption over an 8-month period and for 4 months of follow-up.34 | NA |
| Currently available* | ||
| THIS WAY UP clinic† (https://thiswayup.org.au/clinic/) | Offered to patients with depression and generalized anxiety disorder. Patients must be referred by a physician. The program has been the subject of numerous RCTs. A trajectory study showed significant reductions in psychological distress, measured by the Kessler Psychological Distress Scale (K10), and disability, measured by the World Health Organization Disability Assessment Schedule (WHODAS-II); older adults experienced the most benefit.24,28,30,35 | Australia |
| Diabetergestemd.nl (www.diabetergestemd.nl/) | Modified version of the Colour Your Life program. Designed to treat depression in patients with type 1 or type 2 diabetes mellitus. An RCT involving 255 adult patients showed reduced emotional distress with no change in glycemic control.16,31 | Netherlands |
| Spider Phobia Free† and Stress Free (http://virtually-free.com/) | Advocated by the NHS and AnxietyUK and designed to provide meditation, relaxation, self-hypnosis and breathing techniques to treat fear, anxiety and stress. An app version of each program is available to Canadians. The UK-based website claims more than 19 000 users of the apps. | INT |
| Moodkit† (www.thriveport.com/products/moodkit/) | Designed to provide more than 200 mood-improving activities and thought modulation strategies. Discover magazine called Moodkit “the happiness app.” | INT |
| Beating the Blues† (www.beatingtheblues.co.uk/) | Recommended by the UK NICE and available in Canada for a fee. The program is for patients with depression or anxiety and consists of eight weekly sessions of 50 minutes each, during which patients are taught to identify symptoms and set goals. Data indicate that statistically significant improvements in key measures of anxiety and depression are achieved.36 | INT |
| FearFighter† (www.fearfighter.com/) | Designed to treat patients with panic and phobia. This program is available in Canada for a fee; it is covered for NHS patients in the UK. The program consists of nine interactive steps with downloadable content, videos and homework exercises. An RCT for anxiety and depression showed improvement on a number of measures.37 Patients and referring health care providers reported a high level of satisfaction and ease with using this program.38 | INT |
| CBT-i Coach (available on iTunes) | Developed by the US Department of Veterans Affairs and designed to help patients with insomnia to improve their sleeping habits and to educate patients on how negative thoughts may affect sleep. In contrast to sleeping medications, Internet-delivered CBT for insomnia focuses on underlying reasons (thoughts) that disrupt or prevent healthy sleep patterns. | INT |
| MoodGYM (https://moodgym.anu.edu.au/welcome) | Developed in Australia and geared toward patients with anxiety and depression. There are at least 600 000 registered users, with translation to Finnish, Dutch, Norwegian and Chinese. The program consists of five interactive modules, quizzes and homework. In an RCT, post-intervention evaluation showed a significantly higher reduction in symptoms among patients who completed the program than among wait-listed controls.29 A majority of users found this program as acceptable as in-person CBT, stating that they were more likely to continue using MoodGYM over time.29 | INT |
| Online Therapy USER (www.onlinetherapyuser.ca/wac/welcome-to-the-wellbeing-after-cancer-course/) | Intended for patients who have recently completed cancer therapy and are experiencing depression or anxiety. The program has five parts and is completed in eight weeks, with weekly email interactions with a therapist. According to the website, 101 patients started the course, and 66 fully completed it; 94% of those who completed the program felt it was worth their time. | Saskatchewan |
| PTSD Coach Canada (www.veterans.gc.ca/eng/stay-connected/mobile-app/ptsd-coach-canada) | Developed by Veterans Affairs Canada for patients with post-traumatic stress disorder. Focuses on education as well as CBT techniques. The international version of this app (PTSD Coach) is estimated to have been downloaded more than 130 000 times in at least 78 countries. In a preliminary evaluation, patients reported satisfaction, improved symptom control and better sleep.39 | INT |
| OCFighter† (www.ocfighter.com/) | Developed in the UK for patients with OCD, it is available in Canada and the United States for a fee. The program leads to improvement in OCD symptoms. Two RCTs showed good adherence rates with therapist support for as little as 16 minutes per week.32,33 | INT |
| Pain Squad (www.sickkids.ca/Research/I-OUCH/Pain-Squad-App/index.html) | Developed by the Hospital for Sick Children (Toronto, Ontario), this app helps in management of pain for children with cancer. A usability and feasibility study showed high compliance rates and overall satisfaction.40 | INT |
Note: INT = internationally available, NA = not applicable, NHS = National Health Service (UK), NICE = National Institute for Health and Care Excellence (UK), OCD = obsessive–compulsive disorder, RCT = randomized controlled trial, UK = United Kingdom.
↵* Additional resources are available, some of which may be found at www.getselfhelp.co.uk/links2.htm.
↵† Fees are applicable for access to these programs.