Andrews, G., & Williams, A.D. (2014). Up-scaling clinician assisted internet cognitive behavioural therapy (iCBT) for depression: A model for dissemination into primary care. Clinical Psychology Review. Advance online publication. doi: 10.1016/j.cpr.2014.05.006. PMID: 25043445.
Many internet-based cognitive behavioral therapy (iCBT) courses for depression have been developed and tested. In this article, the authors review the evidence for these courses and present a model for using iCBT courses in primary care settings. iCBT courses typically use psychoeducational techniques to help patients control throughts, behaviors, and emotions contributing to depression. Previous studies have shown that iCBT courses contribute to long-lasting decreases in depressive symptoms. When compared to face-to-face CBT programs, iCBT courses reduce depression comparably. Although primary care providers worried that iCBT courses might be associated with increased suicidality or worsening of depression symptoms, past research found that iCBT courses are safe and effective for patients. The authors also described a model for disseminating iCBT to primary care patients with depression. By making iCBT programs available to primary care clinicians in Australia, doctors and psychiatrists were able to assess patients, and then refer them to a relevant iCBT program. Patients were charged a one-time fee to access an iCBT course, and could then complete the program at home. Providers were notified if patients became suicidal or had increased depressive symptoms. While this article provides one model for disseminating iCBT to patients, the authors suggest that more research on dissemination is needed.