Treatment engagement and effectiveness of an internet-delivered cognitive behavioral therapy program at a university...

Objective: Technology can provide affordable, accessible mental health care and some research suggests internet-delivered Cognitive Behavior Therapy (iCBT) can be an effective treatment for various problems and can be an affordable, accessible alternative to traditional treatments. Advantages of iCBT over face-to-face therapy include lower cost, no travel time, easy access, no waitlists, and trackable progress. To our knowledge there have been no studies of iCBT programs used during the course of routine care. This study evaluated the usage and effectiveness of one iCBT program, SilverCloud (SC), in a university counseling center. Methods: Participants (N = 5568) were students at a large, private western university. Participants were either self-referred to the program, chose to enroll at intake as a standalone intervention, or were referred by their treating clinician as an adjunct to regular treatment. Data was analyzed using regression models with robust standard errors that allowed us to take into account the fact that there may be an effect of participants seeing the same therapist. Results: Results indicated that all three groups had comparable outcomes. However, usage was generally low (less than 10% of the program) and SC usage accounted for less than 1% of the variance in outcome. Conclusions: These results suggest that internet-delivered therapy may be a viable alternative to in-person therapy.