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Cognitive therapy, pioneered by Aaron T. Beck in the 1960s, is a structured approach to addressing psychological distress by focusing on the influence of thoughts on emotions and behaviors. All cognitive therapies involve the basic assumption that human beings have control over their feelings, and that how individuals feel about something depends on how they think about it. Unlike psychoanalytic methods that delve into unconscious processes or humanistic approaches emphasizing...
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Behavior therapy incorporates diverse techniques rooted in classical conditioning principles to address maladaptive behaviors and anxiety disorders. These methods aim to reduce avoidance behaviors, foster adaptive coping mechanisms, and alter associations between stimuli and responses, making them effective in a wide range of therapeutic contexts.
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Web-Based, Human-Guided, or Computer-Guided Transdiagnostic Cognitive Behavioral Therapy in University Students With

Jurrijn Koelen1, Anke Klein1, Nine Wolters1

  • 1Department of Developmental Psychology, University of Amsterdam, Amsterdam, Netherlands.

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Summary

Internet-based cognitive behavioral interventions (iCBTs) are effective for depression and anxiety. This study found both human-guided and computer-guided iCBTs were marginally better than usual care for students, with no significant difference between guided approaches.

Keywords:
human guidanceiCBTinternet-based cognitive behavioral interventiontechnological guidancetransdiagnosticuniversity students

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Area of Science:

  • Mental Health
  • Digital Therapeutics
  • Clinical Psychology

Background:

  • Internet-based cognitive behavioral interventions (iCBTs) are established treatments for depression and anxiety.
  • The efficacy and feasibility of adding human guidance to iCBTs in large educational settings remain under investigation.

Purpose of the Study:

  • To compare the efficacy of human-guided iCBT, computer-guided iCBT, and care as usual (CAU) in university students.
  • To determine if human-guided iCBT is superior to computer-guided iCBT for treating depression and anxiety.

Main Methods:

  • 801 university students with elevated depression or anxiety were randomized to human-guided iCBT, computer-guided iCBT, or CAU.
  • Primary outcomes included depression (PHQ) and anxiety (GAD-7) scores, analyzed using linear mixed models.
  • Secondary outcomes assessed substance use, with follow-up at 6 and 12 months.

Main Results:

  • Both iCBT variants showed marginal superiority over CAU for depression and anxiety over 6 months.
  • All groups improved significantly over time; no significant differences were found between human-guided and computer-guided iCBT.
  • Human-guided iCBT demonstrated higher adherence than computer-guided iCBT.

Conclusions:

  • Transdiagnostic iCBT is a practical and effective mental health treatment for university students.
  • Human guidance is not demonstrably superior to technological guidance in this context.
  • Future research should explore implementation scale and cost-effectiveness of human support in iCBT.