Do the effects of internet-delivered cognitive-behavioral therapy (i-CBT) last after a year and beyond? A meta-analysis of 154 randomized controlled trials (RCTs)

Simple item page
dc.contributor.affiliationHarvard Medical School, Department of Health Care Policy, Boston, MA, USA; National University of Singapore, Department of Psychology, Kent Ridge Campus, Singapore
dc.contributor.emailhanizainal@nus.edu.sg (N.H. Zainal)
dc.creatorZainal, Nur Hani
dc.creatorSoh, Chui Pin
dc.creatorVan Doren, Natalia
dc.creatorBenjet, Corina
dc.date2024
dc.date.accessioned2026-05-27T18:36:24Z
dc.date.issued2024
dc.date.published2024
dc.descriptionAlthough the short-term efficacy of internet-delivered cognitive-behavioral therapy (i-CBT) is well-established, its long-term efficacy remains understudied. Robust variance estimation meta-analysis was thus conducted across guided and self-guided i-CBT, synthesizing data from 154 randomized controlled trials (N = 45,335) with ≥ 12-month follow-ups. For binary outcomes, guided (52.3% vs. 38.6%; log-risk ratio [LOG-RR] = 1.15 95% confidence interval [1.04, 1.26]) yielded higher remission, reliable improvement, and response rates, and lower suboptimal treatment outcome rates (9.3% vs. 10.8%; LOG-RR = 0.63 [0.45, 0.80]) than treatment-as-usual, active controls, and waitlists at ≥12 months. Insufficient studies precluded testing the efficacy between self-guided i-CBT and controls for binary outcomes. For baseline-to-12-month dimensional outcomes, guided i-CBT produced greater reductions in anxiety, depressive, post-traumatic stress disorder (PTSD) symptoms, and repetitive negative thinking (Hedge's g = -1.86 to -0.31), and self-guided i-CBT yielded stronger reductions in depressive symptoms (g = -0.51) than all controls. For outcome scores aggregated at ≥ 12-month follow-ups, guided i-CBT alleviated anxiety, depression, distress, insomnia, PTSD symptoms, role impairment, emotion regulation, and quality of life (g = -0.31 to 0.26), and self-guided i-CBT yielded lower anxiety and depressive symptoms (g = -0.16 to -0.09) than all controls. No significant differences in efficacy emerged between guided and self-guided i-CBT when sufficient studies existed for a meta-analysis. There was no evidence for publication bias. Long-term efficacy was similar to short-term efficacy for most outcomes. Implementing scalable i-CBTs should entail transparency about their long-term benefits and drawbacks.
dc.formatPDF
dc.identifierJC19DIEP24
dc.identifier.doi10.1016/j.cpr.2024.102518
dc.identifier.eissn1873-7811
dc.identifier.issn0272-7358
dc.identifier.organizacionInstituto Nacional de Psiquiatría Ramón de la Fuente Muñiz
dc.identifier.placeEstados Unidos
dc.identifier.urihttps://repositorio.inprf.gob.mx/handle/123456789/33
dc.identifier.urihttps://doi.org/10.1016/j.cpr.2024.102518
dc.identifier.urihttps://pmc.ncbi.nlm.nih.gov/articles/PMC11849760/
dc.language.isoeng
dc.publisherElsevier
dc.relation114:102518
dc.relation.jnabreviadoCLIN PSYCHOL REV
dc.relation.journalClinical Psychology Review
dc.rightsAcceso Cerrado
dc.subject.kwCommon mental disorders
dc.subject.kwDigital mental health interventions
dc.subject.kwInternet-delivered cognitive behavioral therapy
dc.subject.kwLong-term efficacy
dc.subject.kwMeta-analysis
dc.subject.kwRandomized controlled trial
dc.titleDo the effects of internet-delivered cognitive-behavioral therapy (i-CBT) last after a year and beyond? A meta-analysis of 154 randomized controlled trials (RCTs)
dc.typeArtículo

Files

License bundle

Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed to upon submission
Description:
Download

Collections

Artículos de revista