Cognitive Behavioral Therapy Online for Adult Depression: A 10 Year Systematic Literature Review

Abstract

Background: Acceptance, adherence and efficacy aspects of Cognitive Behavioural Therapy (CBT) online have invited significant interest, especially in the context of “stepped care” models, which advocate progressive stages of intervention in addressing depression. Objectives: The current work aspires to comprehensively identify critical factors linked to the applicability of online CBT, in order to inform clinical practices and future research targeting depressive behaviors in early and middle adulthood. Methods: To serve these goals: a) the PRISMA systematic literature perspective is followed; b) a systematic search of online databases between 2008-2018 was undertaken and; c) a compositehybrid model, resulting from the integration of broadly adopted conceptualizations from the areas of psychological treatment and internet use behaviors, was combined with an interpretative phenomenological analysis perspective to organize the findings. Results: In total, 28 studies were included in the present review. Factors defining the efficacy, adherence and acceptability of online CBT targeting depression (during early and middle adulthood) were classified into parameters related to the individual receiver, the context and the CBT activities involved. Conclusion: Despite the cautiousness warranted by the limitations, as well as the diverge methodology of the reviewed studies, findings appear to favour the provision of brief, therapist supported, online CBT interventions, especially in addressing moderate depression during early and middle adulthood.