Efficacy and Effectiveness of Online CBT: A decade of Interapy Research (2011)

Ruwaard, J., A. Lange, B. Schrieken and P. Emmelkamp (2011). Efficacy and Effectiveness of Online Cognitive Behavioral Treatment: A decade of Interapy Research. Annual Review of Cybertherapy and Telemedicine 2011. Advanced Technologies in Behavioral, Social and Neurosciences. B.K. Wiederhold, S. Bouchard and G. Riva. Amsterdam, The Interactive Media Institute and IOS Press: 9-14.


Abstract Since 1996, researchers of the Interapy research group of the University of Amsterdam have been examining the effects of online cognitive behavioral treatment (online CBT). Over the years, the group conducted nine controlled trials of online CBT of a variety of mental health disorders, among a total of 840 participants. These studies suggest that online CBT is a viable and effective alternative to face to face treatment. Treatment adherence was 82%, and reductions in psychopathology represented a large between-group effect size of SMD = 0.9 (95% CI: .7 to 1.1), which were maintained over long periods. The research culminated in the foundation of the Interapy clinic, which received Dutch health regulatory body approval in 2005. Since then, costs of online CBT are reimbursed through public health insurance. A large study of treatment outcome of 1500 patients of the Interapy clinic showed that effects in clinical practice are similar to those observed in the controlled trials, and comparable to selected benchmarks of naturalistic studies of face to face CBT. The accumulated evidence provides compelling support for the efficacy and effectiveness of online CBT.

Keywords. Cognitive Behavior Therapy; Computer assisted protocol directed therapy; Effectiveness Studies; Follow-Up Studies; Internet; Randomized controlled trial; Treatment Outcome;