The aim of the paper was to systematically review the literature on computer-based psychological treatments for depression and conduct a meta-analysis of the RCT studies, including examining variables which may effect outcomes. Database and hand searches were made using specific search terms and inclusion criteria. The review included a total of 40 studies (45 published papers), and 19 RCTs (23 published papers)were included in a standard meta-analysis. The review describes the different computer- research is required to determine the best type, frequency, and duration of human support for users (Marks, Cavanagh, & Gega, 2007). Secondly, dropout is a continued cause of concern, with only just over half completing all sessions (Waller & Gilbody, 2009). Whether support predicts dropout is of importance, but has yet to be determined.The current systematic review and meta-analysis sought to evaluate the overall effectiveness of computer-based treatments for depression, as well as examining the impact of support on dropout rates and clinical outcomes. A number of other reviews and meta-analysis exist to date (Andersson & Cuijpers, 2009; Barak, Hen, BonielNissim, & Shapira, 2008; Spek, Cuijpers et al., 2007).This paper aimed to provide a systematic update to this previous work and to use meta- All results were assessed at either title, abstract, or by reading the full paper to determine whether the study met the established inclusion criteria. Included studies could be deployed using a variety of different computer-based technologies, synchronously and asynchronously, they could be solely self-administered or therapistled; or a blended delivery using both. Study participants had to be adults (18+ years) with depression (self-report or diagnosis), established using valid and reliable measures, whom may also have had comorbidity, e.g. anxiety or physical health problems. Studies included were published in peer-reviewed journals in English in the last 10 years, which investigated a computer-based treatment for depression, and included reliable and valid A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPTCOMPUTER-BASED PSYCHOLOGICAL TREATMENTS FOR DEPRESSION 5 outcome measures for assessing depression. Participants could be from the general population or a clinical group so long as depression was specifically measured.Preliminary research into recent developments in computerized paradigms for depression such as cognitive bias modification (CBM) based interventions were not considered for inclusion (e.g. Blackwell & Holmes, 2010).Duplicates were rejected and studies were assessed by the first author, any difficulties discussed with the second author, and a final decision reached. Finally, a hand search was made of papers to identify other relevant studies for inclusion. For the systematic review a comprehensive summary of information extracted from the papers was written, that considered the interventions employed, methodological design, communication and support types used in the studies, clinical outcomes, ...

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Future analysis should investigate these confounding variables, helping shape the future of obesity management programmes and oral health interventions, through determining common risk factors.

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Objective: This article aimed to critically review the literature on online counseling.Method: Database and hand--searches were made using search terms and eligibility criteria, yielding a total of 123 studies.Results: The review begins with what characterizes online counseling. Outcome and process research in online counseling is reviewed. Features and cyberbehaviors of online counseling such as anonymity and disinhibition, convenience, time--delay, the loss of social signaling, and writing behavior in cyberspace are discussed. Ethical behavior, professional training, client suitability, and clients' and therapists' attitudes and experiences of online counseling are reviewed.Conclusion: A growing body of knowledge to date is positive in showing that online counseling can have a similar impact and is capable of replicating the facilitative conditions as face--to--face encounters. A need remains for stronger empirical evidence to establish efficacy and effectiveness and to understand better the unique mediating and facilitative variables.The field of cyberpsychology involves the study of human experiences (cognitive, emotional, and behavioral) that are related to or effected by developing technologies, in other words the psychological study of human--technology interaction (Richards & Viganó, 2012). One area of cyberpsychology is online counseling, also referred to as e--therapy, e--counseling, or cybertherapy. While the very nature and definition of online counseling have been debated, we will use the one employed by Richards and Viganó (2012), defining online counseling as the delivery of therapeutic interventions in cyberspace where the communication between a trained professional counselor and client(s) is facilitated using computer--mediated communication (CMC) technologies, provided as a stand--alone service or as an adjunct to other therapeutic interventions.Alongside technological developments online counseling has grown in the past 15 or so years. Researchers in online counseling have been considering the potential effectiveness of online counseling and whether it is possible to establish a therapeutic relationship in cyberspace. Research studies have focused on establishing its potential benefits and challenges, client suitability for online counseling, therapists' and clients' attitudes and experiences of online counseling, and professional training for working online with clients. Additionally, its very nature and definition as a therapeutic intervention has been debated. Researchers have been exploring newly observed phenomena that form part of understanding the psychology of online counseling behavior. Areas of interest include the effects of apparent anonymity and distance, disinhibition, identity and impression management, writing and emotional expression in cyberspace, and ethical behavior in cyberspace.While other reviews of online counseling have been written, notably, the special issue from the Journal of Clinical Psychology, 2004, and the volume from The Counseling Psychologist, 2005,...

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Utilization of internet-delivered cognitive behavioural therapy (iCBT) for treating depression and anxiety disorders in stepped-care models, such as the UK’s Improving Access to Psychological Therapies (IAPT), is a potential solution for addressing the treatment gap in mental health. We investigated the effectiveness and cost-effectiveness of iCBT when fully integrated within IAPT stepped-care settings. We conducted an 8-week pragmatic randomized controlled trial with a 2:1 (iCBT intervention: waiting-list) allocation, for participants referred to an IAPT Step 2 service with depression and anxiety symptoms (Trial registration: ISRCTN91967124). The primary outcomes measures were PHQ-9 (depressive symptoms) and GAD-7 (anxiety symptoms) and WSAS (functional impairment) as a secondary outcome. The cost-effectiveness analysis was based on EQ-5D-5L (preference-based health status) to elicit the quality-adjust life year (QALY) and a modified-Client Service Receipt Inventory (care resource-use). Diagnostic interviews were administered at baseline and 3 months. Three-hundred and sixty-one participants were randomized (iCBT, 241; waiting-list, 120). Intention-to-treat analyses showed significant interaction effects for the PHQ-9 (b = −2.75, 95% CI −4.00, −1.50) and GAD-7 (b = −2.79, 95% CI −4.00, −1.58) in favour of iCBT at 8-week and further improvements observed up to 12-months. Over 8-weeks the probability of cost-effectiveness was 46.6% if decision makers are willing to pay £30,000 per QALY, increasing to 91.2% when the control-arm’s outcomes and costs were extrapolated over 12-months. Results indicate that iCBT for depression and anxiety is effective and potentially cost-effective in the long-term within IAPT. Upscaling the use of iCBT as part of stepped care could help to enhance IAPT outcomes. The pragmatic trial design supports the ecological validity of the findings.