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Providing therapist‐guided cognitive behaviour therapy via the Internet (ICBT) has advantages, but a central research question is to what extent similar clinical effects can be obtained as with gold‐standard face‐to‐face cognitive behaviour therapy (CBT). In a previous meta‐analysis published in this journal, which was updated in 2018, we found evidence that the pooled effects for the two formats were equivalent in the treatment of psychiatric and somatic disorders, but the number of published randomized trials was relatively low (n=20). As this is a field that moves rapidly, the aim of the current study was to conduct an update of our systematic review and meta‐analysis of the clinical effects of ICBT vs. face‐to‐face CBT for psychiatric and somatic disorders in adults. We searched the PubMed database for relevant studies published from 2016 to 2022. The main inclusion criteria were that studies had to compare ICBT to face‐to‐face CBT using a randomized controlled design and targeting adult populations. Quality assessment was made using the Cochrane risk of bias criteria (Version 1), and the main outcome estimate was the pooled standardized effect size (Hedges’ g) using a random effects model. We screened 5,601 records and included 11 new randomized trials, adding them to the 20 previously identified ones (total n=31). Sixteen different clinical conditions were targeted in the included studies. Half of the trials were in the fields of depression/depressive symptoms or some form of anxiety disorder. The pooled effect size across all disorders was g=0.02 (95% CI: –0.09 to 0.14) and the quality of the included studies was acceptable. This meta‐analysis further supports the notion that therapist‐supported ICBT yields similar effects as face‐to‐face CBT.

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ImportanceSocial anxiety disorder (SAD) can be adequately treated with cognitive behavioral therapy (CBT). However, there is a large gap in knowledge on factors associated with prognosis, and it is unclear whether symptom severity predicts response to CBT for SAD.ObjectiveTo examine baseline SAD symptom severity as a moderator of the association between CBT and symptom change in patients with SAD.Data SourcesFor this systematic review and individual patient data meta-analysis (IPDMA), PubMed, PsycInfo, Embase, and the Cochrane Library were searched from January 1, 1990, to January 13, 2023. Primary search topics were social anxiety disorder, cognitive behavior therapy, and randomized controlled trial.Study SelectionInclusion criteria were randomized clinical trials comparing CBT with being on a waiting list and using the Liebowitz Social Anxiety Scale (LSAS) in adults with a primary clinical diagnosis of SAD.Data Extraction and SynthesisAuthors of included studies were approached to provide individual-level data. Data were extracted by pairs of authors following the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline, and risk of bias was assessed using the Cochrane tool. An IPDMA was conducted using a 2-stage approach for the association of CBT with change in LSAS scores from baseline to posttreatment and for the interaction effect of baseline LSAS score by condition using random-effects models.Main Outcomes and MeasuresThe main outcome was the baseline to posttreatment change in symptom severity measured by the LSAS.ResultsA total of 12 studies including 1246 patients with SAD (mean [SD] age, 35.3 [10.9] years; 738 [59.2%] female) were included in the meta-analysis. A waiting list–controlled association between CBT and pretreatment to posttreatment LSAS change was found (b = –20.3; 95% CI, −24.9 to −15.6; P d = –0.95; 95% CI, −1.16 to −0.73). Baseline LSAS scores moderated the differences between CBT and waiting list with respect to pretreatment to posttreatment symptom reductions (b = –0.22; 95% CI, −0.39 to −0.06; P = .009), indicating that individuals with severe symptoms had larger waiting list–controlled symptom reductions after CBT (Cohen d = –1.13 [95% CI, −1.39 to −0.88] for patients with very severe SAD; Cohen d = –0.54 [95% CI, −0.80 to −0.29] for patients with mild SAD).Conclusions and RelevanceIn this systematic review and IPDMA, higher baseline SAD symptom severity was associated with greater (absolute but not relative) symptom reductions after CBT in patients with SAD. The findings contribute to personalized care by suggesting that clinicians can confidently offer CBT to individuals with severe SAD symptoms.

Preliminary evidence suggest psilocybin in conjunction with psychotherapy may be effective in reducing depression and anxiety symptoms, but patient-level variables associated with treatment response are unclear. This study will use an individual participant data meta-analysis to investigate baseline predictors of treatment response in psilocybin trials.

Preliminary evidence suggest psilocybin in conjunction with psychotherapy may be effective in reducing depression and anxiety symptoms, but prevalence of adverse effects in these trials is unclear. This study will use an individual participant data meta-analysis to investigate clinically significant worsening of depression and anxiety symptoms in psilocybin trials.

The goal of this study is to test the effectiveness of an internet-based intervention, Med-Stress SOS dedicated to medical professionals. This intervention has been designed to support its users in coping with prolonged exposure to critical stressors at work. Although it was created in response to the pandemia of SARS-CoV-2, it can be also used under other difficult circumstances. It focuses on enhancing psychological resources—self-efficacy and perceived social support—and on decreasing strain through relaxation, mindfulness, physical and pleasant activities. The effectiveness of Med-Stress SOS will be tested in a pretest-posttest design.

Additional file 1. TIDIER.

SPIRIT 2013 Checklist: Recommended items to address in a clinical trial protocol and related documents. (DOCX 39 kb)

Table S1. Trial registration data. (DOCX 17 kb)

Background Internet-based cognitive behavioral therapy (ICBT) has proven to be an effective treatment in improving patients' ability to cope with tinnitus. However, some patients prefer face-to-face therapy to ICBT, and a few studies have shown considerable dropout rates if the treatment is not guided. This renders it important to identify factors that contribute to the commencement and continuation of ICBT programs. Aims Because treatment motivation and expectations are important factors in psychological treatment, the aim of our study was to investigate what leads tinnitus patients to seek out ICBT, what helps them to keep up with the treatment, and what (if any) impact these factors have on dropout rates and treatment outcomes. Method 112 tinnitus patients taking part in ICBT for tinnitus responded to symptom-related questionnaires at three points in time (pre-treatment, post-treatment, and one-year-follow-up) and to a questionnaire consisting of open-ended questions about their treatment motivation and expectations before beginning treatment. Data were analyzed using qualitative content analysis, and the results were used to divide the participants into groups. The treatment outcomes of these groups were compared using t-tests, χ2-tests, and both one-factorial and mixed ANOVAs. Results Four main categories emerged as factors conducive to starting treatment: 1) Targets participants wanted to address, 2) circumstances that led to participation, 3) attitudes towards the treatment, and 4) training features. Participants identified six facilitators for continuing the treatment: success, training, individual attitude, hope, evidence, and support. Naming specific tinnitus-associated problems as targets was associated with greater improvement from pre-treatment to 1-year-follow-up. Describing an active involvement in the treatment was related to increased improvement from post-treatment to follow-up. Conclusion There are several motivational factors that tinnitus patients consider relevant for beginning and continuing ICBT. Particularly, focusing on specific targets that do not involve the tinnitus itself, and encouraging participants to take an active role in treatment may increase treatment effectiveness. However, further hypothesis-guided research is necessary to confirm our explorative results., Highlights • Analysis of tinnitus patients’ explanations what makes them seek and keep up an Internet-based treatment • Most participants started treatment to address the tinnitus and its accompanying problems, or due to a lack of alternatives • Especially treatment success and helpful training contents were regarded as important for keeping up motivation • Having specific targets other than the tinnitus and taking an active role might be beneficial for treatment outcome

Psychology as a science offers an enormous diversity of theories principles and methodological approaches to understand mental health abnormal functions and behaviours and mental disorders. A selected overview of the scope current topics as well as strength and gaps in Psychological Science may help to depict the advances needed to inform future research agendas specifically on mental health and mental disorders. From an integrative psychological perspective most maladaptive health behaviours and mental disorders can be conceptualized as the result of developmental dysfunctions of psychological functions and processes as well as neurobiological and genetic processes that interact with the environment. The paper presents and discusses an integrative translational model linking basic and experimental research with clinical research as well as population based prospective longitudinal studies. This model provides a conceptual framework to identify how individual vulnerabilities interact with environment over time and promote critical behaviours that might act as proximal risk factors for ill health and mental disorders. Within the models framework such improved knowledge is also expected to better delineate targeted preventive and therapeutic interventions that prevent further escalation in early stages before the full disorder and further complications thereof develop. In contrast to conventional "personalized medicine" that typically targets individual (genetic) variation of patients who already have developed a disease to improve medical treatment the proposed framework model linked to a concerted funding programme of the "Science of Behaviour Change" carries the promise of improved diagnosis treatment and prevention of health risk behaviour constellations as well as mental disorders.