ORIGINAL RESEARCH article
Front. Psychol.
Sec. Psychology for Clinical Settings
Volume 16 - 2025 | doi: 10.3389/fpsyg.2025.1494729
The Association between Patient Engagement and Treatment Outcome in Guided Internet-delivered CBT for Anxiety and Depression
Provisionally accepted
- 1University of Oslo, Oslo, Norway
- 2Braive AS, Oslo, Norway
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Objective: This paper is a replication study seeking to examine the relationship between usage aspects of guided internet-delivered CBT (iCBT) and treatment outcomes for individuals suffering from depression and anxiety in a routine-care setting. Methods: Anonymous data of 514 patients who signed up for an internet-delivered, guided treatment program for depression or anxiety, were obtained for estimating patterns of change and the impact of predictors of change using Multilevel Modeling. Initial assessment after sign-up included various questionnaires and demographic information. Log data from user interactions with the guided iCBT programs was used to assess patient and clinician engagement. Clinical outcomes included symptoms of depression (Patient Health Questionnaire, PHQ-9) and anxiety (Generalized Anxiety Disorder-7, GAD-7). Results: Patients started a mean of 7.14 modules, completed 64.7% of assigned modules and 62.8% of assigned activities. Patients with clinical depression or anxiety levels experienced significant changes between initial assessment and first outcome assessment as well as significant symptom reduction during treatment. Initial symptom levels and engagement persistence predicted treatment outcomes. Conclusions: The present study replicates previous findings suggesting that safeguarding exposure to and engagement with content is significantly associated with outcome.
Keywords: Anxiety, Depression, iCBT, Symptom change, Predictors of change, User engagement, routine care
Received: 11 Sep 2024; Accepted: 13 May 2025.
Copyright: © 2025 Hammerfald, Jahren and Solbakken. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Karin Hammerfald, University of Oslo, Oslo, Norway
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