Up-scaling clinician assisted internet cognitive behavioural therapy (iCBT) for depression: A model for dissemination into primary care

• iCBT for depression meets criteria for a well-established treatment.
• iCBT can function as a therapy enhancer and physician extender.
• Upscaling of iCBT into primary care is feasible.

Depression is a global health problem but only a minority of people with depression receive even minimally adequate treatment. Internet delivered automated cognitive behaviour therapy (iCBT) which is easily distributed and in which fidelity is guaranteed could be one solution to the problem of increasing coverage. In this review of iCBT for Major Depressive Disorder in adults, we address the concerns of clinicians in utilizing this technology by reviewing the research evidence with reference to efficacy and effectiveness and presenting a model for dissemination and uptake of iCBT into practice. This review includes studies of participants who would meet criteria for major depressive disorder who were supported as they learnt and implemented changes in thoughts, emotions and behaviours by using cognitive behaviour principles. We conclude that this form of treatment is effective and acceptable to both patients and clinicians.