The Efficacy and Effectiveness of Online CBT - Jeroen Ruwaard

58 Chapter 3. Online CBT of Depression3.4.3 Future directionsThe present results certainly are encouraging and warrant further study of this programme.The treatment shares many characteristics with existing computer-aidedCBT, but includes more therapist guidance and appears to be more effective. Theresults therefore underscore the suggestion of Palmqvist et al. (2007) and Spek et al.(2007) that the efficacy of internet-based CBT is related to the amount of therapistguidance. However, the cost-benefit of various approaches of internet-based CBTawaits further exploration. Future trials should aim for direct comparisons betweenprogrammes with varying amounts of therapist guidance, and should evaluate patientpreference and treatment adherence as well as efficacy and costs.