Internet Cognitive Behavioral Therapy is Effective and Cost Efficient

Cognitive behavioral therapy (CBT) is a common therapeutic approach used to address a variety of mental health issues. However, not everyone has access to CBT services. The financial burden of receiving treatment can also prohibit many individuals from reaping the rewards of this type of therapy. Untreated mental health conditions extract a big cost from individuals, families, and society. For people with health anxiety, the overuse of medical services can put a financial burden on communities and families. Therefore, it is imperative that people with health anxiety be provided every opportunity to get the help they need, including access to CBT, which has been shown to be highly effective in the treatment of anxiety. Utilizing modern technology may be one way to accomplish this, but little research has tested the effectiveness of this type of approach.

To validate the effectiveness of Internet CBT (ICBT), Erik Hedman of the Division of Psychology and the Department of Clinical Neuroscience at Karolinska Institutet in Sweden recently conducted a study comparing the immediate and long-term effects of ICBT to an attention control method (CC) in a sample of 81 participants with health anxiety. He found that those in the ICBT condition improved far more than those in the CC. Also, each case of remission that occurred in the ICBT group led to a statistical financial gain for society, decreasing the overall economic burden of health anxiety. Additionally, the gains made during the ICBT were maintained over the one year follow-up period.

These results are significant for many reasons. First, ICBT requires a minimal investment of time for therapists. In fact, in this study, therapists invested approximately two hours of time for each participant during the one year period. This factor alone is promising as the minimal investment of time and resources allows therapists to extend their therapeutic reach without compromising consistency and effectiveness. Also, results show that most relapses will occur prior to one year. In this study, the gains made during ICBT were mostly maintained over the one year period, indicating that the long-term costs of personal and societal burden were dramatically reduced. “From an economic societal health-care policy perspective, the findings strongly support the implementation of ICBT because health gains can be made while reducing the net costs of the disorder,” said Hedman.

Hedman, E., et al. Cost effectiveness and long-term effectiveness of Internet-based cognitive behaviour therapy for severe health anxiety. Psychological medicine 43.2 (2013): 363-74. ProQuest Research Library. Web. 30 Jan. 2013.

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  • Laura g

    Laura g

    February 5th, 2013 at 3:51 PM

    I sure do hope that this ends up being the reality because I have to admit that the first thing that I asked myself when I saw tyhis story title was “Yes but is it any good?”

    there are so many good people who need help and the internet might be the only feasible way for them to receive it, but at what cost? You don’t want to have something that is that readily accessible but that in the end could do more damage that it can do good.

    I guess I am still kind of old school with my approach, thinking that I would get more bang for my effort by meeting with a therapist face to face. But I guess this isn’t a possibility for some people, so I suppose that it would at least be worth a try.

  • Jason


    February 6th, 2013 at 3:55 AM

    If you can find good therapists willing to offer their services in an online setting, and they know they will be reaching more people than their normal practice alone would, then I think that this is a brilliant idea. Many people who need care do not have access, time, or even the money or insurance to seek out this kind of care. This is the thing that will be allowed to fall to the bottom of the totem pole in terms of importance. There are other things that they feel have to be a priority.

    But if you think about it, offering services like this for them could actually increase their individual productivity and make them much more engaged in society as a whole once they start to feel better. This is truly a win-win situation if the services are made available to those who may not have otherwise had access to it.

  • Mike


    February 6th, 2013 at 3:26 PM

    still not the end all solution
    there are still quite a few people who don’t have internet
    so that doesn’t help them out too much with access to services

  • Joel


    February 6th, 2013 at 11:59 PM

    As much as I’d like this to be a success, what I’d also like to see is some sort of mental health tourism. We have a few places now where it’s easier to get health treatment at a much cheaper price than here. Maybe we could have something of that sort with regard to mental healthcare?

    Also what needs to be considered is the healthcare facilities here. Because not having insurance can have you making a choice between spending and a threat to your life.

  • stacie r

    stacie r

    February 7th, 2013 at 4:05 AM

    I am all for this! We are all online all the time anyway, so why not find something more constructive to do with our web time than to simply look at sites that are brain numbing? How about doing something good for ourselves online for a change? I think that this is a wonderful avenue for anyone to pursue, especially those people who may have more limited funds or access to good care- this is the perfect answer for them. So now there are no excuses, no barriers, they simply have to be willing to seek it out or have someone help them to find a reputable site and therapist who is working with and accepting online clients. Brilliant!

  • kenny


    February 8th, 2013 at 12:31 PM

    happy to hear that treatment will now be more accessible to more and more people. but they should also fine tune the things that would play a part if this is to be a success on a larger platform. first of all the way a therapist should interact online would be a little different than IRL.. next the feedback that they relieve from the client would also be a little different. Then how the client and therapist choose to meet again or have another session needs to be sorted out.all minors issues and if they really out in some effort this could be life changing for so many people out there who can hardly pay for therapy.

  • Rebecca Fountain

    Rebecca Fountain

    March 4th, 2013 at 6:23 PM

    As a young therapist in the psychology field, I am so excited to see the research build on the efficacy of internet therapy. Internet therapy will allow individuals to get specialized treatment in a much more convenient format. Yes, there are certainly issues to consider and ethical guidelines to adapt to this new modality; however, making therapy and treatment more convenient will hopefully greatly improve mental health as a whole in the US. I actually have several blog posts on this very topic on my own site,

  • Eileen


    February 22nd, 2016 at 3:53 PM

    I have been researching ICBT and find it to be very promising. It will give many more people access to care. However I seem to be finding that some people are assuming it will be free. While it may be less expensive, depending on the website, it won’t be free. While the cost is definitely a factor, the real plus will be access to services. Think of people with agoraphobia, shut-ins, perhaps even people being abused and fearful of leaving the house because it will anger their partner, patients receiving chemo and so many other reason they can’t make in to a therapist, or people that live in rural areas that can’t get into a town. I, myself, am looking forward to seeing what this can bring to the world of therapy.

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