Intended for healthcare professionals


Therapist guided internet delivered cognitive behavioural therapy

BMJ 2014; 348 doi: (Published 10 March 2014) Cite this as: BMJ 2014;348:g1977
  1. Erik Hedman, postdoctoral researcher
  1. 1Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden
  1. kire.hedman{at}

Can be highly effective and is used to increase access to psychological treatment

There are two main forms of internet delivered cognitive behavioural therapy—fully automated open access programmes without therapist contact and programmes guided by a therapist, which are conducted in a context similar to that of regular healthcare. This editorial focuses on therapy that is guided by a therapist, with scheduling that mirrors face to face treatment.1

Because the mechanisms for improvement are the same for internet delivered cognitive behavioural therapy as for face to face therapy, the patient should be exposed to the same interventions. So, if exposure to a feared object—such as snakes in patients with a phobia about snakes—is important in face to face therapy, then it is equally important in internet delivered therapy. In essence, internet delivered therapy is not a new treatment in itself but rather a new framework for providing psychological treatments.

The patient accesses the treatment through a personal account in a secure internet based treatment platform. The most important elements of the treatment are modules, often eight to 15, whose content reflects that of sessions in face to face therapy and provides …

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