Skip to main content Accessibility help

Computerised cognitive behavioural therapy: helping Ireland log on

  • C. Twomey (a1) (a2), G. O'Reilly (a1) and M. Byrne (a2)

The aim of this article is to review and highlight evidence-based computerised cognitive behavioural therapy (cCBT) programmes that can potentially be used in Ireland for the treatment of mild-to-moderate mental health difficulties.


The authors undertook a literature search using three databases, and consulted a recognised, university-developed web portal. For a programme to be included in this review, it had to (a) have at least one randomised controlled trial demonstrating its efficacy; (b) be available on the internet; and (c) be delivered in English.


Twenty-five cCBT programmes that met the inclusion criteria were profiled. Taken together, these programmes target various anxiety difficulties (i.e. generalised anxiety, panic/phobia, social anxiety and post-traumatic stress), depression (or low mood), eating problems, stress, insomnia, pain and alcohol misuse.


cCBT programmes, preferably administered as part of a stepped-care model, offer effective, low-cost and low-intensity interventions for a wide range of psychological problems. Their use could be beneficial given how underdeveloped primary care mental health services are in Ireland.

Corresponding author
*Address for correspondence: Dr M. Byrne, Principal Psychologist Manager, Psychology Department, Health Service, Executive West, Primary Care Centre, Golf Links Road, Roscommon, Dublin, Ireland. (Email
Hide All
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorder, 4th edn. American Psychiatric Association: Washington, DC.
Andersson, G, Cuijpers, P (2009). Internet-based and other computerized psychological treatments for adult depression: a meta-analysis. Cognitive Behaviour Therapy 38, 196205.
Andrews, G, Cuijpers, P, Craske, MG, McEvoy, P, Titov, N (2010). Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: a meta-analysis. PLoS ONE 5, e13196 . doi:10.1371/journal.pone.0013196.
Andrews, G, Davies, M, Titov, N (2011). An effectiveness randomized controlled trial of face to face versus internet cognitive behaviour therapy for social phobia. Australian and New Zealand Journal of Psychiatry 45, 337340.
Barr Taylor, C, Bryson, S, Luce, KH, Cunning, D, Celio Doyle, A, Abascal, LB, Rockwell, R, Dev, P, Winzelberg, AJ, Wilfley, DE (2006). Prevention of eating disorders in at-risk college-age women. Archives of General Psychiatry 63, 881888.
Beacon [homepage on the internet] (2012). Accessed 5 April 2012.
Beck, AT, Steer, RA (1990). Beck Anxiety Inventory Manual. The Psychological Corporation: San Antonia, TX.
Beck, AT, Steer, A, Brown, GK (1996). Beck Depression Inventory Manual, 2nd edn. The Psychological Corporation: San Antonia, TX.
Billings, DW, Cook, RF, Hendrickson, A, Dove, DC (2008). A web-based approach to managing stress and mood disorders in the workforce. Journal of Occupational and Environmental Medicine 50, 960968.
Blankers, M, Koeter, MJW, Schippers, GM (2011). Internet therapy versus internet self-help versus no treatment for problematic alcohol use: a randomized controlled trial. Journal of Consulting and Clinical Psychology 79, 330341.
Botella, C, Gallego, MJ, García-Palacios, A, Guillen, V, Baños, RM, Quero, S, Alcaniz, M (2010). An internet-based self-help treatment for fear of public speaking: a controlled trial. Cyberpsychology, Behaviour and Social Networking 13, 407421.
Calear, AL, Christensen, H, Mackinnon, A, Griffiths, KM, O'Kearney, R (2009). The YouthMood Project: a cluster randomized controlled trial of an online cognitive behavioral program with adolescents. Journal of Consulting and Clinical Psychology 77, 10211032.
Carlson, EB, Putnam, FW, Ross, CA, Torem, M, Coons, P, Dill, DL, Loewenstein, RJ, Braun, BG (1993). Validity of the Dissociative Experiences Scale in screening for multiple personality disorder: a multicenter study. American Journal of Psychiatry 150, 10301036.
Carrad, I, Crepin, C, Rouget, P, Lam, T, Golay, A, Van der Linden, M (2011). Randomised controlled trial of a guided self-help treatment on the internet for binge eating disorder. Behaviour Research and Therapy ; doi:10.1016/j.brat.2011.05.004.
Celio, AA, Winzelberg, AJ, Wilfley, DE, Eppstein-Herald, E, Springer, EA, Dev, P, Barr Taylor, C (2000). Reducing risk factors for eating disorders: comparison of an internet- and a classroom-delivered psychoeducational program. Journal of Consulting and Clinical Psychology 68, 650657.
Chambless, DL, Caputo, GC, Bright, P, Gallagher, R (1984). Assessment of fear of fear in agoraphobics: The Body Sensations Questionnaire and the Agoraphobic Cognitions Questionnaire. Journal of Consulting and Clinical Psychology 52, 10901097.
Chambless, DL, Caputo, GC, Jasin, SE, Gracely, EJ, Williams, C (1985). The mobility inventory for agoraphobia. Behaviour Research and Therapy 23, 3544.
Chiauzzi, E, Pujol, LA, Wood, M, Bond, K, Black, R, Yiu, E, Zacharoff, K (2010). PainACTION-Back pain: a self-management website for people with chronic back pain. Pain Medicine 11, 10441058.
Christensen, H, Griffiths, KM, Jorm, AF (2004). Delivering interventions for depression by using the internet: randomised controlled trial. BMJ 328, 265268.
Christensen, H, Murray, K, Calear, AL, Bennett, K, Bennett, A, Griffiths, KM (2010). Beacon: a web portal to high-quality mental health websites for use by health professionals and the public. Medical Journal of Australia 192, S40S44.
Clarke, G, Kelleher, C, Hornbrook, M, DeBar, L, Dickerson, J, Gullion, C (2009). Randomized effectiveness trial of an internet, pure self-help, cognitive behavioral intervention for depressive symptoms in young adults. Cognitive Behavior Therapy 38, 222234.
Cleeland, CS, Ryan, KM (1994). Pain assessment: global use of the brief pain inventory. Annals of the Academy of Medicine, Singapore 23, 129138.
Copty, M (2004). Mental Health in Primary Care. Irish College of General Practitioners/South Western Area Health Board: Dublin.
Cuijpers, P, Smit, F, Bohlmeijer, E, Hollon, SD, Andersson, G (2010). Efficacy of cognitive-behavioural therapy and other psychological treatments for adult depression: meta-analytic study of publication bias. British Journal of Psychiatry 196, 173178.
Department of Health and Children (2006). A Vision for Change: Report of the Expert Group on Mental Health Policy. Stationery Office: Dublin.
Fairbank, JC, Couper, J, Davies, JB, O'Brien, JP (1980). The Oswestry Low Back Pain Disability Questionnaire. Physiotherapy 66, 271273.
Fairburn, CG, Beglin, SJ (1994). Assessment of eating disorders: interview or self-report questionnaire? International Journal of Eating Disorders 16, 363370.
Farrer, L, Christensen, H, Griffiths, KM, Mackinnon, A (2011). Internet-based CBT for depression with and without telephone tracking in a national helpline: randomised controlled trial. PLoS ONE 6, e28099 . doi:10.1371/journal.pone.0028099.
Furmark, T, Tillfors, M, Everz, P, Marteinsdottir, I, Gefvert, O (1999). Fredikson MSocial phobia in the general population: prevalence and sociodemographic profile. Social Psychiatry and Psychiatric Epidemiology 34, 416424.
Garner, DM, Olmsted, MP (1984). Eating Disorder Inventory Manual. Psychological Assessment Resources: New York.
Goldberg, D (1972). The Detection of Psychiatric Illness by Questionnaire. Maudsley Monograph no. 21. London: Oxford University Press.
Griffiths, KM, Christensen, H, Jorm, AF, Evans, K, Groves, C (2004). Effect of web-based depression literacy and cognitive-behavioural therapy interventions on stigmatising attitudes to depression: randomised controlled trial. British Journal of Psychiatry 185, 342349.
HeadsUp [homepage on the internet] (2012). Accessed 10 April 2012.
Hickie, IB, Davenport, TA, Luscombe, GM, Moore, M, Griffiths, KM, Christensen, H (2010). Practitioner-supported delivery of internet-based cognitive behaviour therapy: evaluation of the feasibility of conducting a cluster randomised trial. Medical Journal of Australia 192, S31S35.
Hicks, CL, von Baeyer, CL, McGrath, PJ (2006). Online psychological treatment for pediatric recurrent pain: a randomized evaluation. Journal of Pediatric Psychology 31, 724736.
Hoifort, RS, Strom, C, Kolstrup, N, Eisemann, M, Waterloo, K (2011). Effectiveness of cognitive behavioural therapy in primary health care: a review. Family Practice 28, 489504.
Hollon, SD, Kendall, PC (1980). Cognitive self statements in depression: development of an automatic thoughts questionnaire. Cognitive Therapy Research 4, 383395.
Houck, PR, Spiegel, DA, Shear, MK, Rucci, P (2002). Reliability of the self report version of the panic disorder severity scale. Depression and Anxiety 15, 183185.
Hughes, M, Byrne, M, Synnott, J (2010). Prevalence of psychological distress in general practitioner adult attendees. Clinical Psychology Forum 206, 3338.
Jacobi, C, Morris, L, Beckers, C, Bronisch-Holtze, J, Winter, J, Winzelberg, AJ, Barr Taylor, C (2007). Maintenance of internet-based prevention: a randomized controlled trial. International Journal of Eating Disorders 40, 114119.
Jensen, MP, Turner, JA, Romano, JM, Strom, SE (1995). The chronic pain coping inventory: development and preliminary validation. Pain 60, 203216.
Kenardy, J, McCafferty, K, Rosa, V (2003). Internet-delivered indicated prevention for anxiety disorders: a randomized controlled trial. Behaviour Cognitive Psychotherapy 31, 279289.
Kenardy, J, McCafferty, K, Rosa, V (2006). Internet-delivered indicated prevention for anxiety disorders: six-month follow-up. Clinical Psychologist 10, 3942.
Kessler, RC, Andrews, G, Colpe, LJ, Mroczek, DK, Walters, EE, Zaslavsky, AM, Normand, S, Hiripi, E (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine 32, 959976.
Khawaja, NG, Oei, TPS, Baglioni, AJ (1994). Modification of the Catastrophic Cognitions Questionnaire (CCQ-M) for normals and patients: exploratory and LISREL analysis. Journal of Psychopathology Behavioural Assessment 16, 325342.
Killen, JD, Taylor, CB, Hayward, C, Wilson, DM, Haydel, F, Hammer, LD, Robinson, TN, Litt, I, Varady, A, Kraemer, H (1994). Pursuit of thinness and onset of eating disorder symptoms in a community sample of adolescent girls: a three-year prospective analysis. International Journal of Eating Disorders 16, 227238.
Kroenke, K, Spitzer, RL, Williams, JB (2001). The PHQ-9. Validity of a brief depression severity measure. Journal of General Internal Medicine 16, 606613.
Leary, MR (1983). A brief version of the Fear of Negative Evaluation Scale. Personality & Social Psychology Bulletin 9, 371375.
Lewis, G (1994). Assessing psychiatric disorder with a human interviewer or a computer. Journal of Epidemiology and Community Health 48, 207210.
Lintvedt, OK, Griffiths, KM, Sørensen, K, Ostvik, AR, Wang, CE, Eisemann, M, Waterloo, K (2013). Evaluating the effectiveness and efficacy of unguided internet-based self-help intervention for the prevention of depression: a randomized controlled trial. Clinical Psychology and Psychotherapy 20, 1027.
Lovibond, SH, Lovibond, PF (1995). The structure of negative emotional states: comparison of the Depression Anxiety and Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research Therapy 33, 335342.
Mackinnon, A, Griffiths, KM, Christensen, H (2008). Comparative randomised trial of online cognitive–behavioural therapy and an information website for depression: 12-month outcomes. British Journal of Psychiatry 192, 130134.
March, S, Spence, SH, Donovan, CL (2009). The efficacy of an internet-based cognitive-behavioral therapy intervention for child anxiety disorders. Journal of Pediatric Psychology 34, 474487 . doi:10.1093/jpepsy/jsn099.
Marks, IM (1986). Behavioural Psychotherapy: Maudsley Pocket Book of Clinical Management. John Wright: Bristol.
Marks, IM, Kenwright, M, McDonough, M, Whittaker, M, Mataix-Cols, D (2004). Saving clinicians’ time by delegating routine aspects of therapy to a computer: a randomized controlled trial in phobia/panic disorder. Psychological Medicine 34, 918.
Marks, IM, Mathews, AM (1979). Brief standard self-rating for phobic patients. Behaviour Research Therapy 23, 563569.
Marsden, J, Gossop, M, Stewart, D, Best, D, Farrell, M, Lehmann, P, Edwards, C, Strang, J (1998). The Maudsley Addiction Profile (MAP): a brief instrument for assessing treatment outcome. Addiction 93, 18571867.
Mataix-Cols, D, Cameron, R, Gega, L, Kenwright, M, Marks, IM (2006). Effect of referral source on outcome with cognitive-behavior therapy self-help. Comprehensive Psychiatry 47, 241245.
Mattick, RP, Clarke, JC (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research Therapy 36, 455470.
Meyer, B, Berger, T, Caspar, F, Beevers, CG, Andersson, G, Weiss, M (2009). Effectiveness of a novel integrative online treatment for depression (Deprexis): randomized controlled trial. Journal of Medical Internet Research 11, 118.
Meyer, TJ, Miller, ML, Metzger, RL, Borkovec, TD (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research Therapy 28, 487495.
Morin, CM (1993). Insomnia: Psychological Assessment and Management. Guilford Press: New York.
National Institute for Health and Clinical Excellence (NICE) (2006). Computerised Cognitive Behaviour Therapy for Depression and Anxiety (Review of Technology Appraisal 51). Technology Appraisal 97. NICE: London.
National Institute for Health and Clinical Excellence (NICE) (2009). Depression. The Treatment and Management of Depression in Adults. CG 90. NICE: London.
National Institute for Health and Clinical Excellence (NICE) (2011). Generalised Anxiety Disorder and Panic Disorder (with or without Agoraphobia) in Adults. Management in Primary, Secondary and Community Care, CG 113. NICE: London.
Nicholas, MK (2007). The pain self-efficacy questionnaire: taking pain into account. European Journal of Pain 11, 153163.
Orioli, EM, Jaffe, DT, Scott, CD (1991). Stressmap: Personal Diary Edition. The Ultimate Stress Management, Self-Assessment, and Coping Guide, Developed by Essi Systems. (Expanded personal diary ed.) Newmarket Press: New York.
O'Shea, G, Byrne, M (in press). The Improving Access to Psychological Therapies (IAPT) programme – opportunity knocks? The Irish Psychologist.
Palermo, TM, Wilson, AC, Peters, M, Lewandowski, A, Somhegyi, H (2009). Randomized controlled trial of an internet delivered family cognitive behavioral therapy intervention for children and adolescents with chronic pain. Pain 146, 205213.
Palermo, TM, Witherspoon, D, Valenzuela, D, Drotar, D (2004). Development and validation of the child activity limitations interview: a measure of pain related functional impairment in school-age children and adolescents. Pain 109, 461470.
Perini, S, Titov, N, Andrews, G (2009). Clinician-assisted internet-based treatment is effective for depression: randomized controlled trial. Australian and New Zealand Journal of Psychiatry 43, 571578.
Peterson, RA, Reiss, S (1992). The Anxiety Sensitivity Index, 2nd edn. International Diagnostic Systems: Worthington, OH.
Postel, MG, de Haan, HA, ter Huurne, ED, Becker, ES, de Jong, CA (2010). Effectiveness of a web-based intervention for problem drinkers and reasons for dropout: randomized controlled trial. Journal of Medical Internet Research 12, 112.
Proudfoot, J, Goldberg, AM, Everitt, B, Marks, I, Gray, JA (2003). Computerized, interactive, multimedia cognitive-behavioural program for anxiety and depression in general practice. Psychological Medicine 33, 217227.
Proudfoot, J, Ryden, C, Everitt, B, Shapiro, D, Goldberg, D, Mann, A, Tylee, A, Marks, I, Gray, JA (2004). Clinical efficacy of computerised cognitive-behavioural therapy for anxiety and depression in primary care: randomised controlled trial. British Journal of Psychiatry 185, 4654.
Randolf, LS (1977). The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement 1, 385401.
Reynolds, CR, Richmond, BO (1985). The Revised Children's Manifest Anxiety Scale: Manual. Western Psychological Services: New York.
Ritterband, LM, Thorndike, FP, Gonder-Frederick, LA, Magee, JC, Bailey, ET, Saylor, DK, Morin, CM (2009). Efficacy of an internet-based behavioral intervention for adults with insomnia. Archives of General Psychiatry 66, 692698.
Robinson, E, Titov, N, Andrews, G, McIntyre, K, Schwenke, G, Solley, K (2010). Internet treatment for generalized anxiety disorder: a randomized controlled trial comparing clinician vs. technician assistance. PLoS ONE 5, e10942 . doi:10.1371/journal.pone.0010942.
Rooke, S, Thorsteinsson, E, Karpin, A (2010). Computer-delivered interventions for alcohol and tobacco use: a meta-analysis. Addiction 105, 13811390.
Sanchez-Ortiz, VC, Munro, C, Stahl, D, House, J, Startup, H, Treasure, J, Williams, C, Schmidt, U (2011). A randomized controlled trial of internet-based cognitive-behavioural therapy for bulimia nervosa or related disorders in a student population. Psychological Medicine 41, 407417.
Saunders, JB, Aasland, OG, Babor, TF, de la Fuente, JR, Grant, M (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption. Addiction 88, 791804.
Schneider, AJ, Mataix-Cols, D, Marks, IM, Bachofen, M (2005). Internet-guided self-help with or without exposure therapy for phobic and panic disorders. A randomised controlled trial. Psychotherapy Psychosomatics 74, 154164.
Sethi, S, Campbell, AJ, Ellis, LA (2010). The use of computerized self-help packages to treat adolescent depression and anxiety. Journal of Technology Human Service 28, 144160.
SilverCloud [homepage on the internet] (2012). Accessed 10 April 2012.
Silverman, WK, Albano, AM (1996). Anxiety Disorders Interview Schedule for Children for DSM-IV: Child and Parent Versions. The Psychological Corporation: San Antonio, TX.
Spek, V, Cuijpers, P, Nyklicek, I, Riper, H, Keyzer, J, Pop, V (2007). Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis. Psychological Medicine 37, 319328 . doi:10.1017/S0033291706008944.
Spence, SH (1998). A measure of anxiety symptoms among children. Behaviour Research Therapy 36, 545566.
Spence, SH (1999). Spence Children's Anxiety Scale (parent version). University of Queensland: Brisbane.
Spence, SH, Donovan, CL, March, S, Gamble, A, Anderson, RE, Prosser, S, Kenardy, J (2011). A randomized controlled trial of online versus clinic-based CBT for adolescent anxiety. Journal of Consulting and Clinical Psychology 79, 629642.
Spence, SH, Holmes, JM, March, S, Lipp, OV (2006). The feasibility and outcome of clinic plus internet delivery of cognitive-behavior therapy for childhood anxiety. Journal of Consulting and Clinical Psychology 74, 614621.
Spence, J, Titov, N, Dear, BF, Johnston, L, Solley, K, Lorian, C, Wootton, B, Zou, J, Schwenke, G (2011). A randomized controlled trial of internet-based cognitive behavioural therapy for posttraumatic stress disorder. Depression and Anxiety 28, 541550.
Spitzer, RL, Kroenke, K, Williams, JB (1999). Validation and utility of a self-report version of PRIME-MD: The PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA 282, 17371744.
Spitzer, RL, Kroenke, K, Williams, JB, Lowe, B (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine 166, 10921097.
Spring, B (2007). Evidence-based practice in clinical psychology: what it is, why it matters; what you need to know. Journal of Clinical Psychology 63, 611631.
Stunkard, AJ, Messick, S (1985). The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. Journal of Psychosomatic Research 29, 7183.
Sullivan, MJ, Bishop, SR, Pivik, J (1995). The Pain Catastrophizing Scale: development and validation. Psychological Assessment 7, 524532.
Tedstone Doherty, D, Moran, R, Kartalova-O'Doherty, Y (2008). Psychological Distress, Mental Health Problems and Use of Health Services in Ireland. Health Research Board (HRB) Research Series 5. HRB: Dublin.
Titov, N, Andrews, G, Choi, I, Schwencke, G, Mahoney, A (2008). Shyness 3: randomized controlled trial of guided versus unguided internet-based CBT for social phobia. Australian and New Zealand Journal of Psychiatry 42, 10301040.
Titov, N, Andrews, G, Davies, M, McIntyre, K, Robinson, E, Solley, K (2010). Internet treatment for depression: a randomized controlled trial comparing clinician vs. technician assistance. PLoS ONE 5, e10939.
Titov, N, Andrews, G, Johnston, L, Robinson, E, Spence, J (2010). Transdiagnostic internet treatment for anxiety disorders: a randomized controlled trial. Behaviour Research Therapy 48, 890899.
Titov, N, Andrews, G, Robinson, E, Schwenke, G, Johnston, L, Solley, K, Choi, I (2009). Clinician-assisted internet-based treatment is effective for generalized anxiety disorder: randomized controlled trial. Australian and New Zealand Journal of Psychiatry 43, 905912.
Titov, N, Andrews, G, Schwencke, G (2008). Shyness 2: treating social phobia online: replication and extension. Australian and New Zealand Journal of Psychiatry 42, 595605.
Titov, N, Andrews, G, Schwencke, G, Drobny, J, Einstein, D (2008). Shyness 1: distance treatment for social over the internet. A randomized controlled trial. Australian and New Zealand Journal of Psychiatry 42, 585594.
Titov, N, Dear, BF, Schwencke, G, Andrews, G, Johnston, L, Craske, M, McEvoy, P (2011). Transdiagnostic Internet treatment of anxiety and depression: a randomised controlled trial. Behaviour Research Therapy 49, 441452.
Twomey, C, Byrne, M (2012). Beat the blues with brief psychological therapies. Forum (ICGP) 29, 4547.
Varni, JW (1998). Pediatric Quality of Life Inventory (Version 4.0). Mapi Research Institute: Lyon, France.
Wade, AG (2010). Use of the internet to assist in the treatment of depression and anxiety: a systematic review. Primary Care Companion to the Journal of Clinical Psychiatry 12. Published online 24 November 2009. PCC.09r00876 . doi:10.4088/PCC.09r00876blu.
Watson, D, Friend, R (1969). Measurement of social evaluative anxiety. Journal of Consulting and Clinical Psychology 33, 448457.
Weathers, FW, Litz, BT, Herman, DS, Huska, JA, Keane, TM (1993). The PTSD checklist (PCL): Reliability, validity, and diagnostic utility. Paper presented at the 9th Annual Meeting of the International Society for Traumatic Stress Studies, San Antonio, TX.
Wims, E, Titov, N, Andrews, G, Choi, I (2010). Clinician-assisted internet-based treatment is effective for panic: a randomized controlled trial. Australian and New Zealand Journal of Psychiatry 44, 599607.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Irish Journal of Psychological Medicine
  • ISSN: 0790-9667
  • EISSN: 2051-6967
  • URL: /core/journals/irish-journal-of-psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed