Meg Skelton

In this blog, PhD student Meg Skelton and Placement student Jade Pusey discuss internet enabled Cognitive Behavioural Therapy.



Psychological therapies (also known as talking therapies) are a popular method of treating mental health illnesses, including anxiety and depression. The most common type of psychological therapy in the UK is Cognitive Behavioural Therapy (CBT), which focuses on learning how to modify negative, unhelpful thoughts and behaviours. Although pharmacological options, such as antidepressant medication, may be more effective for some individuals, most people experiencing mental illness report a preference for psychological therapy [1]. This could in part be because they are able to learn skills and techniques to help prevent and/or cope with future episodes, not just alleviate their current symptoms.


Anxiety and depression are common, disabling illnesses. The challenge health services are faced with is how to provide much needed treatment options on a large scale. The NHS England Improving Access to Psychological Therapies (IAPT) service receives almost 2 million referrals a year from people experiencing symptoms of anxiety and/or depression. To meet this demand, a wide range of treatments is available, delivered in a NICE-recommended framework of low and high intensity stepped-care. These treatments include guided self-help books, group therapy sessions, one-to-one CBT and counselling.

In recent years, other routes of administering treatment have become available through IAPT, in addition to the more traditional methods. By exploiting advances in technology, researchers have developed computerised and internet based psychological treatments. Internet-enabled CBT consists of therapy sessions that follow CBT principles and are delivered in real-time by an accredited therapist on an online platform. Remote therapy has several advantages: reducing strain on physical services, increasing accessibility for individuals with disabilities or who are geographically isolated, and flexibility in administration outside of normal office hours. Research shows that internet-enabled CBT provided by a therapist in this way is effective at reducing symptoms of anxiety and depression [2]

Ieso Digital Health is a company that delivers individualised, structured and confidential internet-enabled CBT, through the IAPT service. They aim “to make mental health accessible for all” by offering one-to-one, real-time CBT via their online messaging system. The EDIT Lab team is embarking on a new and exciting project with Ieso, which looks at predicting outcomes following CBT. We will be assessing a range of psychological factors, such as ways of thinking and learning, to see how they relate to therapy. The online format of this project is both innovative and necessary; experiments are typically confined to lab settings and treatment to clinics, so we are bridging that gap to provide high quality, realistic data to help improve treatment outcomes.


In the global coronavirus pandemic, it’s become the norm to do everything online or over the phone, from working to celebrating birthdays. Therapy is no exception to this. Mental health is an especially pressing concern for us all during this extremely difficult time. Thankfully, it appears that remote therapy is an effective way of getting help and will remain a useful option for individuals who cannot access face-to-face therapy in the (hopefully not too distant) post-pandemic future.



[1] McHugh RK, Whitton SW, Peckham AD, et al. Patient preference for psychological vs pharmacologic treatment of psychiatric disorders: a meta-analytic review. J Clin Psychiatry 2013; 74: 595–602.

[2] Kessler D, Lewis G, Kaur S, et al. Therapist-delivered Internet psychotherapy for depression in primary care: a randomised controlled trial. Lancet 2009; 374: 628–634.


Megan Skelton

Author Megan Skelton

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