Current and Future Trends in Internet-Supported Mental Health Interventions

Despite growing research in the past two decades involving Internet-supported or online mental health interventions, there has been only a few attempts to provide a synthesis of the research findings and future trends. The Internet has grown exponentially during this time, providing greater access to a wider population than ever before. Consequently, online mental health interventions have the potential to be cost-effective, convenient, and reach a more diverse population than traditional, face-to-face interventions. This paper reviews and summarizes the current research for online mental health interventions and discusses future trends. These interventions range from psychoeducational static webpages and complex, personalized, interactive cognitive-behavioral-based self-help programs, to videoconferencing, self-help support groups, blogging, and professional-led online therapy. Future trends in online interventions include the greater prevalence of online therapy and the use of video chat and videoconferencing technologies to enhance and extend the therapeutic relationship. The use of texting or short message service (SMS), mobile communications, smart phone applications, gaming, and virtual worlds extends the intervention paradigm into new environments not always previously considered as intervention opportunities. We find that there is strong evidence to support the effective use and future development of a variety of online mental health applications.

[1]  P. Robinson,et al.  Getting better byte by byte: a pilot randomised controlled trial of email therapy for bulimia nervosa and binge eating disorder. , 2008, European eating disorders review : the journal of the Eating Disorders Association.

[2]  R. Whittaker,et al.  A Multimedia Mobile Phone–Based Youth Smoking Cessation Intervention: Findings From Content Development and Piloting Studies , 2008, Journal of medical Internet research.

[3]  Elsa Marziali,et al.  An E-Health Community of Practice: Online Communication in an E-Health Service Delivery Environment , 2007, HCI.

[4]  John Suler,et al.  The Online Disinhibition Effect , 2004, Cyberpsychology Behav. Soc. Netw..

[5]  D. Antonacci,et al.  Empirical evidence on the use and effectiveness of telepsychiatry via videoconferencing: implications for forensic and correctional psychiatry. , 2008, Behavioral sciences & the law.

[6]  S. O'brian,et al.  Online CBT I: Bridging the gap between Eliza and modern online CBT treatment packages , 2009 .

[7]  Giuseppe Riva,et al.  A NeuroVR based tool for cognitive assessment and rehabilitation of post-stroke patients: two case studies , 2009, Annual Review of Cybertherapy and Telemedicine.

[8]  J. Finn,et al.  A descriptive study of e-counsellor attitudes, ethics, and practice , 2010 .

[9]  D’Arcy J. Reynolds,et al.  An investigation of session impact and alliance in internet based psychotherapy: Preliminary results , 2006 .

[10]  M. Battersby,et al.  Exposure Therapy for Problem Gambling via Videoconferencing: A Case Report , 2008, Journal of Gambling Studies.

[11]  R. Steele,et al.  A meta-analytic review of eHealth interventions for pediatric health promoting and maintaining behaviors. , 2010, Journal of pediatric psychology.

[12]  Monisha Pasupathi,et al.  Blogging About Trauma: Linguistic Measures of Apparent Recovery , 2008 .

[13]  M. Terry Telemedicine and autism: researchers and clinicians are just starting to consider telemedicine applications for the diagnosis and treatment of autism. , 2009, Telemedicine journal and e-health.

[14]  Jerry Finn,et al.  The LivePerson Model for Delivery of Etherapy Services: A Case Study , 2008 .

[15]  Jason S. Zack,et al.  Online therapy: review of relevant definitions, debates, and current empirical support. , 2004, Journal of clinical psychology.

[16]  Britt Klein,et al.  A therapist-assisted cognitive behavior therapy internet intervention for posttraumatic stress disorder: pre-, post- and 3-month follow-up results from an open trial. , 2010, Journal of anxiety disorders.

[17]  E. Balas,et al.  Healthcare via cell phones: a systematic review. , 2009, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[18]  A. Akabayashi,et al.  Earthquake in Japan , 2011, Nature.

[19]  J. Pennebaker Writing About Emotional Experiences as a Therapeutic Process , 1997 .

[20]  D. Ciliska,et al.  Internet-Based Innovations for the Prevention of Eating Disorders: A Systematic Review , 2006, Eating disorders.

[21]  D. Giles,et al.  Inside the “Pro-ana” Community: A Covert Online Participant Observation , 2007, Eating disorders.

[22]  Scott W. Campbell,et al.  Mobile phone use among Alcoholics Anonymous members: new sites for recovery , 2008, New Media Soc..

[23]  Cristina Botella,et al.  The Intelligent e-Therapy system: a new paradigm for telepsychology and cybertherapy , 2009 .

[24]  K. J. Ruskin,et al.  The Internet and medicine: past, present, and future. , 1996, The Yale journal of biology and medicine.

[25]  M. Neve,et al.  Effectiveness of web‐based interventions in achieving weight loss and weight loss maintenance in overweight and obese adults: a systematic review with meta‐analysis , 2010, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[26]  Feng-Yang Kuo,et al.  Can Blogging Enhance Subjective Well-Being Through Self-Disclosure? , 2009, Cyberpsychology Behav. Soc. Netw..

[27]  Gerhard Andersson,et al.  Computer‐Aided Psychotherapy for Anxiety Disorders: A Meta‐Analytic Review , 2009, Cognitive behaviour therapy.

[29]  Jennifer L. Pomeranz,et al.  The Delivery of Public Health Interventions via the Internet: Actualizing Their Potential , 2011 .

[30]  Michael E. Labhard,et al.  Mobile Therapy: Case Study Evaluations of a Cell Phone Application for Emotional Self-Awareness , 2010, Journal of medical Internet research.

[31]  H. Christensen Increasing access and effectiveness: using the internet to delivery low intensity CBT , 2010 .

[32]  W H Brouwer,et al.  The efficacy of SMS text messages to compensate for the effects of cognitive impairments in schizophrenia. , 2010, The British journal of clinical psychology.

[33]  Matthew Bambling,et al.  Telephone and online counselling for young people: A naturalistic comparison of session outcome, session impact and therapeutic alliance , 2006 .

[34]  Rosa María Baños,et al.  An e-Health System for the Elderly (Butler Project): A Pilot Study on Acceptance and Satisfaction , 2009, Cyberpsychology Behav. Soc. Netw..

[35]  Soledad Quero,et al.  The acceptability of an Internet-based self-help treatment for fear of public speaking , 2009 .

[36]  P. Cuijpers,et al.  Cost-Utility and Cost-Effectiveness of Internet-Based Treatment for Adults With Depressive Symptoms: Randomized Trial , 2010, Journal of medical Internet research.

[37]  D. Todder,et al.  Acute-phase trauma intervention using a videoconference link circumvents compromised access to expert trauma care. , 2007, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[38]  R. Pennington,et al.  Using Desktop Videoconferencing to Deliver Interventions to a Preschool Student With Autism , 2010 .

[39]  J. Snibbe,et al.  A Comparison of Computer-Assisted Psychotherapy and Cognitive-Behavioral Therapy in Groups , 1998, Journal of Clinical Psychology in Medical Settings.

[40]  Sherif Karama,et al.  BMC Research Notes BioMed Central , 2008 .

[41]  Susan Imholz The therapeutic stage encounters the virtual world , 2008 .

[42]  O. Kristjansdottir,et al.  Written online situational feedback via mobile phone to support self-management of chronic widespread pain: a usability study of a Web-based intervention , 2011, BMC musculoskeletal disorders.

[43]  Heidi Zinzow,et al.  Internet-based interventions for traumatic stress-related mental health problems: a review and suggestion for future research. , 2009, Clinical psychology review.

[44]  Jean-François Etter,et al.  Comparing Computer-Tailored, Internet-Based Smoking Cessation Counseling Reports with Generic, Untailored Reports: A Randomized Trial , 2009, Journal of health communication.

[45]  R. Brooner,et al.  Assessing the effectiveness of an Internet-based videoconferencing platform for delivering intensified substance abuse counseling. , 2009, Journal of substance abuse treatment.

[46]  Wiebo Brouwer,et al.  SMS text messages as a prosthetic aid in the cognitive rehabilitation of schizophrenia , 2007 .

[47]  Martin Tanis Online social support groups , 2009 .

[48]  H. Riper,et al.  One-year follow-up results of unsupported online computerized cognitive behavioural therapy for depression in primary care: A randomized trial. , 2011, Journal of behavior therapy and experimental psychiatry.

[49]  P. Emmelkamp,et al.  Web-based therapist-assisted cognitive behavioral treatment of panic symptoms: a randomized controlled trial with a three-year follow-up. , 2010, Journal of anxiety disorders.

[50]  L. Bradley,et al.  Facilitating Online Counseling: Perspectives From Counselors in Training , 2008 .

[51]  C. V. van Uden-Kraan,et al.  Participation in online patient support groups endorses patients' empowerment. , 2009, Patient education and counseling.

[52]  N. Titov,et al.  Shyness Programme: Longer Term Benefits, Cost-Effectiveness, and Acceptability , 2009, The Australian and New Zealand journal of psychiatry.

[53]  Felipe Fregni,et al.  The efficacy of Web-based cognitive behavioral interventions for chronic pain: a systematic review and meta-analysis. , 2010, The journal of pain : official journal of the American Pain Society.

[54]  Stephanie Bauer,et al.  The Exploration of the Effectiveness of Group Therapy through an Internet Chat as Aftercare: A Controlled Naturalistic Study , 2007, Psychotherapy and Psychosomatics.

[55]  John Suler,et al.  Fostering empowerment in online support groups , 2008, Comput. Hum. Behav..

[56]  M. Blankers Internet Therapy versus Internet Self-help versus No Treatment for Problematic Alcohol Use: a Randomized Controlled Trial , 2010 .

[57]  K. Carroll,et al.  Cost-effectiveness of computer-assisted training in cognitive-behavioral therapy as an adjunct to standard care for addiction. , 2010, Drug and alcohol dependence.

[58]  Brendan Mulhern,et al.  The effectiveness of web-based interventions designed to decrease alcohol consumption--a systematic review. , 2008, Preventive medicine.

[59]  A. Barak,et al.  A Comprehensive Review and a Meta-Analysis of the Effectiveness of Internet-Based Psychotherapeutic Interventions , 2008 .

[60]  M. Cantrell,et al.  Enhancing Hope Among Early Female Survivors of Childhood Cancer via the Internet: A Feasibility Study , 2008, Cancer nursing.

[61]  D. Wiersma,et al.  Why is self-help neglected in the treatment of emotional disorders? A meta-analysis , 2004, Psychological Medicine.

[62]  Lorien C Abroms,et al.  iPhone apps for smoking cessation: a content analysis. , 2011, American journal of preventive medicine.

[63]  Pamela M. Kato,et al.  Video Games in Health Care: Closing the Gap , 2010 .

[64]  Bethany A. Koestner,et al.  An Interactive Web-Based Method of Outreach to College Students at Risk for Suicide , 2008, Journal of American college health : J of ACH.

[65]  J. Elhai,et al.  Therapist Adherence and Competence With Manualized Cognitive-Behavioral Therapy for PTSD Delivered via Videoconferencing Technology , 2007, Behavior modification.

[66]  Heleen Riper,et al.  Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis , 2006, Psychological Medicine.

[67]  Robert W. Kolodinsky,et al.  Counseling on the Information Highway: Future Possibilities and Potential Problems , 1997 .

[68]  Katy Day,et al.  Starving in cyberspace: a discourse analysis of pro-eating-disorder websites , 2008 .

[69]  Amy Przeworski,et al.  A review of technology-assisted self-help and minimal contact therapies for drug and alcohol abuse and smoking addiction: is human contact necessary for therapeutic efficacy? , 2011, Clinical psychology review.

[70]  Nicholas Tarrier,et al.  Virtual reality in mental health : a review of the literature. , 2007, Social psychiatry and psychiatric epidemiology.

[71]  Zheng Yan,et al.  Cracking the walnut: Using a computer game to impact cognition, emotion, and behavior of highly aggressive fifth grade students , 2008, Comput. Hum. Behav..

[72]  Chris Barker,et al.  Outcome of an Online Mutual Support Group for College Students with Psychological Problems , 2008, Cyberpsychology Behav. Soc. Netw..

[73]  Miriam Wanner,et al.  Comparison of Trial Participants and Open Access Users of a Web-Based Physical Activity Intervention Regarding Adherence, Attrition, and Repeated Participation , 2010, Journal of medical Internet research.

[74]  A. Eccles Ethical Considerations Around the Implementation of Telecare Technologies , 2010 .

[75]  John Suler The Future of Online Clinical Work , 2002 .

[76]  G. Andersson,et al.  An open study of Internet-based bibliotherapy with minimal therapist contact via email for social phobia , 2006 .

[77]  Terry Hanley,et al.  Counselling Psychology and the internet: A review of the quantitative research into online outcomes and alliances within text-based therapy , 2009, Counselling Psychology Review.

[78]  Y. Khazaal,et al.  Quality of web-based information on bipolar disorder. , 2008, Journal of affective disorders.

[79]  A. Barak,et al.  Defining Internet-Supported Therapeutic Interventions , 2009, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[80]  D. DiLillo,et al.  To Google or Not to Google: Graduate Students’ Use of the Internet to Access Personal Information about Clients , 2011 .

[81]  Jersino Jean-Mary,et al.  Internet and Mobile Phone Text Messaging Intervention for College Smokers , 2008, Journal of American college health : J of ACH.

[82]  Gerhard Andersson,et al.  Internet-delivered treatment to promote health , 2011, Current opinion in psychiatry.

[83]  Michel Pépin,et al.  The effectiveness of cognitive-behavioral group therapy for loneliness via inter relaychat among people with physical disabilities. , 2003 .

[84]  Mike R. Schoenberg,et al.  Comparison of Functional Outcomes and Treatment Cost Between a Computer-Based Cognitive Rehabilitation Teletherapy Program and a Face-to-Face Rehabilitation Program , 2008 .

[85]  Rosa María Baños,et al.  Cybertherapy: Advantages, Limitations, and Ethical Issues , 2009, PsychNology J..

[86]  Stephen A. Rains,et al.  Human Communication Research Issn 0360-3989 a Meta-analysis of Research on Formal Computer-mediated Support Groups: Examining Group Characteristics and Health Outcomes , 2022 .

[87]  G. Andersson,et al.  Please Scroll down for Article Cognitive Behaviour Therapy Therapist Factors in Internet-delivered Cognitive Behavioural Therapy for Major Depressive Disorder , 2022 .

[88]  G. Andersson,et al.  Internet-based treatment of social phobia: a randomized controlled trial comparing unguided with two types of guided self-help. , 2011, Behaviour research and therapy.

[89]  Megan Jones,et al.  Randomized, Controlled Trial of an Internet-Facilitated Intervention for Reducing Binge Eating and Overweight in Adolescents , 2008, Pediatrics.

[90]  James Archer,et al.  An Exploratory Study of Client Perceptions of Internet Counseling and the Therapeutic Alliance , 2006 .

[91]  Russell E Glasgow,et al.  eHealth evaluation and dissemination research. , 2007, American journal of preventive medicine.

[92]  K. Siau,et al.  Mobile healthcare informatics , 2006, Medical informatics and the Internet in medicine.

[93]  “So wat do u want to wrk on 2day?”: The Ethical Implications of Online Counseling , 2010 .

[94]  Thomas Berger,et al.  The Future Is Bright , 2005 .

[95]  F. Smit,et al.  Modeling the Cost-Effectiveness of Health Care Systems for Alcohol Use Disorders: How Implementation of eHealth Interventions Improves Cost-Effectiveness , 2011, Journal of medical Internet research.

[96]  Dan J Stein,et al.  Self-Help and Internet-Guided Interventions in Depression and Anxiety Disorders: A Systematic Review of Meta-Analyses , 2009, CNS Spectrums.

[97]  G. Riva,et al.  A Second Life for eHealth: Prospects for the Use of 3-D Virtual Worlds in Clinical Psychology , 2008, Journal of medical Internet research.

[98]  B. Fjeldsoe,et al.  Behavior change interventions delivered by mobile telephone short-message service. , 2009, American journal of preventive medicine.

[99]  Donna M. Midkiff,et al.  Ethical Issues in the Provision of Online Mental Health Services (Etherapy) , 2008 .

[100]  Yong Sik Lee,et al.  Changes in Cue-Induced, Prefrontal Cortex Activity with Video-Game Play , 2010, Cyberpsychology Behav. Soc. Netw..

[101]  James R. Baker,et al.  Distress, Coping, and Blogging: Comparing New Myspace Users by Their Intention to Blog , 2008, Cyberpsychology Behav. Soc. Netw..

[102]  The Future of Health Care and Online Counseling , 2011 .

[103]  Stephen Goss,et al.  The Use of Technology in Mental Health: Applications, Ethics and Practice , 2010 .

[104]  Helen Thomas,et al.  The use of technology in mental health: applications, ethics and practice , 2012 .

[105]  Heleen Riper,et al.  Web-based self-help for problem drinkers: a pragmatic randomized trial. , 2008, Addiction.

[106]  Kathleen M Griffiths,et al.  Effect of web-based depression literacy and cognitive–behavioural therapy interventions on stigmatising attitudes to depression , 2004, British Journal of Psychiatry.

[107]  Emily A. Holmes,et al.  Can Playing the Computer Game “Tetris” Reduce the Build-Up of Flashbacks for Trauma? A Proposal from Cognitive Science , 2009, PloS one.

[108]  B. Rimer,et al.  How Cancer Survivors Provide Support on Cancer-Related Internet Mailing Lists , 2007, Journal of medical Internet research.

[109]  Michele L. Ybarra,et al.  Internet-Based Mental Health Interventions , 2005, Mental health services research.

[110]  Stéphane Bouchard,et al.  Assessment of the Therapeutic Alliance in Face-to-Face or Videoconference Treatment for Posttraumatic Stress Disorder , 2009, Cyberpsychology Behav. Soc. Netw..

[111]  Eric A. Finkelstein,et al.  Cost Effectiveness of Internet Interventions: Review and Recommendations , 2009, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[112]  H. Christensen,et al.  Beacon: a web portal to high‐quality mental health websites for use by health professionals and the public , 2010, The Medical journal of Australia.

[113]  Kate Anthony,et al.  Developments in the use of technology in counselling and psychotherapy , 2009 .

[114]  D. Cox,et al.  Internet interventions: In review, in use, and into the future. , 2003 .

[115]  A. Barak Psychological applications on the internet: A discipline on the threshold of a new millennium , 1999 .

[116]  Peter Yellowlees,et al.  The psychiatrist-patient relationship of the future: anytime, anywhere? , 2010, Harvard review of psychiatry.

[117]  L. Gamberini,et al.  A game a day keeps the doctor away: a short review of computer games in mental healthcare. , 2008 .

[118]  J Li,et al.  Is guided self-help as effective as face-to-face psychotherapy for depression and anxiety disorders? A systematic review and meta-analysis of comparative outcome studies , 2010, Psychological Medicine.

[119]  Liina Savolainen,et al.  An Internet-based videoconferencing system for supporting frail elderly people and their carers , 2008, Journal of telemedicine and telecare.

[120]  R. Glasgow,et al.  The delivery of public health interventions via the Internet: actualizing their potential. , 2009, Annual review of public health.

[121]  Foojan Zeine,et al.  Online Therapy: A Therapist's Guide to Expanding Your Practice , 2005 .

[122]  H. Christensen,et al.  A controlled trial of a school‐based Internet program for reducing depressive symptoms in adolescent girls , 2009, Depression and anxiety.

[123]  S. Simpson Psychotherapy via videoconferencing: a review , 2009 .

[124]  Rebecca P Ang,et al.  Online Video Game Therapy for Mental Health Concerns: A Review , 2008, The International journal of social psychiatry.

[125]  F. Goodwin,et al.  The de facto US mental and addictive disorders service system. Epidemiologic catchment area prospective 1-year prevalence rates of disorders and services. , 1993, Archives of general psychiatry.

[126]  Kathleen M Griffiths,et al.  A Comparison of Changes in Anxiety and Depression Symptoms of Spontaneous Users and Trial Participants of a Cognitive Behavior Therapy Website , 2004, Journal of medical Internet research.

[127]  Clare S. Rees,et al.  Therapeutic Alliance in Face-to-Face Versus Videoconferenced Psychotherapy. , 2005 .

[128]  M. Cruz-cunha,et al.  Handbook of Research on Developments in E-health and Telemedicine: Technological and Social Perspectives , 2009 .

[129]  Albert Rizzo,et al.  Virtual reality for psychotherapy: Current reality and future possibilities. , 2003 .

[130]  Peter Yellowlees,et al.  Can virtual reality be used to conduct mass prophylaxis clinic training? A pilot program. , 2008, Biosecurity and bioterrorism : biodefense strategy, practice, and science.

[131]  R. Kessler,et al.  The epidemiology of co-occurring addictive and mental disorders: implications for prevention and service utilization. , 1996, The American journal of orthopsychiatry.

[132]  Leanne M. Casey,et al.  The use of mobile telephones as adjuncts to cognitive behavioral psychotherapy. , 2008 .

[133]  K. Patrick,et al.  A Text Message–Based Intervention for Weight Loss: Randomized Controlled Trial , 2009, Journal of medical Internet research.

[134]  Andrea Gaggioli,et al.  NeuroVR 1.5 in Practice: Actual Clinical Applications of the Open Source VR System , 2009, Annual Review of Cybertherapy and Telemedicine.

[135]  J. Abelson,et al.  Videoconferencing-based cognitive-behavioral therapy for obsessive-compulsive disorder. , 2006, Behaviour research and therapy.

[136]  Pål Kraft,et al.  A Digital Smoking Cessation Program Delivered Through Internet and Cell Phone Without Nicotine Replacement (Happy Ending): Randomized Controlled Trial , 2008, Journal of medical Internet research.

[137]  Leon Tan,et al.  Psychotherapy 2.0: MySpace blogging as self-therapy. , 2008, American journal of psychotherapy.

[138]  Jay Starkey,et al.  Earthquake in Japan , 2011 .

[139]  Kate Cavanagh,et al.  Computer-aided psychological treatments: evolving issues. , 2009, Annual review of clinical psychology.

[140]  Berenice Serrano,et al.  Etherapy: A Training Program for Development of Clinical Skills in Distance Psychotherapy , 2008 .

[141]  G. Andersson Using the Internet to provide cognitive behaviour therapy. , 2009, Behaviour research and therapy.

[142]  J. Horrigan,et al.  Home broadband adoption 2007 , 2007 .

[143]  M. Reger,et al.  A meta-analysis of the effects of internet- and computer-based cognitive-behavioral treatments for anxiety. , 2009, Journal of clinical psychology.

[144]  J. Brug,et al.  Strategies to Facilitate Exposure to Internet-Delivered Health Behavior Change Interventions Aimed at Adolescents or Young Adults: A Systematic Review , 2011, Health education & behavior : the official publication of the Society for Public Health Education.

[145]  Jason S. Zack How Sturdy is that Digital Couch? Legal Considerations for Mental Health Professionals Who Deliver Clinical Services via the Internet , 2008 .

[146]  John Suler Psychological Aspects of Cyberspace: Cybertherapeutic Theory and Techniques , 2008 .

[147]  Daniele La Barbera,et al.  Cybertherapy Meets Facebook, Blogger, and Second Life: an Italian Experience , 2009, Annual Review of Cybertherapy and Telemedicine.

[148]  J. Suler The Psychology of Text Relationships , 2011 .

[149]  Cheryl K. Olson,et al.  Video Games in Psychotherapy , 2010 .

[150]  Jo-Anne M Abbott,et al.  Best Practices in Online Therapy , 2008 .

[151]  Seung-Kwon Myung,et al.  Effects of Web- and computer-based smoking cessation programs: meta-analysis of randomized controlled trials. , 2009, Archives of internal medicine.

[152]  Adekola O. Alao,et al.  Cybersuicide: Review of the Role of the Internet on Suicide , 2006, Cyberpsychology Behav. Soc. Netw..

[153]  Andrea Gaggioli,et al.  NeuroVR: An Open Source Virtual Reality Platform for Clinical Psychology and Behavioral Neurosciences , 2007, MMVR.

[154]  G. Parker,et al.  Community Attitudes to the Appropriation of Mobile Phones for Monitoring and Managing Depression, Anxiety, and Stress , 2010, Journal of medical Internet research.

[155]  K. Humphreys Individual and social benefits of mutual aid self-help groups , 1997 .

[156]  Yasser Khazaal,et al.  Quality of web‐based information on depression , 2010, Depression and anxiety.

[157]  Ricardo Araya,et al.  Therapist-delivered internet psychotherapy for depression in primary care: a randomised controlled trial , 2009, The Lancet.

[158]  Azy Barak,et al.  Emotional support and suicide prevention through the Internet: A field project report , 2007, Comput. Hum. Behav..

[159]  Writing therapy using new technologies—the art of blogging , 2009 .

[160]  F. Rabar The future is present , 1976 .

[161]  Dion Hoe-Lian Goh,et al.  Strategies for designing effective psychotherapeutic gaming interventions for children and adolescents , 2008, Comput. Hum. Behav..

[162]  H. Christensen,et al.  Adherence in Internet Interventions for Anxiety and Depression: Systematic Review , 2009, Journal of medical Internet research.

[163]  Elissa D. Giffords Social Work on the Internet: An Introduction , 1998 .

[164]  G. Andersson,et al.  Internet-delivered treatments with or without therapist input: does the therapist factor have implications for efficacy and cost? , 2007, Expert review of pharmacoeconomics & outcomes research.

[165]  Jason S. Zack,et al.  Online Counseling: A Handbook for Mental Health Professionals , 2003 .

[166]  D. Brendel,et al.  Patient‐Targeted Googling: The Ethics of Searching Online for Patient Information , 2010, Harvard review of psychiatry.

[167]  P. Cuijpers,et al.  One-year follow-up results of a randomized controlled clinical trial on internet-based cognitive behavioural therapy for subthreshold depression in people over 50 years , 2008, Psychological Medicine.

[168]  A. Kazdin,et al.  Rebooting Psychotherapy Research and Practice to Reduce the Burden of Mental Illness , 2011, Perspectives on psychological science : a journal of the Association for Psychological Science.

[169]  Azy Barak,et al.  Factors Related to Perceived Helpfulness in Supporting Highly Distressed Individuals through an Online Support Chat , 2006, Cyberpsychology Behav. Soc. Netw..

[170]  R. Whittaker,et al.  A Theory-Based Video Messaging Mobile Phone Intervention for Smoking Cessation: Randomized Controlled Trial , 2011, Journal of medical Internet research.

[171]  Amanda Aitken Ba Pgce DipCouns Suicide and the internet , 2009 .

[172]  H. Christensen,et al.  Internet-based mental health programs: a powerful tool in the rural medical kit. , 2007, The Australian journal of rural health.

[173]  S. Bauer,et al.  Mobile therapy: Use of text-messaging in the treatment of bulimia nervosa. , 2010, The International journal of eating disorders.

[174]  Rosa María Baños,et al.  Telepsychology and Self-Help: The Treatment of Phobias Using the Internet , 2008, Cyberpsychology Behav. Soc. Netw..

[175]  Lee M Ritterband,et al.  The Science of Internet Interventions , 2009, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[176]  H. Christensen,et al.  Effects of a Cognitive‐Behavioural Internet Program on Depression, Vulnerability to Depression and Stigma in Adolescent Males: A School‐Based Controlled Trial , 2006, Cognitive behaviour therapy.

[177]  Ana Pasztor,et al.  Second Life, Bio-Sensors, and Exposure Therapy for Anxiety Disorders , 2009, Annual Review of Cybertherapy and Telemedicine.

[178]  M. Litt,et al.  Bibliotherapy as a Treatment for Depression in Primary Care , 2010, Journal of Clinical Psychology in Medical Settings.

[179]  Milton P. Huang,et al.  The Internet and the future of psychiatry. , 1996, The American journal of psychiatry.

[180]  A. Przeworski,et al.  A review of technology-assisted self-help and minimal contact therapies for anxiety and depression: is human contact necessary for therapeutic efficacy? , 2011, Clinical psychology review.

[181]  Barb Ruppert,et al.  New Directions in Virtual Environments and Gaming to Address Obesity and Diabetes: Industry Perspective , 2011, Journal of diabetes science and technology.

[182]  Stéphane Bouchard,et al.  Effectiveness of Cognitive Behavioural Therapy Administered by Videoconference for Posttraumatic Stress Disorder , 2009, Cognitive behaviour therapy.

[183]  J. Brug,et al.  Effectiveness of online word of mouth on exposure to an Internet-delivered intervention , 2009, Psychology & health.

[184]  Per Carlbring,et al.  Establishing Guidelines for Executing and Reporting Internet Intervention Research , 2011, Cognitive behaviour therapy.

[185]  A. Chester,et al.  Online counselling: a descriptive analysis of therapy services on the Internet , 2006 .

[186]  Ethical Issues in Online Counseling , 2011 .

[187]  Kathryn M. Bigelow,et al.  Txt u ltr , 2008, Child maltreatment.

[188]  Soledad Quero,et al.  An Internet-Based Self-Help Program for the Treatment of Fear of Public Speaking: A Case Study , 2008 .

[189]  Kathleen M Griffiths,et al.  Review of randomised controlled trials of Internet interventions for mental disorders and related conditions , 2006 .

[190]  L. Murphy,et al.  Cybercounseling Online: The Development of a University-Based Training Program for E-mail Counseling , 2008 .

[191]  A. Joinson Disinhibition and the Internet , 2007 .

[192]  C. B. Taylor,et al.  Reduction of overweight and eating disorder symptoms via the Internet in adolescents: a randomized controlled trial. , 2008, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[193]  Paul P. Freddolino,et al.  Therapeutic Applications of Online Gaming , 2008 .

[194]  L. W. Jerome,et al.  The coming of age of telecommunications in psychological research and practice. , 2000, The American psychologist.

[195]  John Quinn,et al.  Surfing the Net for medical information aboutpsychological trauma: An empirical study of thequality and accuracy of trauma-related websites , 2006, Medical informatics and the Internet in medicine.

[196]  B. Simons-Morton,et al.  A Process Evaluation of E-Mail Counselling for Smoking Cessation in College Students: Feasibility, Acceptability and Cost , 2009 .

[197]  Suk-Il Kim,et al.  Effectiveness of mobile and internet intervention in patients with obese type 2 diabetes , 2008, Int. J. Medical Informatics.

[198]  G. Andersson,et al.  Internet-administered cognitive behavior therapy for health problems: a systematic review , 2007, Journal of Behavioral Medicine.