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Evidence to Improve Care

Internet-Delivered Cognitive Behavioural Therapy for Major Depression and Anxiety Disorders


Final Recommendation

  • Health Quality Ontario, under the guidance of the Ontario Health Technology Advisory Committee, recommends publicly funding guided internet-delivered cognitive behavioural therapy for mild to moderate major depression and anxiety disorders

Read the Final Recommendation Report

Cognitive behavioural therapy (or “CBT”) is a form of psychotherapy that has proven effective in treating major depression and anxiety disorders. However, it can often be difficult for people to access this therapy because of long wait times, the cost of sessions, and travel time to get to sessions. Cognitive behavioural therapy delivered via the internet is an option that may be more accessible for some people.

Internet-delivered cognitive behavioural therapy (or “iCBT”) involves following a series of structured sessions that people can access using a computer, tablet, or smartphone. It may be delivered with guidance from a regulated health care professional or without guidance, in which people work through the program on their own.

This health technology assessment looked at the safety, effectiveness, and value for money of guided and unguided internet-delivered cognitive behavioural therapy for the treatment of adults with mild to moderate major depression or anxiety disorders. We also looked at the budget impact of publicly funding internet-delivered cognitive behavioural therapy and the preferences, values, and experiences of people with mild to moderate major depression or anxiety disorders.

Read the full Health Technology Assessment report for more information.

Health Quality Ontario, in collaboration with the Canadian Agency for Drugs and Technologies in Health (CADTH), has undertaken a health technology assessment to assess the clinical benefits, cost-effectiveness, and patient experiences with Internet-delivered cognitive behavioural therapy for major depression and anxiety disorders.

The Ministry of Health is currently reviewing this recommendation.

The Ministry of Health has provided the following response: The Ministry has a standardized process in place to review Health Quality Ontario recommendations. This takes into consideration Ministry priorities, implementation options, the need for consultation with impacted stakeholders, and funding considerations.

Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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