ArticleInternet interventions2026
Internet-delivered unguided psychodynamic vs. cognitive behavior therapy for anxiety and depression symptoms: A large, full factorial randomized controlled trial on treatment length and peer support.
Article in Internet interventions, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
Objective: Depressive and anxiety disorders are highly comorbid and widely prevalent, yet a significant treatment gap remains. Scalable, unguided transdiagnostic internet interventions may increase access to care. This study evaluated the efficacy of two distinct unguided transdiagnostic treatments, internet-delivered cognitive behavioral therapy based on Unified Protocol (UP) and internet-delivered affect-focused psychodynamic therapy (IPDT). Furthermore the study examined the impact of treatment duration and assessed the value of peer support. Method: In a 3 × 2 × 2 factorial design, adults in Sweden with self-reported symptoms of depression and/or anxiety ( Results: Overall, adherence was low, with participants completing fewer than half of the treatment modules on average and high attrition on measurements. At posttreatment, both UP and IPDT resulted in significant reductions in depressive and anxiety symptoms compared to the waitlist control, with small to moderate between-group effect sizes ( Conclusions: Unguided transdiagnostic internet interventions can effectively reduce symptoms of depression and anxiety and improve quality of life. Since the 16-week duration provided no added value over the 8-week format, the shorter duration appears sufficient for unguided delivery. However, the low adherence rates suggest that unguided self-help may not be suitable for everyone. The substantial attrition, particularly at follow-up, limits the interpretability of long-term outcomes and highlights the need for strategies to improve engagement in unguided formats. Trial registration: ClinicalTrials.govNCT05016843.
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