Date of Award

Spring 2023

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)


Physician Assistant Studies

First Advisor

Stavetig, Mindy


Cognitive Behavior Therapy, CBT, Internet Cognitive Behavior Therapy, ICBT, Anxiety, Depression


According to the American Psychiatric Association, the prevalence of anxiety and depression in adults in their lifetime are nearly 30% and 16.6% respectively. The combination of pharmacotherapy and psychotherapy interventions (including talk therapy or cognitive behavior therapy (CBT)) are considered best practice, but in recent years there has been an increase in the popularity of applications and web-based services categorized as “internet cognitive behavior therapy”, or ICBT. The question proposed is, are these services as good for patient outcomes as traditional in-person CBT? A literature review was performed using electronic medical database PubMed with key word searches for cognitive behavior therapy and internet delivered cognitive behavior therapy for both anxiety and depression in adults. All searches were limited to the years between 2015 and 2022, with preference to 2018 to 2022 and filters were set to include “Clinical Trial” and “Randomized Control Trial” only. Many articles were eliminated to only include adult populations and the use of true “internet cognitive behavior therapy”, not telemedicine use. Data reviewed shows evidence that participants who used ICBT had statistically significant (p < 0.05) improvement in anxiety or depressive symptoms similar to that of traditional CBT and both CBT and ICBT show substantial improvement from control groups. Overall, more studies are needed utilizing a focus of anxiety or depression alone in adults, for longer periods of time utilized or followed, and as more applications or ICBT options become available. The data thus far is evident, though, that ICBT provides a promising option for patients in which in-person CBT is not an option or is not desired.