Evaluating Internet-Based Cognitive Behavioural Therapy for Mild-to-Moderate Anxiety and Depression in Singapore A Randomized Study Comparing iCBT to Usual Care with Cost and Effectiveness Analysis

What this Trial Is About

Researchers are evaluating internet-based cognitive behavioural therapy iCBT for adults aged 21 and older with mild-to-moderate depression andor anxiety. This study compares guided iCBT to usual care traditional CBT and other mental health services to assess its effectiveness, cost-efficiency, and acceptability within Singapores primary and community healthcare settings. The trial also explores how individual user characteristics affect treatment outcomes and identifies factors influencing the use and engagement with iCBT. Participants in the intervention group will use a mobile application to complete eight weekly online CBT modules with interactive exercises and homework, supported by three scheduled counsellor check-ins via video or face-to-face sessions at weeks 3, 5, and 8. The control group will continue receiving usual care, including general practitioner consultations and standard face-to-face CBT. Both groups will complete questionnaires at five timepoints across 8 to 10 months. A qualitative component will involve interviews with selected intervention participants and service providers to understand experiences, barriers, and facilitators related to iCBT implementation. Participants will attend up to six study visits over 8 to 10 months, completing questionnaires assessing depression PHQ-9, anxiety GAD-7, functioning WHODAS 2.0, patient satisfaction, healthcare use, and costs. Selected participants in the intervention group will be invited to a one-hour semi-structured interview about their experiences with iCBT. Service providers will also participate in interviews to provide insights into integrating iCBT into routine care. The study measures changes in mental health symptoms, functional status, quality of life, and cost-effectiveness, with safety monitored throughout the trial.

Internet-Based Cognitive Behavioural Therapy (iCBT) for Anxiety and Depression in Singapore