Implementation of Internet delivered cognitive behavioural therapy for depression: a review. From an implementation science theoretical framework perspective

Abstract

Effectiveness of Internet delivered cognitive behavioural therapy (iCBT) for depression has previously been extensively documented, however, uptake of iCBT into regular clinical practice is slow. This literature review aims to investigate iCBT in an implementation science theoretical context in order to better understand barriers towards uptake of iCBT and to elucidate areas well covered in the literature as well as areas in need of attention. To be included in the review, articles needed to describe implementation aspects in relation to Internet or computerised treatment for depression. The main results showed that studies tend to focus on similar implementation aspects while leaving others untouched. Political and economical aspects, organisational culture and knowledge levels among stakeholders are aspects well documented. The literature on specific implementation processes is, however, scarce. Many important aspects for successful implementation (e.g. readiness for implementation, implementation climate, individual characteristics, networking and communication between organisations, complexity of the intervention perceived by stakeholders, trialability of the intervention, design and packaging, and costs associated with implementation) were generally poorly described in the literature. In summary, this review identifies multiple aspects important to successful implementation of iCBT as well as a possible explanation to why uptake of iCBT into regular clinical care is slow.