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Internet-Delivered Interventions for Depression and Anxiety Symptoms in Children and Young People: Systematic Review and Meta-analysis

Nora Eilert, DCounsPsych; Rebecca Wogan, MSc; Aisling Leen, BA; Derek Richards, PhD (2022)

This work provides an up-to-date examination of the available intervention options and their effectiveness for children and young people (CYP).

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Durability of treatment effects following internet-delivered cognitive behavioural therapy for depression and anxiety delivered within a routine care setting

Authors: Jorge E. Palacios, Angel Enrique, Olwyn Mooney, Simon Farrell, Caroline Earley, Daniel Duffy, Nora Eilert, Siobhan Harty, Ladislav Timulak, Derek Richards (2022)

This study is the first to explore the remission and relapse rates after an acute phase of iCBT treatment, within a routine, stepped-care setting. The results add to the scarce literature on the durability of the effects of iCBT treatment in routine care settings, where patients are not typically followed up after receiving a completed course of treatment.

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The Acceptability and Initial Effectiveness of “Space From Money Worries”: An Online Cognitive Behavioral Therapy Intervention to Tackle the Link Between Financial Difficulties and Poor Mental Health

Thomas Richardson, Angel Enrique, Caroline Earley, Adedeji Adegoke, Douglas Hiscock and Derek Richards (2022)

This pilot study examined the preliminary effects of a digital program on financial difficulties and mental health within an routine clinical setting. The results showed patients experienced significant improvements in depression, anxiety and perceived financial wellbeing. Satisfaction rates with the program were at 95%, suggesting it was highly accepted.”

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Nora Eilert; Ladislav Timulak; Daniel Duffy; Caroline Earley; Angel Enrique; Polly Kennedy; Clare McCormack; Jorge Palacios; Rebecca Wogan; Derek Richards (2021). Following up internet-delivered cognitive behaviour therapy (CBT): A longitudinal qualitative investigation of clients' usage of CBT skills. Request a Copy
Rebecca Wogan, Angel Enrique, Adedeji Adegoke, Caroline Earley, Sarah Sollesse , Sophie Gale, Marie Chellingsworth, Derek Richards (2021) Internet-delivered CBT Intervention (Space for Sleep) for insomnia in a routine care setting: results from an open pilot study. Request a copy
Nora Eilert; Ladislav Timulak; Daniel Duffy; Caroline Earley; Angel Enrique; Polly Kennedy; Clare McCormack; Jorge Palacios; Rebecca Wogan; Derek Richards (2021). Following up internet-delivered cognitive behaviour therapy (CBT): A longitudinal qualitative investigation of clients' usage of CBT skills. Request a Copy
Matthew Franklin; Angel Enrique; Jorge Palacios; Derek Richards. Psychometric assessment of EQ‑5D‑5L and ReQoL measures in patients
with anxiety and depression: construct validity and responsiveness. Request a copy
Camille Nadal, Caroline Earley, Angel Enrique, Noemi Vigano, Corina Sas,Derek Richards, Gavin Doherty (2021).  Integration of a smartwatch within an internet-delivered intervention for depression: Protocol for a feasibility randomized controlled trial on acceptance. Request a copy 

Nora Eilert, Angel Enrique, Rebecca Wogan, Olwyn Mooney, Ladislav Timulak, Derek Richards (2021). The effectiveness of Internet‐delivered treatment for generalized anxiety disorder: An updated systematic review and meta‐analysis. Request a copy

Angel Enrique Roig, PhD; Olwyn Mooney, MSc; Alicia Salamanca-Sanabria, PhD; Chi Tak Lee, MSc; SimonFarrell, MSc; Derek Richards, PhD (2021). Assessing the Efficacy and Acceptability of a Web-Based Intervention for Resilience Among College Students: Pilot Randomized Controlled Trial. Request a copy



David C. Mohr, Ph.D., Francisca Azocar, Ph.D., Andrew Bertagnolli, Ph.D., Tanzeem Choudhury, Ph.D., Paul Chrisp, Ph.D., Richard Frank, Ph.D., Henry Harbin, M.D., Trina Histon, Ph.D., Debra Kaysen, Ph.D., Camille Nebeker, Ed.D., M.S., Derek Richards, Ph.D., Stephen M. Schueller, Ph.D., Nickolai Titov, Ph.D., John Torous, M.D., Patricia A. Areán, Ph.D., on behalf of the Banbury Forum on Digital Mental Health (2021). Banbury Forum Consensus Statement on the Path Forward for Digital Mental Health Treatment. Request a copy

Chien I., MEng; Enrique A., Ph.D.; Palacios J., MD, Ph.D.; Regan T., Ph.D.; Keegan D., MSc; Carter D., Ph.D.; Tschiatschek S., Ph.D.; Nori A., Ph.D.; Thieme A., Ph.D.; Richards D., Ph.D.; Doherty D., DPhil; Belgrave D., PhD. A machine learning approach to understanding patterns of engagement with internet-delivered mental health interventions. Request a copy

A. Enrique, O. Mooney, A. Salamanca-Sanabria, C.T. Lee, S. Farrell, D. (2020). Richards. Assessing the efficacy and acceptability of an internet-delivered intervention for resilience among college students: A pilot randomised control trial protocol. Request a copy

Richards D., Enrique A., Eilert N., Franklin M., Palacios J.E., Duffy D., Earley C., Chapman J., Jell G., Sollesse S. & Timulak L. (2020). A pragmatic randomized waitlist-controlled effectiveness and cost-effectiveness trial of digital interventions for depression and anxiety. Request a copy
J. Jardine, C. Earley, D. Richards, L. Timulak, J E Palacios, D. Duffy, K. Tierney, G. Doherty (2020). The experience of guided online therapy: a longitudinal, qualitative analysis of client feedback in a naturalistic RCT. Request a copy


Duffy, D., Enrique, A., Connell, S., Connolly, C. & Richards, D. (2019). Internet-Delivered Cognitive Behavior Therapy as a Prequel to Face-To-Face Therapy for Depression and Anxiety: A Naturalistic Observation. Request a copy

Enrique A., Palacios J.E., Ryan H., Richards D. (2019). Exploring the Relationship Between Usage and Outcomes of an Internet-Based Intervention for Individuals With Depressive Symptoms: Secondary Analysis of Data From a Randomized Controlled Trial. Request a copy

Salamanca-Sanabria, A., Richards, D., & Timulak, L. (2019). Adapting an internet-delivered intervention for depression for a Colombian college student population: An illustration of an integrative empirical approach. Internet Interventions, 15, 76-86. doi: Request a copy



Book Chapters

Richards, D., Enrique, E., & Palacios, J. (in press). Internet-delivered Cognitive Behaviour Therapy. In S. Parry (Ed.), The Handbook of Brief Therapies: A Practical Guide. London: Sage.

Richards., D., Enrique, A., Palacios, J., & Duffy, D. (2018). Internet-Delivered Cognitive Behaviour Therapy. In Ömer Şenormancı & G. Şenormancı (Eds.), Cognitive Behavioral Therapy and Clinical Applications (pp. 223-238). Netherlands: InTech. Request a copy

Peer-reviewed journals

Richards D, Duffy D, Burke J, Anderson M, Connell S, Timulak L (2018). Supported Internet-Delivered Cognitive Beavior for Adults with Severe Depressive Symptoms: a Secondary Analysis. Request a Copy

Wright, J.H., Owen, J.J., Richards, D., Ells, T.D., Richardson, T., Brown, G.K., Barrett, M., Rasku, M.A., Polser, G., Thase, M. (in press). Computer-assisted Cognitive-Behavior Therapy for Depression: A Systematic Review and Meta-analysis.  Journal of Clinical Psychiatry.

Salamanca-Sanabria, A., Richards, D., Timulak, L., (in review). Culturally Adapted Cognitive Behavioural internet-delivered treatment for depression: A systematic review. Global Mental Health.

Richards, D., Duffy., D., Blackburn, B., Earley, C., Enrique, A., Palacios, J., Franklin, M., Clarke, G., Sollesse, S., Connell, S., Timulak, L. (2018). Digital IAPT: The effectiveness & cost-effectiveness of Internet-delivered interventions for depression and anxiety disorders in the Improving Access to Psychological Therapies programme: study protocol for a randomised control trial. BMC Psychiatry, 18(1). doi:10.1186/s12888-018-1639-5. Request a copy

Salamanca-Sanabria, A., Richards, D., Timulak, L., Castro-Camacho, L., Mojica-Perilla, M., & Parra-Villa, Y. (2018). Assessing the efficacy of a culturally adapted cognitive behavioural internet-delivered treatment for depression: protocol for a randomised controlled trial. BMC Psychiatry, 18(1). doi:10.1186/s12888-018-1634-x.  Request a copy

Richards, D., Dowling, M., O’Brien, E., Viganó, N., Timulak, L. (2018) Significant events in an internet-delivered (Space from Depression) intervention for depression. Counselling and Psychotherapy Research, 18, 35-48. doi:10.1002/capr.12142.  Request a copy

Wells, M.J., Owen, J.J., McCray, L.W., Bishop, L.B., Ells, T.D., Brown, G.K., Richards, D., Thase, M.E., Wright, J.H. (2018). Computer-assisted cognitive-behaviour therapy for depression in primary care: Systematic review and meta-analysis. Primary Care Companion for the Journal of Clinical Psychiatry Request a copy

Richards, D., Duffy, D., Burke, J., Anderson-Gibbons, M., Connell, S., Timulak, L. (in press). A secondary analysis of internet-delivered cognitive-behaviour treatment for adults with severe depressive symptoms. JMIR Ment Health. doi:10.2196/10204

Enrique, A., Burke, J., Richards, D., Timulak, L. (2018) Quality of life outcomes in internet-delivered (Space from depression) treatment for depression. Applied Research in Quality of Life.  Request a copy

Burke, J., Richards, D., & Timulak, L. Helpful and Hindering Events in Internet-Delivered Cognitive Behavioural Treatment for Generalized Anxiety. Behavioural and Cognitive Psychotherapy, 1-14. doi:10.1017/S1352465818000504.  Request a copy



Earley, C., Richards, D., Timulak, L. (2017). Preventing depression: examining the benefits of depression-focused iCBT for participants who do not meet clinical thresholds. Internet Interventions Request a copy

Richards, D., Murphy, T., Viganó, N., Timulak, L., Doherty, G., Sharry, J., & Hayes, C. (2017) Acceptability, satisfaction and perceived efficacy of “Space from Depression” an internet-delivered treatment for depression. Internet Interventions, 5, 12-22. doi:10.1016/j.invent.2016.06.007. 

Palacios, J., Lee, G. A., Duaso, M., Clifton, A., Norman, I. J., Richards, D., & Barley, E. A. (2017). Internet-Delivered Self-management Support for Improving Coronary Heart Disease and Self-management-Related Outcomes: A Systematic Review. Journal of Cardiovascular Nursing, Publish Ahead of Print. doi:10.1097/jcn.0000000000000392.  Request a copy



Walsh, A., & Richards, D. (2016) Experiences and Engagement with the Design Features and Strategies of an Internet-Delivered Treatment Programme for Generalized Anxiety Disorder: A Service-Based Evaluation. British Journal of Guidance & Counselling. doi:10.1080/03069885.2016.1153039.  Request a copy

Richards, D, Richardson, T., Timulak, L., Vigano, N, Mooney, J. Sharry, J., Doherty, G, & Hayes, C. (2016). Predictors of depression severity in a treatment-seeking sample. International Journal of Clinical and Health Psychology. doi: Request a copy

Richards, D, Richardson, T., Timulak, L., Vigano, N, Mooney, J. (2016).  Predictores de la gravedad de la depresión en personas adultas que buscan tratamiento . International Journal of Clinical and Health Psychology. doi:  Request a copy

Frazier, P., Richards, D., Mooney, J., Hofmann, S. G., Beidel, D., Palmieri, P. A., & Bonner, C. (2016). Acceptability and proof of concept of internet-delivered treatment for depression, anxiety, and stress in university students: protocol for an open feasibility trial. Pilot and Feasibility Studies, 2(1). doi:10.1186/s40814-016-0068-9. Request a copy

Richards, D., Timulak, L., Rashleigh, C., McLoughlin, O., Colla, A., Joyce, C., . . . Duffy, D., Anderson-Gibbons, M. (2016). Effectiveness of an Internet-delivered intervention for generalized anxiety disorder in routine care: A randomised controlled trial in a student population. Internet Interventions, 6, 80-88. doi:10.1016/j.invent.2016.10.003. Request a copy



Richards, D., Timulak, L., O’Brien, E., Hayes, C., Vigano, N., Sharry, J., & Doherty, G. (2015). A randomized controlled trial of an internet-delivered treatment: Its potential as a low-intensity community intervention for adults with symptoms of depression. Behaviour Research Therapy, 75, 20-31. doi:10.1016/j.brat.2015.10.005.  Request a copy

Richards, D., Richardson, T., Timulak, L., & McElvaney, J. (2015). The efficacy of online delivered treatment for generalized anxiety disorder: A systematic review and meta-analysis. Internet Interventions, 2(3), 272-282. doi:10.1016/j.invent.2015.07.003. Request a copy

Barley, E. A., Clifton, A., Lee, G., Norman, I., O’Callaghan, D., Tierney, K., Richards, D. (2015) The Space From Heart Disease Intervention for People With Cardiovascular Disease and Distress: A Mixed-Methods Study. JMIR Res Protocols, 4(3), e81. doi: 10.2196/resprot.4280. Request a copy



Morrison, C. & Doherty, G. (2014). Analysing Engagement in a Web-based Intervention Platform through Visualising Log-Data, Journal of Medical Internet Research, 16(11):e252. doi: 10.2196/jmir.3575 . Request a copy

Richards, D., Timulak, L., Doherty, G., Sharry, J., Colla, A., Joyce, C., & Hayes, C. (2014). Internet-delivered treatment: its potential as a low-intensity community intervention for adults with symptoms of depression: protocol for a randomized controlled trial. BMC Psychiatry, 14(147), 1-11. doi: 10.1186/1471-244X-14-147. Request a copy

Richards, D., Timulak, L., Doherty, G., Sharry, J., McLoughlin, O., Rashleigh, C., . . . Joyce, C. (2014). Low-intensity internet-delivered treatment for generalized anxiety symptoms in routine care: protocol for a randomized controlled trial. Trials, 15(145), 1-11. doi: 10.1186/1745-6215-15-145. Request a copy

Barley, E. A., Clifton, A., Enright, A., Lee, G., Norman, I., Richards, D. (2014) An online intervention for wellbeing and self-management of CVD: Results from a feasibility trial.

Richards, D., & Salamanca, A. (2014). Point-prevalence of depression and associated risk factors. The journal of psychology: Interdisciplinary and applied, 148(3), 305-326. Request a copy



Sharry, J., Davidson, R., McLoughlin, O & Doherty, G. (2013). A Service-Based Evaluation of a Therapist-Supported Online Cognitive Behavioural Therapy Programme for Depression, J Med Internet Res, 15(6):e121. doi:10.2196/jmir.2248. Request a copy

Richards, D., Timulak, L., & Hevey, D. (2012). A comparison of two online cognitive-behavioural interventions for symptoms of depression in a student population: The role of therapist responsiveness. Counselling and Psychotherapy Research, 13(3), 184-193. doi: 10.1080/14733145.2012.733715 Request a copy

Richards, D. (2013). Developments in technology-delivered psychological interventions. Universitas Psychologica, 12(2), 571-579. Request a copy

Richards, D., & Viganó, N. (2013). Online Counseling: A Narrative and Critical Review of the Literature. Journal of Clinical Psychology, 69(9), 994-1011. doi:10.1002/jclp.21974. Request a copy



Doherty, G., Coyle, D. & Sharry, J. (2012). Engagement with Online Mental Health Interventions: An Exploratory Clinical Study of a Treatment for Depression , ACM CHI 2012 Conference on Human Factors in Computing Systems, Austin, TX, ACM, pp.1421-1430. doi 10.1145/2207676.2208602. Request a copy

Richards, D., & Richardson, T. (2012). Computer-based psychological treatments for depression: A systematic review and meta-analysis. Clinical Psychology Review, 32(4), 329-342. doi: 10.1016/j.cpr.2012.02.004. Request a copy

Richards, D., & Timulak, L. (2012). Client-identified helpful and hindering events in therapist-delivered vs. self-administered online cognitive-behavioural treatments for depression in college students. Counselling Psychology Quarterly, 25(3), 251-262. doi: 10.1080/09515070.2012.703129. Request a copy

Richards, D., & Timulak, L. (2012). Satisfaction with therapist-delivered vs. self-administered online cognitive-behavioural treatments for depression symptoms in college students. British Journal of Guidance & Counselling, 41(2), 193-207. doi: 10.1080/03069885.2012.726347. Request a copy



Richards, D. (2011). Prevalence and clinical course of depression: A review. Clinical Psychology Review, 31(7), 1117-1125. doi: 10.1016/j.cpr.2011.07.004. Request a copy



Doherty, G., Coyle, D. & Matthews, M. (2010). Design and Evaluation Guidelines for Mental Health Technologies, Interacting with Computers, 22(4), pp.43-252. doi 10.1016/j.intcom.2010.02.006. Request a copy



Coyle, D., Doherty, G., Sharry, J. & Matthews, M. (2007). Computers in Talk-Based Mental Health Interventions, Interacting with Computers, 19(4), pp.545-562. doi 10.1016/j.intcom.2007.02.001.   Request a copy