Improving Access to Psychological Services Through Therapist-Assisted, Internet-Delivered Cognitive Behaviour Therapy

Depression and anxiety are prevalent yet undertreated conditions. Therapist-assisted Internet-delivered cognitive behaviour therapy (ICBT) is efficacious for these conditions and can serve to overcome barriers to accessing mental health care (e.g., distance, time). In therapist-assisted ICBT, patients review cognitive behavioural treatment materials over the Internet. In addition, providers offer support and direction most commonly through weekly emails or phone calls. Despite the evidence for and advantages of therapist-assisted ICBT, very few patients have access to this treatment in Canada. In this paper, we describe the Online Therapy Unit for Service, Education and Research that was developed at the University of Regina to improve patient access to ICBT in Saskatchewan. With the support of national and provincial funding, this unit created an ICBT web application for the treatment of depression and anxiety, established policies and procedures for delivery of ICBT, trained therapists to deliver the service, and has been coordinating the delivery of ICBT across multiple diverse settings in Saskatchewan. The current paper describes how the Unit is organized and collaborates with community mental health clinics, thus serving to improve access to ICBT. We provide information on the web application, and the process of ICBT from both the patient and provider perspective. We further describe patient and provider utilization of and feedback about ICBT along with recent and future directions for the Unit. Thus far, the Unit has had a positive impact expanding access to psychological services in Saskatchewan and has the potential to inform similar initiatives in other provinces.