. 2023 Jul 3;14(11):1981–2000. doi: 10.7150/jca.82632

Table 2.

Recent Advancements and Novel Developments in Internet-Based Cognitive Behavioral Therapy (iCBT)

Advancements/New Developments	Description
Machine Learning	Machine learning algorithms can personalize iCBT by predicting treatment response and tailoring treatment to individual needs. Machine learning can also be used to automate therapist support and improve treatment outcomes. Machine learning algorithms can analyze user data to predict treatment response, identify risk factors, and personalize therapy based on user characteristics and preferences. Machine learning can also be used to develop chatbots and other digital tools that can provide automated support to users and supplement therapist support²¹, ²².
Transdiagnostic iCBT	Transdiagnostic iCBT is a treatment approach that targets multiple disorders with similar underlying mechanisms, such as anxiety and depression. Transdiagnostic iCBT can be delivered through online self-help programs or in conjunction with a therapist and has been found to be effective for reducing symptoms of anxiety and depression. Transdiagnostic iCBT can be more efficient and cost-effective than disorder-specific interventions, as it can address common underlying factors across multiple conditions²³.
Virtual Reality (VR) iCBT	VR technology is being used to create immersive environments for treating conditions such as social anxiety disorder (SAD) and post-traumatic stress disorder (PTSD). In VR iCBT, users can interact with computer-generated stimuli that simulate real-life situations and experiences, allowing them to practice coping strategies and exposure therapy in a controlled and safe environment²⁴.
Metaverse-based iCBT	Metaverse is a term used to describe the convergence of virtual reality and physical reality in a digital space. It is a virtual world in which people can interact through digital selves or avatars²⁵. It is possible that in the future, metaverse technology could be used to create immersive environments for delivering iCBT, allowing users to interact with therapy materials and practice coping strategies in a more engaging and interactive way²⁶. However, more research is needed to determine the feasibility and effectiveness of metaverse-based iCBT. Overall, while the potential for metaverse-based iCBT is an exciting prospect, it is still in its early stages and more research is needed to determine its feasibility and effectiveness.
Mobile-based iCBT	The use of mobile apps has made iCBT more accessible and convenient for users, allowing them to access therapy on-the-go. Mobile-based iCBT can include interactive exercises, video or audio sessions, and progress tracking to help users manage their mental health from anywhere.²⁷.
Guided vs Unguided iCBT	Guided iCBT involves support from a therapist or coach, while unguided iCBT is self-guided without therapist support. Research suggests that guided iCBT may be more effective for depression and anxiety, as therapist support can help users better understand and apply therapy techniques and provide accountability and motivation to complete therapy modules²⁸.
Tailored iCBT	Tailored iCBT refers to personalized interventions that are customized based on a user's needs and preferences, including language, culture, and personal goals. Tailored iCBT can improve engagement and treatment outcomes by adapting the content and delivery of therapy to fit the unique needs of each user. Tailored iCBT can be delivered through online self-help programs or in conjunction with a therapist or coach²⁹.
Integration with other technologies	iCBT can be integrated with other digital tools, such as wearables, chatbots, and artificial intelligence, to enhance therapy and improve outcomes. Wearable devices can track physiological and behavioral data to provide personalized feedback and insights to users. Chatbots can provide support and guidance to users outside of therapy sessions, while artificial intelligence can personalize therapy by predicting treatment response and tailoring treatment to individual needs³⁰.
Stepped Care	Stepped care is a hierarchical model of mental health care that matches the intensity of treatment to the severity of the condition. iCBT can be used as a low-intensity treatment in the initial stages of stepped care and may reduce the need for more intensive treatments later on. In stepped care, users receive treatment that is tailored to their needs and gradually progresses to more intensive levels of care as needed. Stepped care can improve access to mental health care and reduce the burden on healthcare systems by ensuring that users receive the appropriate level of care for their needs³¹.
Blended Care and Blended iCBT	Blended care, a hybrid mental health treatment, merges face-to-face therapy with digital tools like iCBT for effective management of depression, anxiety, and other conditions. This flexible, individualized approach combines digital convenience with personalized in-person sessions. Blended iCBT may involve supplementing therapy with videoconferencing or online programs, or offering support between sessions³².