Implementation trial I: Clinical outcomes and acceptability of an internet-delivered intervention for anxiety and depression delivered as part of routine care for university students in New Zealand

Background: Psychological distress is highly prevalent among university students and can contribute to poor academic performance and drop-out. Help-seeking has increased in recent years, contributing to growing interest in employing internet-delivered psychological treatments to support the mental health of university students. However, few large-scale "real-world" effectiveness trials have been conducted in routine care settings for this population.

Aim: The aim of the current study was to examine the acceptability and effectiveness of a brief, five-week internet-delivered cognitive behavioural therapy (iCBT) intervention for anxiety and depression when delivered as part of routine care by a university counselling service in New Zealand.

Design: A large, prospective, single-group Phase IV clinical trial.

Method: Students (N = 1044) engaging with the university counselling service between 2018 and 2023 were provided the option to receive the intervention based on their needs and preferences. Students completed standardised measures of depression and anxiety severity at pre-treatment, each week of the intervention, and post-treatment. A subsample (n = 405) also completed these at 3-month follow-up.

Results: Over a 5-year period, 839 students participated in the intervention. Significant reductions in symptoms of depression (% reduction = 35%, Hedges' g = 0.56) and anxiety (% reduction = 36%, Hedges' g = 0.73) were observed, alongside high levels of satisfaction (> 60%). Symptom deterioration was observed in <10% of students.

Conclusion: The current results provide further support for the provision of internet-delivered psychological interventions as routine care to university students with symptoms of anxiety and depression.