A secondary analysis investigating therapist-effects in a guided internet-based intervention for adults with symptoms of depression.

Manuel Heinrich, Pavle Zagorscak, Lars Schulze, Christine Knaevelsrud

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In one paragraph

Article in Internet interventions, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Manuel HeinrichFreie Universität Berlin, Department of Education and Psychology, Division of Clinical-Psychological Intervention, Berlin, Germany.

Pavle ZagorscakFreie Universität Berlin, Department of Education and Psychology, Division of Clinical-Psychological Intervention, Berlin, Germany.

Lars SchulzeFreie Universität Berlin, Department of Education and Psychology, Division of Clinical Psychology and Psychotherapy, Germany.

Christine KnaevelsrudFreie Universität Berlin, Department of Education and Psychology, Division of Clinical-Psychological Intervention, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Studies consistently show that guided internet-based interventions (IBIs) are more effective than unguided IBIs for depression. Yet, little is known about whether average symptom change and rates of treatment discontinuation differ between therapists who guide clients through IBIs (IBI therapists). Method: This secondary analysis draws on data from three randomized controlled trials (RCTs; RCT1: Results: Estimated therapist effects for treatment discontinuation were cVPC = 0.3 to 7.5% and cMOR = 1.081 to 1.617; for treatment response, cVPC = 0.4 to 3.1% and cMOR = 1.088 to 1.332; and for symptom change, conditional ICC = 0.2 to 0.7% and conditional median absolute difference = 0.121 to 0.275 PHQ-9 points. No association between the number of treated clients and any outcome emerged. However, longer feedback was associated with a reduced likelihood of treatment discontinuation. Conclusion: The between-therapist differences in discontinuation and symptom change in guided IBIs for depression can be small.

Indexed as

DepressionInternet-based CBT (iCBT)Internet-based intervention (IBI)Randomized-controlled trial (RCT)Secondary analysisTherapist-effects

Identifiers

PMID42339009

DOI10.1016/j.invent.2026.100964

PMCPMC13284498

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