Psychiatr. praxi. 2026;27(1):36-42 | DOI: 10.36290/psy.2026.006

Internet-based CBT for depression: a pilot study

MUDr. Jan Pásztor^{1, 2}, prof. MUDr. Ján Praško, CSc.^1-5, PhDr. Marie Ocisková, Ph.D.^{1, 2, 5}, MUDr. Vlastimil Nesnídal¹, MUDr. Kryštof Kantor⁵, MUDr. Kristýna Vrbová, Ph.D.¹, Mgr. et Mgr. Zdeněk Maté^{1, 2}, David Kwolek⁵, Anton Sverlov⁵, MUDr. František Vlček, Ph.D.^{2, 5}, Ing. Jelena Holomany, MSc.⁵

¹ Klinika psychiatrie, Lékařská fakulta a Fakultní nemocnice Olomouc, Univerzita Palackého v Olomouci

² Centrum duševní rehabilitace, Jessenia a. s., Rehabilitační nemocnice Beroun, Akeso holding, a. s.

³ Univerzita Konštantína Filozofa v Nitre, Fakulta sociálnych vied a zdravotnictva, Katedra psychologických vied, Nitra

⁴ Katedra psychoterapie, IPVZ Praha

⁵ Mindwalk, s. r. o., Praha

Introduction: Major depressive disorder is one of the most common mental disorders, but many patients do not have access to appropriate psychotherapy due to limited service availability, stigma, or financial barriers. Internet-based cognitive behavioral therapy (CBT)-based therapeutic programs represent an innovative and affordable alternative to standard psychotherapy. This study aims to evaluate the feasibility, adherence, and effectiveness of the Mindwell online CBT program for people with mild to moderate depressive symptoms.

Method: A total of 188 patients who were referred by health insurance companies based on referrals from outpatient psychiatrists or general practitioners entered the program between January 1 and May 30, 2024, of whom 126 were included in the study. The PHQ-9, GAD-7, and BAI scales were used to measure depressive and anxiety symptoms at the beginning. PHQ-9 and GAD-7 were completed before the start of therapy and during each module. Adherence was defined as completing at least 6 modules out of a total of 11.

Results: A total of 64 patients (51% of the sample) completed 6 modules. These patients experienced a statistically significant reduction in both depression and anxiety symptoms (PHQ-9, paired t-test: t = 5.883 df = 63; p < 0.0001; GAD-7: t = 5.273 df = 63; p < 0.001). The effect size (for PHQ-9; Cohen's dz = 0.98 for GAD-7 Cohen's dz = 0.62) suggests high program effectiveness. Adherence analysis showed that higher adherence was negatively correlated with the severity of depressive symptoms at baseline, but was not associated with treatment effectiveness.

Conclusion: The results show that the online CBT program is a feasible and effective tool for patients with mild to moderate depression. The program represents a significant step towards improving access to psychotherapy and overcoming barriers associated with traditional treatment.

Keywords: online cognitive behavioral therapy, depression, adherence, feasibility study, internet-based therapeutic programs.

Accepted: March 12, 2026; Published: March 23, 2026  Show citation