Psychiatr. praxi. 2026;27(1):E1-E7 | DOI: 10.36290/psy.2026.009

Internet-based CBT for generalized anxiety: a pilot study

MUDr. Kamila Bělohradová1, prof. MUDr. Ján Praško, CSc.1-5, PhDr. Marie Ocisková, Ph.D.1, 2, 5, MUDr. Jan Pásztor1, 2, MUDr. Kryštof Kantor, Ph.D.2, Mgr. et Mgr. Zdeněk Maté1, 2, MUDr. Vlastimil Nesnídal1, MUDr. Kristýna Vrbová, Ph.D.1, MUDr. František Vlček, Ph.D., MHA5, David Kwolek5, 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 Katedra psychologických vied, Fakulta sociálnych vied a zdravotnictva, Univerzita Konštantína Filozofa v Nitre
4 Katedra psychoterapie, IPVZ Praha
5 Mindwalk, s. r. o., Praha

Background: Generalized Anxiety Disorder (GAD) is one of the most prevalent anxiety disorders, significantly affecting patients' quality of life. However, access to traditional psychotherapy is often hindered by stigma and geographical or financial barriers. Internet-based therapeutic programs, such as Mindwell, offer an accessible alternative based on Cognitive Behavioral Therapy (CBT) principles.

Objective: This study aimed to evaluate the effectiveness and adherence of the internet-based psychoeducational program Mindwell in individuals with mild to moderate symptoms of GAD.

Method: A total of 209 patients were enrolled in the program based on recommendations from health insurance providers between January 1 and May 30, 2024. Participants assessed their symptoms using the GAD-7 and PHQ-9 scales before starting therapy, during the therapy and at the end of the therapy.

Results: Data analysis from 118 participants who completed at least six modules showed a significant anxiety reduction (GAD-7, t = 9.470; p < 0.001) and depressive symptoms (PHQ-9, t = 9.671; p < 0.001). The effect size (Cohen's d = 0.89) confirms a strong intervention impact.

Conclusion: The results confirm the high effectiveness of the Mindwell program for GAD patients. Internet-based CBT therapy proves to be an effective and accessible alternative to traditional psychotherapy and may play a key role in expanding access to anxiety disorder treatment.

Keywords: generalized anxiety disorder, internet therapy, cognitive behavioral therapy, psychoeducation, treatment effectiveness, adherence, feasibility study.

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

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Bělohradová K, Praško J, Ocisková M, Pásztor J, Kantor K, Maté Z, et al.. Internet-based CBT for generalized anxiety: a pilot study. Psychiatr. praxi. 2026;27(1):E1-7. doi: 10.36290/psy.2026.009.
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    References

    1. Kessler RC, Chiu WT, Demler O, et al. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):617-627. Go to original source...
    2. Behar E, DiNardo PA, Barlow DH. Generalized anxiety disorder. In: Barlow DH, editor. Clinical handbook of psychological disorders: A step-by-step treatment manual. 4th ed. New York: Guilford Press; 2009. p. 430-469.
    3. Ruiz P, Lima L, Morillo C. Psychiatric comorbidities and their effects on the clinical course of generalized anxiety disorder. J Anxiety Disord. 2012;26(2):233-240.
    4. Hofmann SG, Asnaani A, Vonk IJ, et al. The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cogn Ther Res. 2012;36(5):427-440. Go to original source...
    5. Andersson G. Internet interventions: A new era in psychotherapies. Handb Psychother. 2016;45(1):6-19.
    6. Titov N, Andrews G, Schwencke G, et al. Internet treatment for depression and anxiety: A systematic review. J Affect Disord. 2015;168:3-14.
    7. Lindenberg CS, Lueke L, Rupprecht R, et al. Efficacy of online cognitive behavioral therapy for generalized anxiety disorder: A meta-analysis. Behav Ther. 2020;51(5):821-830.
    8. Mindwell. Online KBT program. Available from: https://www.mindwell.cz. [Accessed 2024 Feb 8].
    9. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013. Go to original source...
    10. Hollon SD, Stewart MO, Strunk DR. The Efficacy of Cognitive Therapy in Depression: A Review of the Evidence. Arch Gen Psychiatry. 2006;63(5):510-517.
    11. Mitte K. Meta-analysis of cognitive-behavioral treatments for generalized anxiety disorder: A comparison with pharmacotherapy. Psychol Bull. 2005;131(5):785-795. Go to original source...
    12. Beck AT. Cognitive therapy: A 30-year retrospective. Am Psychol. 2011;66(4):356-367.
    13. Clark DA, Beck AT. Cognitive theory and therapy of anxiety and depression: A practitioner's guide. New York: Guilford Press; 2010.
    14. Borkovec TD, Alcaine O, Behar E. Avoidance theory of anxiety disorders. In: Davey G, Tallis F, editors. Wiley Handbook of Anxiety Disorders. New York: Wiley; 2002. p. 77-101.
    15. Barlow DH, Allen LB, Choate ML. Toward a unified treatment for emotional disorders. Behav Ther. 2017;48(2):1-22.
    16. Thew GR, Powell CL, Kwok AP, et al. Internet-based cognitive therapy for social anxiety disorder in Hong Kong: Therapist training and dissemination case series. JMIR Form Res. 2019;3(2): e13446. Go to original source...
    17. Sayar H, Vøllestad J, Nordgreen T. What I missed from my online therapist: A survey-based qualitative investigation of patient experiences of therapist contact in guided internet interventions. Front Psychol. 2023;14:990833. Go to original source...
    18. Spitzer RL, Kroenke K, Williams JB, et al. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006 May 22;166(10):1092-7. Go to original source...
    19. Löwe B, Decker O, Müller S, et al. Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population. Med Care. 2008 Mar;46(3):266-74 Go to original source...
    20. Bolgeo T, Di Matteo R, Simonelli N, et al. Psychometric properties and measurement invariance of the 7-item General Anxiety Disorder scale (GAD-7) in an Italian coronary heart disease population. J Affect Disord. 2023 Aug 1;334:213-219. Go to original source...
    21. Prikner O. Vybrané psychometrické charakteristiky škály GAD-7 [online]. Brno, 2021 [cit. 2022-12-07]. Dostupné z: https://is.muni.cz/th/imwek/. Diplomová práce. Masarykova univerzita, Fakulta sociálních studií. Vedoucí práce Hynek Cígler.
    22. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606-13. Go to original source...
    23. Daňsová P, Masopustová Z, Hanáčková V, et al. Metoda Patient Health Questionnaire-9: Česká verze. Cesk Psychol. 2016;60(5):468-481.
    24. Beck AT, Epstein N, Brown G, et al. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988 Dec;56(6):893-7. Go to original source...
    25. Kamaradova D, Prasko J, Latalova K, et al. Psychometric properties of the Czech version of the Beck Anxiety Inventory - comparison between diagnostic groups. Neuro Endocrinol Lett. 2015 Dec;36(7):706-12.
    26. World Health Organization. International Statistical Classification of Diseases and Related Health Problems. 10th Revision (ICD-10). 2nd ed. Geneva: World Health Organization; 2004.
    27. Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.
    28. Andersson G, Titov N. Advantages and limitations of Internet-based interventions for common mental disorders. World Psychiatry. 2014 Feb;13(1):4-11. Go to original source...
    29. Carlbring P, Andersson G, Cuijpers P, et al. Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: an updated systematic review and meta-analysis. Cogn Behav Ther. 2018;47(1):1-18. Go to original source...
    30. Olthuis JV, Watt MC, Bailey K, et al. Therapist-supported Internet cognitive behavioural therapy for anxiety disorders in adults. Cochrane Database Syst Rev. 2016;3(3):CD011565. Go to original source...
    31. Ebert DD, Zarski AC, Christensen H, et al. Internet and computer-based cognitive behavioral therapy for anxiety and depression in youth: a meta-analysis of randomized controlled outcome trials. PLoS One. 2015;10(3):e0119895. Go to original source...
    32. Carl E, Witcraft SM, Kauffman BY, et al. Psychological and pharmacological treatments for generalized anxiety disorder (GAD): a meta-analysis of randomized controlled trials. Cogn Behav Ther. 2020;49(1):1-21. Go to original source...
    33. Brosan L, Hoppitt L, Shelfer L, et al. Cognitive bias modification for attention and interpretation reduces trait and state anxiety in anxious patients referred to an out-patient service: Results from a pilot study. Journal of Behavior Therapy and Experimental Psychiatry. 2011;42(3):258-264. Go to original source...
    34. Dear BF, Titov N, Sunderland M, et al. Psychometric comparison of the generalized anxiety disorder scale-7 and the Penn State Worry Questionnaire for measuring response during treatment of generalised anxiety disorder. Cogn Behav Ther. 2011;40(3):216-27. Go to original source...
    35. Titov N, Andrews G, Kemp A, et al. Characteristics of adults with anxiety or depression treated at an internet clinic: comparison with a national survey and an outpatient clinic. PLoS One. 2010 May 28;5(5):e10885. Go to original source...
    36. Cuijpers P, Cristea IA, Karyotaki E, et al. How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta-analytic update of the evidence. World Psychiatry. 2016;15(3):245-258. Go to original source...
    37. Baumeister H, Reichler L, Munzinger M, et al. The impact of guidance on Internet-based mental health interventions - A systematic review. Internet Interv. 2014;1(4):205-215. Go to original source...
    38. Linardon J, Cuijpers P, Carlbring P, Messer M, Fuller-Tyszkiewicz M. The efficacy of app-supported smartphone interventions for mental health problems: a meta-analysis of randomized controlled trials. World Psychiatry. 2019; 18(3):325-336. Go to original source...

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