Tailored internet-delivered cognitive behavioural therapy for depression and anxiety in patients with a long-term condition (Chronic Pain, COPD, CHD and Diabetes) in IAPT Services. 



To establish the clinical feasibility of using tailored iCBT programmes for depression and/or anxiety for individuals in IAPT services with Chronic Pain, Chronic Obstructive Pulmonary Disorder or Diabetes. This can further be defined into two research questions: 

  • Can an internet-delivered programme for depression and anxiety, tailored for patients with a chronic illness (COPD, CP, DM), achieve clinical outcomes, improve LTC-related symptoms, and improve health related quality of life?

  • What is the experience of individuals with a chronic illness and comorbid mood disorder in using an iCBT intervention?​


The current study will utilise a mixed-methods, feasibility design examining quantitatively the outcomes of the intervention on scores of depression, anxiety, functioning, health related quality of life and disease-specific outcomes, and qualitatively responses on the patient experience questionnaire. Measurement points will consist of pre and post intervention, and data will be collected via the online platform. Participants will be assigned to groups based on their chronic illness diagnosis, and will progress through the SilverCloud platform. 


Barnett, Enfield and Haringey NHS Trust, IAPT service


The current study will recruit 35 individuals to each of the three ‘Space from’interventions, for a total sample size of 105 individuals (Teare et al., 2014). Participants will be recruited over 12 months from Enfield, Haringey and Barnet IAPT service.

Study outcome measures 

  • Primary outcomes

    • Patient Health Questionnaire-9 

    • Generalized Anxiety Disorder-7 

    Secondary outcomes

    • Work and Social Adjustment 

    • Patient Experience Questionnaire

    • Satisfaction with treatment (SAT) 

    • The EuroQol 5D5L (EQ5D5L) 

    Disorder specific outcomes

    • Diabetes Distress Scale Chronic Pain Acceptance Questionnaire (Revised)

    • Clinical COPD Questionnaire 

    • Chronic Pain Acceptance Questionnaire



Inclusion Criteria

  • Deemed suitable for an initial Step 2 intervention at IAPT and have one of three LTCs (diabetes, chronic pain, COPD)

  • 18 years old and above.

  • Able to read English.

  • Have capacity to consent.

  • Not receiving an intervention or treatment that is outside of treatment as usual or a part of another trial.

  • Does not have specific communication needs.