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This review aims to synthesize evidence on personalizing internet-based cognitive behavioral therapy (iCBT) to improve outcomes for depression.

June 4, 2026npj Digital MedicineOpen Access

A clinically actionable framework for personalizing iCBT to improve depression outcomes

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Narrative review demonstrates a framework for personalized iCBT to improve depression outcomes, suggesting areas for clinical implementation.

This review aims to synthesize evidence on personalizing internet-based cognitive behavioral therapy (iCBT) to improve outcomes for depression.
Synthesize evidence on personalization in iCBT using a three-stage framework: pre-implementation optimization, stratifying treatment, and dynamic adaptation.
Evaluate evidence based on grading principles focusing on volume, consistency, and directness for each stage.
Identify potential future opportunities in personalization through responsiveness, progress monitoring, and digital biomarkers.
Strong evidence supports pre-implementation optimization of engagement and stratification based on baseline severity and treatment history.
Dynamic adaptation shows promise for early identification of nonresponse and treatment intensity adjustment, though trials remain limited.
Engagement and clinical outcomes are related targets for personalization, indicating a need for more rigorous trials specific to depression.

Doorn et al. (2026) studied this question.

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Narrative review demonstrates a framework for personalized iCBT to improve depression outcomes, suggesting areas for clinical implementation.