A new trial from Karolinska Institutet reveals that therapist-supported internet interventions significantly improve depression outcomes in teenagers, offering a promising, cost-efficient alternative to traditional care.
A therapist-supported internet treatment helped teenagers with depression improve more than usual care and did so at lower cost, according to a new trial from Karolinska Institutet published in BMJ Mental Health. The findings add to a growing body of evidence that digital therapies can help ease access problems for young people who struggle to obtain timely psychological support.
The Swedish study enrolled 219 adolescents aged 13 to 17 and compared three approaches over 10 weeks: behavioural activation delivered online with therapist support, the same programme without therapist input, and standard care through child and adolescent mental health services or primary care. Behavioural activation is a structured therapy that aims to lift mood by helping people re-engage with routines and activities that matter to them.
At the three-month follow-up, depressive symptoms had fallen across all groups, but the clearest gains were seen in the therapist-guided online treatment. The self-guided version also appeared to do better than usual care, although that difference was not statistically clear. The researchers said assessments were carried out by clinicians who did not know which treatment each teenager had received.
Rebecca Andersson, the study’s first author and a postdoctoral researcher at Karolinska Institutet, said the results suggest that internet-based treatment with therapist support could offer a practical way to reach young people who otherwise face long waits. She also said self-guided treatment may have a role where therapist access is limited, but added that more research is needed to understand which adolescents benefit most and how to use the format safely.
The team said both online approaches cost less than standard care, with the self-guided option emerging as the most cost-effective. But the authors also noted that the result was not entirely straightforward: depending on the statistical method used, some findings lost significance. That nuance matters, even as the study strengthens the case for digital treatment options in adolescent mental health.
The trial is the first large randomised study of behavioural activation for teenage depression to include a health economics analysis, according to the researchers. Earlier trials have also pointed in the same direction: internet-based cognitive behavioural therapy and other online interventions have been shown to reduce depressive symptoms in adolescents, particularly when some form of therapist contact is included. Together, the studies suggest that digital care may help fill gaps in services, especially for families in areas with limited access to specialist mental health support.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
