Skip to main navigation menu Skip to main content Skip to site footer

SPECIAL ISSUE Digital clinical settings and virtual environments in assessment and treatment

No. 2 (2023)

The effectiveness of psychological interventions delivered online on the mental health of university students: New challenges for psychological sciences

maggio 18, 2023


The purpose of this study was to provide an overview of studies on the effectiveness of online psychological and psychotherapeutic interventions aimed at college students. Studies were identified through a search of PubMed and Scopus. Empirical studies included were in English language with peer review and focused on online psychological or psychotherapeutic interventions. 18 studies were selected. The predominant online intervention was cognitive-behavioral therapy. Online psychological interventions were found to be effective in reducing symptoms of anxiety and depression and treating other conditions. In addition, they have been shown to be at least as effective and acceptable as classical interventions. Interventions delivered online have been found to be effective in improving the mental health of college students. They represent a useful tool to be implemented in health services provided by universities.


  1. Abbott, J. M., Klein, B., & Ciechomski, L. (2008). Best Practices in Online Therapy. Journal of Technology in Human Services, 26, 360-375. DOI: 10.1080/15228830802097257.
  2. Andersson, G., Cuijpers, P., Carlbring, P., Riper, H., & Hedman, E. (2014). Guided Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: a systematic review and meta-analysis. World psychiatry: official journal of the World Psychiatric Association (WPA), 13(3), 288-295. DOI: 10.1002/wps.20151.
  3. Andrews, G., Cuijpers, P., Craske, M. G., McEvoy, P., & Titov, N. (2010). Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: a meta-analysis. PloS one, 5(10), e13196. DOI: 10.1371/journal.pone.0013196.
  4. Andrews, G., Basu, A., Cuijpers, P., Craske, M. G., McEvoy, P., Eng-lish, C. L., & Newby, J. M. (2018). Computer therapy for the anxiety and depression disorders is effective, acceptable and practical health care: An updated meta-analysis. Journal of anxiety disorders, 55, 70-78. DOI: 10.1016/j.janxdis.2018.01.001.
  5. Apolinário-Hagen, J., Harrer, M., Dederichs, M., Fritsche, L., Wop-perer, J., Wals, F., Loerbroks, A., Lehr, D., Salewski, C., Angerer, P., & Ebert, D. D. (2021). Exploring the influence of testimonial source on attitudes towards e-mental health interventions among university students: Four-group randomized controlled trial. PloS one, 16(5), e0252012. DOI: 10.1371/journal.pone.0252012.
  6. Arnberg, F. K., Linton, S. J., Hultcrantz, M., Heintz, E., & Jonsson, U. (2014). Internet-delivered psychological treatments for mood and anxiety disorders: A systematic review of their efficacy, safety, and cost-effectiveness. PLoS One, 9(5). DOI: 10.1371/journal.pone.0098118.
  7. Arnett, J. J., Žukauskienė, R., & Sugimura, K. (2014). The new life stage of emerging adulthood at ages 18-29 years: implications for mental health. The lancet. Psychiatry, 1(7), 569-576. DOI: 10.1016/S2215-0366(14) 00080-7.
  8. Auyeung, L. & Mo, P. K. H. (2019). The Efficacy and Mechanism of Online Positive Psychological Intervention (PPI) on Improving Well-Being Among Chinese University Students: A Pilot Study of the Best Possible Self (BPS) Intervention. Journal of Happiness Studies, 20, 2525-2550. DOI: 10.1007/s10902-018-0054-4.
  9. Baker, K. D., & Ray, M. (2011). Online counseling: The good, the bad, and the possibilities. Counselling Psychology Quarterly, 24, 341-346. DOI: 10.1080/09515070.2011.632875.
  10. Barak, A. (1999). Psychological applications on the Internet: A discipline on the threshold of a new millennium. Applied and Preventive Psychology, 8, 231-245. DOI: 10.1016/S0962-1849(05)80038-1.
  11. Barak, A., Klein, B., & Proudfoot, J. G. (2009). Defining internet-supported therapeutic interventions. Annals of behavioral medicine: a publication of the Society of Behavioral Medicine, 38(1), 4-17. DOI: 10.1007/s12160-009-9130-7.
  12. Baumel, A., Muench, F., Edan, S., & Kane, J. M. (2019). Objective User Engagement with Mental Health Apps: Systematic Search and Panel-Based Usage Analysis. Journal of medical Internet research, 21(9), e14567. DOI: 10.2196/14567.
  13. Baylor, C., Burns, M., McDonough, K., Mach, H., & Yorkston, K. (2019). Teaching Medical Students Skills for Effective Communication with Patients Who Have Communication Disorders. American journal of speech-language pathology, 28(1), 155–164. DOI: 10.1044/2018_AJSLP-18-0130.
  14. Beck, A. T. (1967). Depression: Causes and treatment. Philadelphia: University of Pennsylvania Press.
  15. Benjet, C. (2020). Stress management interventions for college students in the context of the COVID-19 pandemic. Clinical psychology: a publication of the Division of Clinical Psychology of the American Psychological Association, e12353. Advance online publication. DOI: 10.1111/cpsp.12353.
  16. Benton, S. A., Heesacker, M., Snowden, S. J., & Lee, G. (2016). Therapist-assisted, online (TAO) intervention for anxiety in college students: TAO outperformed treatment as usual. Professional Psychology: Research and Practice, 47(5), 363–371. DOI: 10.1037/pro0000097.
  17. Bolton, A. J., & Dorstyn, D. S. (2015). Telepsychology for Posttraumatic Stress Disorder: a systematic review. Journal of Telemedicine and Telecare. DOI: 10.1177/1357633x15571996.
  18. Boyle, S. C., Earle, A. M., LaBrie, J. W., & Smith, D. J. (2017). PNF 2.0? Initial evidence that gamification can increase the efficacy of brief, web-based personalized normative feedback alcohol interventions. Addictive behaviors, 67, 8-17. DOI: 10.1016/j.addbeh.2016.11.024.
  19. Carlbring, P., Andersson, G., Cuijpers, P., Riper, H., & Hedman-Lagerlöf, E. (2018). Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: an updated sys-tematic review and meta-analysis. Cognitive behaviour therapy, 47(1), 1-18. DOI: 10.1080/16506073.2017.1401115.
  20. Cerutti, R., Spensieri, V., Amendola, S., Biuso, G. S., Renzi, A., & Tambelli, R. (2022). Responding to the COVID-19 public health emergency: The usefulness of an online brief psychological intervention with Italian university students. Psychology in the schools, DOI: 10.1002/pits.22785. Advance online publication. DOI: 10.1002/pits.22785.
  21. Celia, G., Tessitore, F., Cavicchiolo, E., Girelli, L., Limone, P., & Cozzolino, M. (2022). Improving University Students’ Mental Health During the COVID-19 Pandemic: Evidence from an Online Counseling Intervention in Italy. Frontiers in psychiatry, 13, 886538. DOI: 10.3389/fpsyt.2022.886538.
  22. Cipolletta, S., & Mocellin, D. (2018). Online counseling: An exploratory survey of Italian psychologists’ attitudes towards new ways of interaction. Psychotherapy research: journal of the Society for Psychotherapy Research, 28(6), 909-924. DOI: 10.1080/10503307.2016.1259533.
  23. De Luca, R., & Calabrò, R. S. (2020). How the COVID-19 Pandemic is Changing Mental Health Disease Management: The Growing Need of Telecounseling in Italy. Innovations in clinical neuroscience, 17(4-6), 16-17.
  24. Dear, B. F., Johnson, B., Singh, A., Wilkes, B., Brkic, T., Gupta, R., Jones, M. P., Bailey, S., Dudeney, J., Gandy, M., Fogliati, R., & Titov, N. (2019). Examining an internet-delivered intervention for anxiety and depression when delivered as a part of routine care for university students: A phase IV trial. Journal of affective disorders, 256, 567-577. DOI: 10.1016/j.jad.2019.06.044.
  25. Dowling, M. & Rickwood, D. (2015). Investigating individual online synchronous chat counselling processes and treatment outcomes for young people. Advances in Mental Health, 12, 216-224. DOI: 10.1080/18374905.2014.11081899.
  26. Duan, L., & Zhu, G. (2020). Psychological interventions for people affected by the COVID-19 epidemic. The lancet. Psychiatry, 7(4), 300-302. DOI: 10.1016/S2215-0366(20)30073-0.
  27. DuPont, C. M., Pressman, S. D., Reed, R. G., Manuck, S. B., Marsland, A. L. & Gianaros, P. J. (2023). Does an Online Positive Psychological Intervention Improve Positive Affect in Young Adults During the COVID-19 Pandemic? Affective Science, 4, 101-117. DOI: 10.1007/s42761-022-00148-z.
  28. Farrer, L. M., Gulliver, A., Katruss, N., Fassnacht, D. B., Kyrios, M., & Batterham, P. J. (2019). A novel multi-component online intervention to improve the mental health of university students: Randomised controlled trial of the Uni Virtual Clinic. Internet interventions, 18, 100276. DOI: 10.1016/j.invent.2019.100276.
  29. Finn, J., & Barak, A. (2010). A descriptive study of e-counsellor attitudes, ethics, and practice. Counselling & Psychotherapy Research, 10(4), 268-277. DOI: 10.1080/14733140903380847.
  30. Fleming, T., Bavin, L., Lucassen, M., Stasiak, K., Hopkins, S., & Mer-ry, S. (2018). Beyond the Trial: Systematic Review of Real-World Uptake and Engagement with Digital Self-Help Interventions for Depression, Low Mood, or Anxiety. Journal of medical Internet research, 20(6), e199. DOI: 10.2196/jmir.9275.
  31. Freeman, D., Sheaves, B., Goodwin, G. M., Yu, L. M., Nickless, A., Harrison, P. J., Emsley, R., Luik, A. I., Foster, R. G., Wadekar, V., Hinds, C., Gumley, A., Jones, R., Lightman, S., Jones, S., Bentall, R., Kinderman, P., Rowse, G., Brugha, T., Blagrove, M., … Espie, C. A. (2017). The effects of improving sleep on mental health (OA-SIS): a randomised controlled trial with mediation analysis. The lancet. Psychiatry, 4(10), 749-758. DOI: 10.1016/S2215-0366(17)30328-0.
  32. Gamble N., Boyle C., & Morris Z. A. (2015). Ethical Practice in Telepsychology. Australian Psychologist, 50, 292-298. DOI: 10.1111/ap.12133.
  33. Greenberg, N., Docherty, M., Gnanapragasam, S., & Wessely, S. (2020). Managing mental health challenges faced by healthcare workers during covid-19 pandemic. BMJ (Clinical research ed.), 368, m1211. DOI: 10.1136/bmj.m1211.
  34. Hedman, E., Ljótsson, B., & Lindefors, N. (2012). Cognitive behavior therapy via the Internet: a systematic review of applications, clinical efficacy and cost-effectiveness. Expert review of pharmacoeconomics & outcomes research, 12(6), 745-764. DOI: 10.1586/erp.12.67.
  35. Johansson, R., Ekbladh, S., Hebert, A., Lindström, M., Möller, S., Petitt, E., ... Andersson, G. (2012). Psychodynamic guided self-help for adult depression through the internet ‒ A randomised controlled trial. PLoS ONE 7(5), e38021. DOI: 10.1371/journal.pone.0038021.
  36. Kivi, M., Eriksson, M. C., Hange, D., Petersson, E. L., Vernmark, K., Johansson, B., & Björkelund, C. (2014). Internet-based therapy for mild to moderate depression in Swedish primary care: short term results from the PRIM-NET randomized controlled trial. Cognitive behaviour therapy, 43(4), 289-298. DOI: 10.1080/16506073.2014.921834.
  37. Lenhard, F., Vigerland, S., Andersson, E., Rück, C., Mataix-Cols, D., Thulin, U., Ljótsson, B., & Serlachius, E. (2014). Internet-delivered cognitive behavior therapy for adolescents with obsessive-compulsive disorder: an open trial. PloS one, 9(6), e100773. DOI: 10.1371/journal.pone.0100773.
  38. Littleton, H., Buck, K., Rosman, L., & Grills-Taquechel, A. (2012). From Survivor to Thriver: A Pilot Study of an Online Program for Rape Victims. Cognitive and behavioral practice, 19(2), 315-327. DOI: 10.1016/j.cbpra.2011.04.002.
  39. Liu, S., Yang, L., Zhang, C., Xiang, Y. T., Liu, Z., Hu, S., & Zhang, B. (2020). Online mental health services in China during the COVID-19 outbreak. The lancet. Psychiatry, 7(4), e17-e18. DOI: 10.1016/S2215-0366(20)30077-8.
  40. Lungu, A., & Sun, M. (2016). Time for a Change: College Students’ Preference for Technology-Mediated Versus Face-to-Face Help for Emotional Distress. Telemedicine journal and e-health: the official journal of the American Telemedicine Association, 22(12), 991-1000. DOI: 10.1089/tmj.2015.0214.
  41. Ma, L., Huang, C., Tao, R., Cui, Z., & Schluter, P. (2021). Meta-analytic review of online guided self-help interventions for depressive symptoms among college students. Internet interventions, 25, 100427. DOI: 10.1016/j.invent.2021.100427.
  42. Na, H., Jo, M., Lee, C., & Kim, D. (2022). Development and Evaluation: A Behavioral Activation Mobile Application for Self-Management of Stress for College Students. Healthcare (Basel, Switzerland), 10(10), 1880. DOI: 10.3390/healthcare10101880.
  43. Novella, J. K., Ng, K. M., & Samuolis, J. (2022). A comparison of online and in-person counseling outcomes using solution-focused brief therapy for college students with anxiety. Journal of American college health: J of ACH, 70(4), 1161-1168. DOI: 10.1080/07448481.2020.1786101.
  44. Oliveira, C., Pacheco, M., Borges, J., Meira, L., & Santos, A. (2023). Internet-delivered cognitive behavioral therapy for anxiety among university students: A systematic review and meta-analysis. Internet interventions, 31, 100609. DOI: 10.1016/j.invent.2023.100609.
  45. Pang, N. T. P., Tio, V. C. S., Singh, A. S. B., Tseu, M. W. L., Shoe-smith, W. D., Abd Rahim, M. A., & Mohd Kassim, M. A. (2023). Efficacy of a single-session online ACT-based mindfulness inter-vention among undergraduates in lockdown during the COVID-19 pandemic. Trends in psychiatry and psychotherapy, 44, e20200172. DOI: 10.47626/2237-6089-2020-0172.
  46. Patel, V., Flisher, A. J., Hetrick, S., & McGorry, P. (2007). Mental health of young people: a global public-health challenge. Lancet (London, England), 369(9569), 1302-1313. DOI: 10.1016/S0140-6736(07)60368-7.
  47. Pedersen, E. R., Neighbors, C., Atkins, D. C., Lee, C. M., & Larimer, M. E. (2017). Brief online interventions targeting risk and protective factors for increased and problematic alcohol use among American college students studying abroad. Psychology of addictive behaviors: journal of the Society of Psychologists in Addictive Behaviors, 31(2), 220-230. DOI: 10.1037/adb0000242.
  48. Perle, J.G., Langsam, L.C., & Nierenberg, B.P. (2011). Controversy clarified: an updated review of clinical psychology and tele-health. Clinical psychology review, 31(8), 1247-58. DOI: 10.1016/j.cpr.2011.08.003.
  49. Pietrabissa, G., Manzoni, G.M., Algeri, D., Mazzucchelli, L., Carella, A., Pagnini, F. and Castelnuovo, G. (2015), Facebook use for consulting psychology. Australian Psychologist, 50, 299-303. DOI: 10.1111/ap.12139.
  50. Räsänen, P., Lappalainen, P., Muotka, J., Tolvanen, A., & Lappalainen, R. (2016). An online guided ACT intervention for enhancing the psychological wellbeing of university students: A randomized controlled clinical trial. Behaviour research and therapy, 78, 30-42. DOI: 10.1016/j.brat. 2016.01.001.
  51. Reangsing, C., Abdullahi, S. G., & Schneider, J. K. (2023). Effects of Online Mindfulness-Based Interventions on Depressive Symptoms in College and University Students: A Systematic Review and Meta-Analysis. Journal of integrative and complementary medicine, 29(5), 292-302. DOI: 10.1089/jicm.2022.0606.
  52. Richards, D., Timulak, L., Hevey, D., (2013). A comparison of two online cognitive-behavioural interventions for symptoms of depression in a student population: the role of therapist responsiveness. Counselling and Psychotherapy Research, 13(3), 184-193. DOI: 10.1080/14733145. 2012.733715.
  53. Richards D. & Viganó N. (2013). Online Counseling: A Narrative and Critical Review of the Literature. Journal of Clinical Psychology, 69(9), 994-1011. DOI: 10.1002/jclp.21974.
  54. Rozental, A., Forsell, E., Svensson, A., Andersson, G., & Carlbring, P. (2015). Internet-based cognitive behavior therapy for procrastination: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 83(4), 808-824. DOI: 10.1037/ccp0000023.
  55. Shafran, R., Wade, T. D., Egan, S. J., Kothari, R., Allcott-Watson, H., Carlbring, P., Rozental, A., & Andersson, G. (2017). Is the devil in the detail? A randomised controlled trial of guided internet-based CBT for perfectionism. Behaviour research and therapy, 95, 99-106. DOI: 10.1016/ j.brat.2017.05.014.
  56. Světlák, M., Linhartová, P., Knejzlíková, T., Knejzlík, J., Kóša, B., Horníčková, V., Jarolínová, K., Lučanská, K., Slezáčková, A., & Šumec, R. (2021). Being Mindful at University: A Pilot Evaluation of the Feasibility of an Online Mindfulness-Based Mental Health Support Program for Students. Frontiers in psychology, 11, 581086. DOI: 10.3389/fpsyg. 2020.581086.
  57. Torous, J., Jän Myrick, K., Rauseo-Ricupero, N., & Firth, J. (2020). Digital Mental Health and COVID-19: Using Technology Today to Accelerate the Curve on Access and Quality Tomorrow. JMIR mental health, 7(3), e18848. DOI: 10.2196/18848.
  58. Vigerland, S., Lenhard, F., Bonnert, M., Lalouni, M., Hedman, E., Ah-len, J., Olén, O., Serlachius, E., & Ljótsson, B. (2016). Internet-delivered cognitive behavior therapy for children and adolescents: A systematic review and meta-analysis. Clinical psychology review, 50, 1-10. DOI: 10.1016/ j.cpr.2016.09.005.
  59. Visvalingam, S., McHardy, H. L., Norder, S. J., Magson, N. R., & Norberg, M. M. (2022). A mixed methods study of an online intervention to reduce perfectionism. Current psychology (New Brunswick, N.J.), 1–16. Advance online publication. DOI: 10.1007/s12144-022-02953-y.
  60. Wagner, B., Horn, A. B., & Maercker, A. (2014). Internet-based versus face-to-face cognitive-behavioral intervention for depression: a randomized controlled non-inferiority trial. Journal of affective disorders, 152-154, 113-121. DOI: 10.1016/j.jad.2013.06.032.
  61. Wasil, A. R., Taylor, M. E., Franzen, R. E., Steinberg, J. S., & DeRu-beis, R. J. (2021). Promoting Graduate Student Mental Health During COVID-19: Acceptability, Feasibility, and Perceived Utility of an Online Single-Session Intervention. Frontiers in psychology, 12, 569785. DOI: 10.3389/fpsyg.2021.569785.
  62. Wasil, A. R., Weisz, J. R., & DeRubeis, R. J. (2020). Three questions to consider before developing a mental health app. World psychiatry: official journal of the World Psychiatric Association (WPA), 19(2), 252-253. DOI: 10.1002/wps.20757.
  63. You, J. H. S., Luk, S. W. C., Chow, D. Y. W., Jiang, X., Mak, A. D. P., & Mak, W. W. S. (2022). Cost-effectiveness of internet-supported cognitive behavioral therapy for university students with anxiety symptoms: A Markov-model analysis. PloS one, 17(5), e0268061. DOI: 10.1371/journal.pone.0268061.
  64. Zhou, X., Snoswell, C. L., Harding, L. E., Bambling, M., Edirippulige, S., Bai, X., & Smith, A. C. (2020). The Role of Telehealth in Reducing the Mental Health Burden from COVID-19. Telemedicine journal and e-health: the official journal of the American Telemedicine Association, 26(4), 377-379. DOI: 10.1089/tmj.2020.0068.
  65. Zhou, Y., Pennesi, J. L., & Wade, T. D. (2020). Online imagery rescripting among young women at risk of developing an eating disorder: A randomized controlled trial. The International journal of eating disorders, 53(12), 1906-1917. DOI: 10.1002/eat.23370.


Metrics Loading ...