Person engaging in an online therapy session with symbols of healing and introspection in the background.

Unlocking Your Inner Self: Can Online Therapy Really Treat Depression?

Theo Raines in Health & Wellness December 2025 • 4 min read.

"Explore the groundbreaking study revealing the potential of online psychodynamic therapy to combat depression and improve mental well-being, offering new hope for accessible mental healthcare."

Depression is a significant global health issue, affecting millions and impacting their quality of life. Traditional treatments, like face-to-face psychotherapy, have proven effective but aren't always accessible to everyone due to geographical constraints, financial limitations, or social stigma. This inaccessibility has spurred the search for innovative ways to deliver mental health support, leading to the exploration of online therapy.

One such innovation is Internet-based psychodynamic therapy (PDT), which applies the principles of psychodynamic theory in a digital format. Psychodynamic therapy traditionally focuses on exploring unconscious patterns and past experiences to understand present emotions and behaviors. But how effective can this approach be when delivered online?

A groundbreaking study published in PLOS ONE sought to answer this question by investigating the efficacy of an Internet-based PDT program for adults with depression. The study, led by Robert Johansson and colleagues, explored whether guided self-help through online modules, combined with therapist support, could provide a viable alternative to traditional therapy.

The Groundbreaking Study: Online Psychodynamic Therapy vs. Active Control

Person engaging in an online therapy session with symbols of healing and introspection in the background.

The study involved 92 participants diagnosed with major depressive disorder (MDD), who were randomly assigned to either an Internet-based PDT group or an active control group. The PDT intervention consisted of nine treatment modules designed around psychodynamic principles, offering guidance on understanding and breaking unhelpful emotional, cognitive, and behavioral patterns. Participants in this group received weekly access to these modules along with ongoing support from a therapist through a secure online messaging system.

The active control group, in contrast, received a structured support intervention that included psychoeducation about depression and scheduled weekly online contacts. This approach provided general information and support but didn't incorporate specific therapeutic techniques.

Participants: 92 adults diagnosed with MDD.
Intervention: Nine-module Internet-based PDT program.
Control: Structured support with psychoeducation.
Duration: 10 weeks.
Primary Outcome Measure: Beck Depression Inventory-II (BDI-II).

The study primarily measured the Beck Depression Inventory-II (BDI-II) scores to assess the severity of depression symptoms. Researchers analyzed the data using mixed-effects models to account for all participants, regardless of their completion status, following the intention-to-treat principle. This rigorous approach ensured that the results accurately reflected the effectiveness of the interventions.

The Future of Mental Healthcare: Accessible, Effective, and Online

This study illuminates the potential of online psychodynamic therapy as a viable and effective treatment for depression. By increasing accessibility and reducing the barriers to traditional therapy, Internet-based PDT offers a promising avenue for individuals seeking mental health support. As technology continues to evolve, online therapeutic interventions like PDT are likely to play an increasingly crucial role in the future of mental healthcare, making quality support available to those who need it, wherever they are.

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Everything You Need To Know

What is the main focus of Internet-based Psychodynamic Therapy (PDT) and how does it differ from traditional therapy?

Internet-based Psychodynamic Therapy (PDT) applies the principles of psychodynamic theory in a digital format. Unlike traditional face-to-face psychotherapy, it's delivered online, making it more accessible. PDT focuses on exploring unconscious patterns and past experiences to understand present emotions and behaviors. The core difference lies in the delivery method and accessibility: PDT utilizes online modules and therapist support via messaging, removing geographical and logistical barriers often present in traditional therapy.

How effective is online psychodynamic therapy for treating depression, and what evidence supports its use?

A groundbreaking study published in PLOS ONE investigated the efficacy of an Internet-based PDT program for adults diagnosed with major depressive disorder (MDD). The study compared an online PDT group to an active control group. The results, measured using the Beck Depression Inventory-II (BDI-II), showed that the online PDT program, incorporating nine treatment modules and therapist support, demonstrated effectiveness in treating depression. The study's rigorous methodology, including the intention-to-treat principle, ensured the reliability of these findings, supporting the potential of PDT as a viable treatment option.

Can you explain the structure of the online PDT program used in the study, including the intervention and the active control group?

The online PDT program consisted of nine treatment modules designed around psychodynamic principles, guiding participants to understand and modify unhelpful emotional, cognitive, and behavioral patterns. Participants received weekly access to these modules, along with support from a therapist through a secure online messaging system. The active control group received a structured support intervention, which included psychoeducation about depression and scheduled weekly online contacts. This group provided general information and support but didn't incorporate specific therapeutic techniques, acting as a comparison to assess the specific impact of the PDT modules and therapist support.

What are the advantages of Internet-based PDT compared to traditional face-to-face therapy, and what challenges might it present?

Internet-based PDT offers several advantages. It increases accessibility, removing geographical constraints and reducing barriers such as financial limitations and social stigma associated with traditional therapy. Individuals can access support from the comfort of their homes, potentially improving engagement and adherence to treatment. However, challenges may include the need for reliable internet access, the potential for technical difficulties, and the importance of ensuring the client's comfort and suitability for an online format. Also, the success of online PDT relies heavily on the participant's self-discipline and ability to engage with the online modules and therapist interactions.

How does the study's use of the Beck Depression Inventory-II (BDI-II) and the intention-to-treat principle contribute to the validity of the findings?

The study's use of the Beck Depression Inventory-II (BDI-II) as the primary outcome measure allowed researchers to quantitatively assess the severity of depression symptoms, enabling direct comparison between the PDT and active control groups. The BDI-II is a well-established and validated tool for measuring depression levels. The intention-to-treat principle, which involved analyzing data for all 92 participants regardless of whether they completed the entire program, enhances the study's validity. This approach accounts for all participants as initially assigned, mitigating bias that could arise from excluding those who dropped out or didn't complete the modules. This ensures that the findings accurately reflect the real-world effectiveness of the intervention.