Delivering online cognitive behavioral therapy to address mental health challenges in correctional workers: a randomized controlled trial
In brief
Online CBT cut correctional workers' symptoms 61% over 12 weeks
In a randomized trial of 84 Ontario correctional workers, online cognitive behavioral therapy reduced depression, anxiety and post-traumatic stress symptoms by 61%, compared with 23% with usual care. Quality of life did not improve significantly more with online therapy, and researchers say future work should address adherence and access.
- Journal
- Frontiers in psychiatry (Q1)
- Published
- 16 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Christina Holmes, Gilmar Gutierrez, Callum Stephenson, Elnaz Moghimi, Niloufar Malakouti, Jasleen Jagayat, et al.
- PMID
- 42964444
- DOI
- 10.3389/fpsyt.2026.1922912
Why clinicians should know about it
- Picked for Psychiatry and Mental Health (paper of the day, 3 November 2026): Online CBT trial for depression, anxiety, and PTSD symptoms
Abstract
BACKGROUND: Correctional workers (CWs), are frequently exposed to traumatic workplace events, placing them at higher risk of experiencing mental health disorders, including major depressive disorder (MDD), generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD). Despite high prevalence of mental health challenges, CWs underutilize mental health services due to stigma, irregular work schedules, and accessibility issues. While cognitive behavioral therapy (CBT) is effective, it poses accessibility challenges. Electronic CBT (eCBT) offers a scalable, accessible alternative, but use among CWs remains underexplored. OBJECTIVE: This study aimed to evaluate the efficacy of diagnosis-specific eCBT programs designed for CWs in reducing symptoms of MDD, GAD, and PTSD compared to treatment as usual (TAU). METHODS: A randomized controlled trial (RCT) was conducted with 84 CWs in Ontario, assigned to either eCBT (n=40) or TAU (n=44). The eCBT program provided diagnosis-specific modules with synchronous personalized feedback from care providers over 12-weeks via the Online Psychotherapy Tool (OPTT). Symptom severity was measured at baseline, week-6, and post-treatment using validated scales for depression, anxiety, PTSD, and quality-of-life. Data analysis included paired samples t-tests, mixed linear models, and effect size calculations (Cohen's d). RESULTS: The eCBT group exhibited significant reductions in symptom severity for depression, anxiety, and PTSD from baseline to post-treatment compared to TAU (p<0.01), with a moderate effect size (Cohen's d=0.68). Symptom severity decreased by 61.37% for eCBT versus 23.29% in TAU. Mixed linear models confirmed a significant treatment-by-time interaction, favoring eCBT (p<0.01). However, no significant differences in quality-of-life improvements were observed between groups. CONCLUSIONS: Diagnosis-specific eCBT programs are effective in reducing symptoms of depression, anxiety, and PTSD for CWs. The asynchronous, accessible format of eCBT addresses current key barriers. Future research should explore strategies to improve adherence and increase the accessibility of services for CWs.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.