Conclusions
depression, anxiety
SECONDARY
This study identified 5 distinct classes of symptom trajectories for depression and anxiety over the course of iCBT treatment. The results showed that although iCBT works for the majority, the way improvement occurs varies, which may have implications for how iCBT is delivered. The absence of effects on the time-varying relationship between platform use and trajectories calls into question the role of use as a mechanism for change. Other contextual information and larger sample sizes may need to be presented to explore these effects better. Further work is necessary to better understand these patterns of change, as well as factors impacting them as insights gained, which may be useful in tailoring treatments for different patient groups and in identifying and monitoring patient groups to enable earlier and enhanced treatment decisions.The authors would like to thank the staff at Berkshire National Health Service Foundation Trust for providing assistance that allowed us to successfully complete the execution of the original study, which is the basis of this secondary analysis.Conflicts of Interest: DCC, AE, JEP, DD, SM, and DR are employees of SilverCloud Health. DR is a shareholder in Amwell, a company that SilverCloud Health has been a subsidiary of since 2021. SM was an employee at Amwell while this work was in progress.Supplementary tables and figures with additional analysis information.