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Barriers to accessing psychologists for the treatment of depression and anxiety include a shortage of specialised therapists, long waiting lists, and the affordability of therapy. This study examined the efficacy of a computerised-based self-help program (MoodGYM) delivered in-conjunction with face-to-face cognitive behavioural therapy (CBT) to expand the delivery avenues of psychological treatment for young adults (aged 18-25 years). Eighty-nine participants suffering from depression and/or generalised anxiety were randomly allocated to a control intervention or to one of three experimental groups: receiving face-to-face CBT, receiving computerised CBT (cCBT), or receiving treatment in-conjunction (face-to-face CBT and cCBT). While MoodGYM did not significantly decrease depression in comparison to the control group, significant decreases were found for anxiety. MoodGYM delivered in-conjunction with face-to-face CBT is more effective in treating symptoms of depression and anxiety compared with standalone face-to-face or cCBT. This study suggests that for youth who are unable to access face-to-face therapy-such as those in rural or remote regions, or for communities in which there is stigma attached to seeking help-computerised therapy may be a viable option. This is an important finding, especially in light of the current capacity-to-treat and accessibility problems faced by youth when seeking treatment for depression and/or anxiety.

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Background Collaborative care involves active engagement of primary care and hospital physicians in shared care of patients beyond usual discharge summaries. This enhances community-based care and reduces dependence on specialists and hospitals. The model, successfully implemented in chronic care management, may have utility for treatment of depression in cancer. The aim of this systematic review was to identify components, delivery and roles and responsibilities within collaborative interventions for depression in the context of cancer. Methods Medline, PsycINFO, CINAHL, Embase, Cochrane Library and Central Register for Controlled Trials databases were searched to identify studies of randomised controlled trials comparing a treatment intervention that met the definition of collaborative model of depression care with usual care or other control condition. Studies of adult cancer patients with major depression or a non-bipolar depressive disorder published in English between 2005 and January 2018 were included. Cochrane checklist for risk of bias was completed (Study Prospero registration: CRD42018086515). Results Of 8 studies identified, none adhered to the definition of ‘collaborative care’. Interventions delivered were multi-disciplinary, with care co-ordinated by nurses ( n = 5) or social workers ( n = 2) under the direction of psychiatrists ( n = 7). Care was primarily delivered in cancer centres ( n = 5). Care co-ordinators advised primary care physicians (GPs) of medication changes ( n = 3) but few studies ( n = 2) actively involved GPs in medication prescribing and management. Conclusions This review highlighted joint participation of GPs and specialist care physicians in collaborative care depression management is promoted but not achieved in cancer care. Current models reflect hospital-based multi-disciplinary models of care. Protocol registration The protocol for this systematic review has been registered with PROSPERO. The registration number is CRD42018086515. Electronic supplementary material The online version of this article (10.1186/s12913-019-3946-z) contains supplementary material, which is available to authorized users.

Objective: Psychological therapies combined with medication are effective treatments for depression and anxiety in patients with cancer. However, the psychooncology workforce is insufficient to meet patient need and is hard to access outside of the major cities. To bridge this gap, innovative models of care are required. Implementation of a new model of care requires attention to the facilitators and barriers.The aim of this study was to explore stakeholders' attitudes to the feasibility and acceptability of a community-based, shared care model for the treatment of depression and anxiety.Methods: Semi-structured interviews were conducted with community-based clinical psychologists (n = 10), general practitioners (n = 6), and hospital-based psychologists working in psycho-oncology (n = 9). Framework analysis was conducted to identify key themes. Results: All stakeholders perceived the model as feasible and acceptable. Potential barriers/facilitators to implementation were summarised under six key themes: (a) initiative, ownership, and autonomy; (b) resources; (c) pathway establishment; (d) support; (e) skill acquisition; and (f) patient engagement. Facilitators included quality communication between health professionals across primary and tertiary care and appropriate education and support for community-based clinicians. Conclusions: This in-depth exploration of Australian health professionals' perceptions of the feasibility and acceptability of a community-based model of psychooncology care revealed that most clinicians were willing to adopt the proposed changes into practice. An RCT of a shared care intervention for depressed patients with cancer is needed.