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Symposia

Treatment - CBT

The Ontario Structured Psychotherapy Program: Insights from a large scale publicly funded CBT program

1 - (SYM 1) Evaluation of a Provincial Stepped-care Program Offering Cognitive Behavioural Therapy for Depression and Anxiety Related Disorders

Friday, November 21, 2025
10:05 AM - 10:22 AM CST
Location: Imperial 11, Level 4
Keywords: CBT, Treatment, Treatment/ Program Design
Recommended Readings: Tasca, G. A., Town, J. M., Abbass, A., & Clarke, J. (2018). Will publicly funded psychotherapy in Canada be evidence based? A review of what makes psychotherapy work and a proposal. Canadian Psychology/Psychologie Canadienne, 59(4), 293.,   Vasiliadis, H. M., Spagnolo, J., & Lesage, A. (2021). Public funding of evidence-based psychotherapy for common mental disorders: increasing calls for action in Canadian provinces. Healthcare Policy, 16(3), 16.,   Oparina, E., Krekel, C., & Srisuma, S. (2024). Talking Therapy: Impacts of a Nationwide Mental Health Service in England (No. 16839). IZA Discussion Papers.,   https://news.ontario.ca/mohltc/en/2017/10/ontario-improving-mental-health-services-for-people-across-the-province.html,  
Abstract Body

Ontario is Canada’s most populous province, home to over 16 million people. To provide evidence-based mental health services to individuals with depression and anxiety-related disorders across this large population, the Ontario Structured Psychotherapy Program (OSP) was launched in 2017. This government-funded program offers free CBT to individuals using a stepped care model, largely based on the Talking Therapies program in the United Kingdom. OSP employs a “hub and spoke” model, with 10 hubs across the province and each hub connected to a number of sites embedded in communities. Clients, therefore, can receive services either in-person or remotely from almost anywhere in the province. In 2024/25, this program is on target to enroll over 23,000 individuals annually to receive a low intensity form of CBT (i.e., internet-based CBT or clinician-assisted bibliotherapy) or a high intensity form of CBT (group or individual sessions).  Clinicians are rigorously trained in CBT for depression, anxiety, and related conditions (e.g., obsessive compulsive disorder, posttraumatic stress disorder, health anxiety) and participants are not required to have an official diagnosis to receive services. Wait times, enrollments, and outcomes are routinely monitored. Symptoms are assessed using the Generalized Anxiety Disorder-7 (Spitzer, Kroenke, Williams, & Lowe, 2006) and the Patient Health Questionnaire (Kroenke, Spitzer, & Williams, 2001) given at each session. From April to November of 2024, the median wait-time from referral to therapy was 39 days for low-intensity and 75 days for high intensity services. Clients ranged in age from 17 to over 65, 62% identified as female, and 43% identified as from a racially diverse background. Just over 60% of clients were triaged to low intensity services as their first step. For clients receiving low-intensity CBT, between 44 and 55% of clients achieved a reliable improvement on symptom measures (depending on the low-intensity service they received). In high intensity treatment, 57% of treatment completers achieved reliable improvement on symptom measures. Implications for system-level programs are discussed.