Skip to main content
ABCT 2025 59th Annual Convention Main banner
Psychology Tools Ad
Final Program


Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Recorded Session
Recorded Session
Ticketed Session
Ticketed Session
ViewAttendees 1

Symposia

Treatment - CBT

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

3 - (SYM 1) The High Impact of Low Intensity in a Stepped Care Psychotherapy Model

Friday, November 21, 2025
10:39 AM - 10:56 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

Low-intensity CBT that offers a guided intervention with self-led components has demonstrated effectiveness in reducing anxiety and depression symptoms (Schumann et al., 2023; Butler et al., 2006; Karyotaki et al., 2017; Lau & Davis, 2019). However, further evidence of how low-intensity can optimize access, investment, and client improvement within a stepped care model is needed to advance its use in health care delivery. The Canadian Mental Health Association, York and South Simcoe delivered two innovative low intensity bibliotherapy services (BounceBack and Clinician Assisted Bibliotherapy or CAB) to 19, 427 clients of the Ontario Structure Psychotherapy (OSP) program from April 2022 to December 2024 (inclusive) holding 74, 919 sessions. 

The critical shortage of effective, affordable, and accessible mental health care in Ontario is leaving millions without necessary support. A stepped care model with low-intensity options offers a cost-effective strategy to meet population needs. In OSP, triage to these services involved assessing case complexity and client preferences and engagement. Clients then engaged with CBT-based workbooks and received one-on-one telephone sessions.

Self-report depression (PHQ-9) and anxiety (GAD-7) were measured at each session. Clients enrolled in CAB had on average 5 sessions and stepped up to a high intensity service (after completion or without completing CAB) 33% of the time. Fifty-two percent of those who enrolled completed the CAB program. The rate of recovery (proportion of CAB clients with two or more sessions no longer considered a clinical case of anxiety or depression at the end of treatment) was 35.2%. The reliable improvement (proportion of clients with two or more sessions with clinically significant improvement after treatment) was 48.8% for CAB. BounceBack clients had on average three sessions and stepped up to a high intensity service 20% of the time. Forty-eight percent of those who enrolled completed the program. Rate of recovery and reliable improvement for all clients who had more than two sessions of BounceBack were 38.3% and 42.0%, respectively. These outcomes will be evaluated in the context of what is achieved in more cost-intensive (or “high intensity”) CBT. Wait-time data and modelling of the changes in clients’ depression and anxiety symptoms will also be presented.  

This work can inform effective use of low intensity services in other large-scale stepped care psychotherapy programs.