**6. Future directions**

The efficacy of iCBT in addressing the symptoms of depression and anxiety disorders has been presented. However, more effectiveness studies conducted in various settings are needed to examine the potential barriers and find appropriate solutions for successfully implementing iCBT. It would seem reasonable to understand that achieving solutions for implementation will be critical to support large-scale adoption of iCBT in practice.

Another issue which merits further study is the effect of mechanisms of change, that is, the underlying factors that aid the efficacy of the interventions. Understanding these mechanisms further will allow for the adaptation of the content to the specific needs of each service user, improving the provision of these treatments in a more efficient way (determining precisely what works and for whom). Indeed, to date, little has been achieved in understanding the relative contribution of mechanisms of change to specific outcomes in iCBT [19]. Further, studies with large sample sizes or individual data meta-analyses are needed to be able to detect any effects of different variables, such as sociodemographic factors or personality traits (i.e., neuroticism).

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Lastly, different modes of implementation of iCBT interventions need also to be explored further. Recent reviews suggest that mobile interventions are also a feasible tool for delivering interventions as a standalone treatment or as an adjunct to face-to-face therapy [44]. Furthermore, innovative devices, such as apps or wearables, could facilitate the inclusion of ecological momentary assessments that allow a more accurate data collection. Hence, more research is needed to explore possibilities for integrating these devices with iCBT. The potential for blended treatments, in which internet interventions act as a supportive tool for the face-to-face therapy, should not go unnoticed. However, this field still needs more research to explore the best ways to integrate both forms of treatment [45].
