18 We recruited adults (aged 18) presenting in primary care

We investigated the effectiveness and acceptability of supported cCBT as an adjunct to usual GP care for depression and the relative effectiveness of free to use and commercially developed packages. Adults presenting with symptoms of depression in primary care were randomised 1:1:1 to receive either usual care from their GP or usual care from their GP plus one of two interventions: a commercially produced cCBT intervention (“Beating the Blues”) or a free to use cCBT intervention (MoodGYM). We set a minimum eligibility criterion based on a widely used measure of depression severity (score 10 on the nine item patient health questionnaire, PHQ 9) as this has been well validated against standardised criteria17 and is also the measure commonly used to assess depression and to inform treatment decisions in UK primary care.18 We recruited adults (aged 18) presenting in primary care with new or existing symptoms of depression (ascertained by PHQ 9), who were not in receipt of cCBT or specialist psychological therapy at the time of recruitment.

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