What is the efficacy of therapist-guided internet-treatment, self-guided internet-treatment with pre-treatment contact, and purely self-guided internet-delivered for older adults (60+) with symptoms of anxiety and depression?

In this trial Australian older adults (60+) with symptoms of anxiety and depression will be randomly allocated to one of three groups. The three groups are: Group 1: Purely self-guided - treatment. Participants in this group will complete the treatment in a purely self-guided format, that is, without pre-treatment contact or weekly support from a therapist. Group 2: Self-guided with pre-treatment contact. Participants in this group will complete the treatment in a self-guided format, that is, with pre-treatment contact but no weekly support from a therapist. Group 3: Guided - treatment. Participants in this group will complete the treatment in a guided format, that is, with pre-treatment contact as well as weekly telephone or email support from a therapist. Pre-treatment contact will occur via a brief 5 - 10 minute telephone call with one of the two clinicians running the Course. The pre-treatment contact will involve a brief discussion about the Course requirements, orienting the participant to the Course structure and online treatment. Weekly contact will be conducted via a brief 5 - 10 minute telephone call by one of two clinicians running the treatment groups. The weekly contact will involve answering participants' questions about the treatment materials, orienting participants to the upcoming treatment materials, encouraging practice of self-management skills, and answering queries about practicing the skills in the Course. Over the 8 weeks, all participants will be directed to read 5 online lessons about management of symptoms. One lesson will be completed every 7 to 14 days. Each lesson will take about 15 minutes to read. Participants will also have access to summaries and homework assignments for each lesson, and will read stories about people with similar symptoms, taking a further 20 minutes per week. Participants in all groups will also receive automatic emails providing reminders about the course and encouragement to continue. Study questionnaires will be administered at pre-treatment, post-treatment, and 3 months post-treatment. These will take about 10-15 minutes to complete. Participants will also complete brief measures of mood and anxiety before each lesson. The treatment materials include cognitive behavioural treatment (CBT) skills.