Introduction: In mental health comorbidity is common, both physical and psychiatric. Normally studies on cognitive behavior therapy (CBT) protocols do not exclude comorbid patients but leave the comorbidity to improve without being addressed, or remain unchanged without being identified. since most cognitive behavior treatment protocols are diagnosis-specific. Based on the idea that several problems can be targeted at once, individually tailored CBT protocols have developed. Including patients’ specific symptom profile and preferences, and the knowledge from established disorder-specific programs these protocols opens for individualization both before and during treatment based on individual progress. Tailoring can also be done to target different age groups and include for example the interface of the treatment program and the clinical examples used.

Methods: Most programs have been tested in randomized controlled trials against active waitlist conditions. Specific symptom measures served as primary outcome measures and measures of life quality as secondary. Some studies also included economic evaluations of cost- effectiveness and ratings of therapeutic alliance. Our samples have been both self-recruited and referred by health care professionals. Most of the studies have measure-points not only directly at post treatment, but also at one- and two-year follow-up.

Results: Taken together the tailored programs show, on average, a medium to large effect size (Cohen’s d) on primary outcome measures regarding both anxiety and depressive symptoms, and small effect sizes on life quality measures. Effects were sustained at follow-up. The tailored treatment proved to be cost-effective administered in regular care. We also found patient ratings of therapeutic alliance to correlate with outcome.

Discussion: Individually tailored internet-administered CBT show promising results. Based on the available data, it might be a feasible approach in treating anxiety and depression. Acceptability, for whom it is most beneficial, and if some components are more powerful than others, are questions left to be answered.