A total of 7 papers were identified and reviewed these included Internet delivered interventions from Sweden (n = 3) and Australia (n = 1), self-exposure (SE) interventions from Brazil (n = 1) and the USA (n = 1) and an intervention involving brief CBT from the UK.

All of the studies reviewed involved self-directed 'home-work' tasks and varying degrees of therapist's time. All of the interventions reviewed proved to be effective compared to controls and were accepted well by the participants. Delivery via the Internet, self-exposure (SE) and brief CBT all reduced consultation time with the therapist. However, feedback from the therapists was important to the patients, ensuring their continued motivation. Whether a lay, trained, 'facilitator' could provide this feedback and encouragement, as with the CDSMC, remains to be explored.

In conclusion, the increasing use of new technologies (e.g. Internet) provides the opportunity for lay-led or minimal therapist input programmes to be developed incorporating techniques from the CDSMC and the evidence above. Providing a valuable patient centred service to complement 'standard care', maximising therapists' time and increasing capacity.