Overall, the reviewed evidence indicated that self-directed CBT improved the clinical ratings of depressive symptoms and that it could be a cost-effective therapy option for individuals with mild to moderate depression. Given the limited evidence, it was uncertain whether self-directed CBT was effective for all individuals with depression; for example, those with more severe depressive symptoms. Also, it was uncertain whether one form of self-directed CBT was superior to another form of self-directed CBT. The factors that optimize the outcomes of selfdirected CBT (for example, degree of assistance) were not explored in this report.