Introduktion: Tidigare forskning visar att det finns flera olika faktorer som bidrar till följsamhet vid läkemedelsbehandling av psykisk sjukdom, både möjligheter och svårigheter. En viktig uppgift som psykiatrisjuksköterskan har i mötet med patienter som lider av psykisk sjukdom är att psykiatrisjuksköterskan ska motivera patienten till att ta emot rekommenderad läkemedelsbehandling. Det är av värde att göra en översikt gällande aktuell forskning kring omvårdnadsmetoder och åtgärder som kan vidtas av psykiatrisjuksköterskan för att motivera patienter med psykisk sjukdom till följsamhet vid läkemedelsbehandling. Syfte: Syfte med denna studie är att undersöka hur sjuksköterskor inom psykiatrisk vård kan motivera personer med psykisk sjukdom till följsamhet vid läkemedelsbehandling. Metod: Metoden för detta examensarbete var litteraturöversikt bestående av 21 vetenskapliga artiklar, varav 14 kvantitativa, 5 kvalitativa och två med mixad metod. Vid litteratursökningenanvändes databaserna Pubmed och CINAHL. Resultat: Analysen av data resulterade i fyra kategorier (figur 3) vilket beskriver hur en sjuksköterska inom psykiatrisk vård kan motivera patienter med psykisk sjukdom tillföljsamhet vid läkemedelsbehandling. Dom fyra kategorierna blev: Den terapeutiska relationen och stöd från anhöriga vid följsamhet till läkemedelsbehandling, Psykoedukation för följsamhet till läkemedelsbehandling, Följsamhetsterapi för läkemedelsbehandling och Andra interventioner för att motivera till följsamhet vid läkemedelsbehandling. Slutsats: Det finns flera olika omvårdnadsinterventioner som specialistsjuksköterskan i psykiatrisk vård kan använda sig av för att motivera patienten att ta emot läkemedel och följa rekommenderad läkemedelsbehandling. Dessa omvårdnadsinterventioner överensstämmer med Roys anpassningsteori där Roy beskriver sjuksköterskans roll i patientens anpassningsförmåga och hur sjuksköterskan hjälper individer att hitta strategier för att hantera olika situationer samt ger individer möjligheter och stöd om behovet finns / Introduction: Previous research has shown that there are several different factors that contributes to adherence to drug treatment of mental illness, both opportunities and difficulties. An important task that the psychiatric nurse has in the meeting with patients suffering from mental illness is that the psychiatric nurse should motivate the patient to accept recommended drug treatment. It is of value to make an overview of current research on the different methods and measures that can be used by the psychiatric nurse to motivate patients with mental illness to adherence to drug treatment. Aim: The aim of this study is to investigate on how nurses in psychiatric care can motivate people with mental illness to adherence to drug treatment. Method: The method for this thesis was a literature review consisting of 21 scientific articles, of which 14 quantitative, 5 Qualitative and two with mixed method. The databases Pubmed and CINAHL were used in the literature search. Results: The analysis of the data resulted in four categories (figure 3), which describes how a nurse in psychiatric care can motivate patients with mental illness to adherence to drug treatment. The four categories were: The therapeutic relationship and support from relatives to motivate adherence to drugtreatment, Psychoeducation for adherence to drug treatment, Adherence therapy for drug treatment and Other interventions to motivate adherence to drug treatment. Conclusion: There are several different nursing interventions that the specialist nurse in psychiatric care can use to motivate a patient to receive medication and follow recommended drug treatment. These nursing interventions are consistent with Roy's adaptation theory where Roy describes the nurse's role in the patient's adaptation capability and how the nurse helps individuals find strategies to handle different situations and gives individuals opportunities and support if needed.

Bakgrund: Stigmatisering, negativa attityder och diskriminering av patienter med psykisk ohälsa är vanligt förekommande både i samhället och i vården. En konsekvens av stigmatisering vid psykisk ohälsa är att många patienter inte söker vård. Negativa attityder hindrar återhämtning och medför att patienten med psykisk ohälsa riskerar att få sämre behandling för sina somatiska sjukdomar. Hälso- och sjukvården har en betydelsefull roll för att minska stigmatiseringen. Specialistsjuksköterskan i psykiatrisk vård ska främja återhämtningen hos patienter med psykisk ohälsa. Attityder till patienter med psykisk ohälsa beskrivs vara en betydande faktor i psykiatrisk omvårdnad. Syfte: Syftet med studien var att belysa faktorer som påverkar attityder till patienter med psykisk ohälsa hos specialistsjuksköterskan i psykiatrisk vård. Metod: Studien genomfördes som en systematisk litteraturstudie baserad på 11 kvantitativa artiklar och data extraherades, syntetiserades och summerades. Resultat: Resultatet presenterades i fyra huvudkategorier; patientens diagnos, sjuksköterskans personliga erfarenheter, sjuksköterskans utbildning och arbetsplatsens kulturella påverkan. Konklusion: Specialistsjuksköterskan i psykiatrisk vård har generellt en mer positiv attityd gentemot patienter med psykisk ohälsa jämfört med grundutbildade sjuksköterskor. Specialistsjuksköterskans personliga erfarenheter så som arbetslivserfarenhet, civilstånd och erfarenhet av att ha släktingar eller vänner med psykisk ohälsa genererar mer positiva attityder till psykisk ohälsa. Utbildning synes vara en väsentlig faktor då specialistsjuksköterskor i psykiatrisk vård generellt har en mer positiv attityd till patienter med psykisk ohälsa. / Background: Stigma, negative attitudes, and discrimination against patients with mental illness are common both in society and globally. A consequence of stigmatization in mental illness is that many patients do not seek care. Negative attitudes hinder recovery and mean that patients with mental illness risk receiving worse treatment for their somatic illnesses. Health care has an important role to play in reducing stigma. The specialist nurse in psychiatric care must promote the recovery of patients with mental illness. Attitudes towards patients with mental illness are described as an influential factor in psychiatric nursing. Aim: The purpose of the study was to highlight which factors influence psychiatric nurses' attitudes towards patients with mental illness. Method: The study was conducted as a systematic literature study based on 11 quantitative articles and data were extracted, synthesized, and summarized. Results: The results were presented in four main categories; the patient's diagnosis, the nurse's personal experiences, the nurse's education, and workplace cultural influences. Conclusion: Specialist nurses in psychiatric care generally have a more positive attitude towards patients with mental illness compared to nurses with basic training. The specialist nurse's personal experiences such as work experience, marital status, and experience of having relatives or friends with mental illness generate more positive attitudes. Education seems to be a significant factor as specialist nurses with education in psychiatric nursing generally have a more positive attitude to patients with mental illness.

Bakgrund: Suicid bidrar till att över 700 000 människor dör årligen och det påverkar såväl människors familjer som samhället i stort. Det finns stigma och fördomar kring suicidala handlingar. Flera personer hade varit i kontakt med sjukvården innan de begick suicid. Personcentrerad vård utgår från personens upplevelse av hälsa och ohälsa, vilket är centralt i det psykiatriska vårdsammanhanget. Syfte: Syftet var att granska och syntetisera kvalitativ forskning om patienters upplevelser av omvårdnad i den psykiatriska vården vid suicidala handlingar. Metod: Strukturerad litteraturöversikt med kvalitativa artiklar. Dataanalys var tematisk analys av Braun och Clarke (2021). Resultat: Det framkom tre teman med tillhörande subteman, ”Miljöns betydelse”, ”Att bli bekräftad”, ”Barriärer för en god vård”. Vården påverkades utav vårdpersonalens bemötande, kommunikationsförmåga och den fysiska miljön. Försvårande faktorer var när kommunikationen och den personcentrerade vården brast. Betydelsefulla aspekter var när personal visade respekt, empati, skapande allians och att anhöriga var delaktiga i vården. Slutsats: Studiens resultat kan komma att få betydelse för patienter som vårdas i anslutning till suicidala handlingar, även för vårdpersonal som kan vara behov av handledning. Vidare forskning behövs på flera perspektiv, för att skapa en bredare förståelse som kan påverka omvårdnaden och förbättra den personcentrerade vården. / Background: Suicide contributes to the death of over 700,000 people annually and it affects both people's families and society at large. There is stigma and prejudice surrounding suicidal acts. Several people had been in contact with the health care system before committing suicide. Person-centred care is based on the person's experience of health and ill health, which is central to the psychiatric care context. Aim: The aim was to review and synthesize qualitative research on patients' experiences of nursing care in psychiatric care for suicidal acts. Method: Structured literature review with qualitative articles. Data analysis was thematic analysis by Braun and Clarke (2021). Results: Three themes emerged with associated subthemes, "The importance of the environment", "Being confirmed", "Barriers to good care". The care was influenced by the care staff's treatment, communication skills and the physical environment. Aggravating factors were when communication and person-centred care broke down. Significant aspects were when staff showed respect, empathy, creating an alliance and that relatives were involved in the care. Conclusion: The results of the study may have significance for patients who are cared for in connection with suicidal acts, also for healthcare personnel who may need supervision. Further research is needed on several perspectives, to create a broader understanding that can influence nursing and improve person-centered care.

Bakgrund: Suicid är ett globalt och nationellt problem. Suicidalt beteende grundar sig ofta i bakomliggande psykisk diagnos. Sjuksköterskorna bör inledande i omvårdnaden identifiera risk och skyddsfaktorer som patienten har, för att kunna ge omvårdnad som är personcenterad och god. Syfte: Att beskriva svårigheter som sjuksköterskor kunde uppleva i mötet med suicidnära patienter. Metod: Studien var en allmän litteraturstudie. Studiens resultat baserades på 13 artiklar från databaserna CINAHL, PubMed samt PsycInfo. Resultat: Tre huvudkategorier identifierades: (1) Utmaningar med suicidprevention, (2) Utmaningar i arbetsmiljön och (3) Utmaningar med betungande känslor. De uttryckta utmaningarna var brist på kunskap, brist på utbildning samt negativa känslor för sjuksköterskor. Det bristande organisatoriska stödet, brist på adekvat personal samt brist på kunskap har negativ inverkan på omvårdnaden för suicidnära patienter. Konklusion: För att sjuksköterskor ska kunna ge god omvårdnad för den suicidnära patienter krävs mer utbildning i såväl sjuksköterskeutbildningen som fördjupande utbildningar på arbetsplatsen. Det krävs fortsatt forskning för att förstå sjuksköterskors utmaningar i arbetet, för att omvårdnaden av suicidnära patienter ska utvecklas. / Background: Suicide is a global and national problem. Suicidal behavior is often based on an underlying psychiatric diagnosis. At the beginning of nursing, the nurses should identify risk and protective factors that the patient has, to provide nursing care that is person-centered and good. Aim: To describe difficulties that nurses could experience when dealing with suicidal patients. Method: The study was a general literature study. The study's results were based on 13 articles from the databases CINAHL, PubMed and PsycInfo. Results: Three main categories were identified: (1) Challenges with suicide prevention, (2) Challenges in the work environment, and (3) Challenges with burdensome emotions. The challenges expressed were lack of knowledge, lack of training and the nurse's perceived negative emotions. The lack of organizational support, lack of adequate staff and lack of knowledge have a negative impact on nursing care for suicidal patients. Conclusion: For nurses to be able to provide good care for suicidal patients, more education is required in both nursing education and in-depth training in the workplace. Continued research is required to understand nurses' difficulties in their work, for the care of suicidal patients to develop.

Bakgrund: Runt 429 000 barn drabbas årligen av cancer världen över. Att leva med cancer och genomgå behandlingar är en svår utmaning för barn och närstående. Coping är ett verktyg som hjälper individer möta påfrestande situationer. Många studier belyser copingstrategier använda av föräldrar och andra personer nära cancerdrabbade barn, men underlaget är inte lika stort gällande barns egna beskrivningar av sin coping. Av denna anledning är det väsentligt att identifiera använda copingstrategier ur barns perspektiv. Syfte: Syftet med litteraturstudien var att beskriva vilka copingstrategier barn med cancer använder sig av för att hantera sjukdomen och dess behandling. Metod: Studien är en beskrivande litteraturstudie. Databassökningen genomfördes i PubMed. Sökningen resulterade i tio artiklar där åtta var kvalitativa, en var kvalitativ med mixad metod och en var kvantitativ. Framkomna data analyserades genom tematisk dataanalys. Huvudresultat: Barn med cancer använde olika copingstrategier som kategoriseras som problemfokuserade, emotionsfokuserade och meningsskapande copingstrategier. Till problemfokuserade copingstrategier hörde ”Symtomlindring och underlättande av behandling”, ”Information, kunskap och insikt” samt ”Anpassning och bibehållande av en normal vardag”. I emotionsfokuserade copingstrategier återfanns ”Stöd och känslohantering”, ”Distrahering och undvikande” samt ”Acceptans, motivation och framtidshopp”. Meningsskapande copingstrategier var ”Positiv omvärdering” och ”Personlig utveckling och att se sjukdomen som en utmaning”. Slutsats: Barn med cancer använder olika copingstrategier för att hantera sin sjukdom och dess behandling. Strategierna tillämpas växelvis beroende på situation och syftet med användningen av vald copingstrategi är individuell. Genom ökad kännedom kring ämnet kan cancerdrabbade barn erbjudas personcentrerad vård och lämpligt stöd. / Background: About 429 000 children are annually affected by cancer worldwide. Living with cancer and undergoing treatment is a difficult challenge for children and close relatives. Coping is a tool that helps individuals face stressful situations. Many studies shed light on coping strategies used by parents and other people close to children affected by cancer, but the basis is not as extensive regarding children's own descriptions of their coping. For this reason, it is essential to identify used coping strategies from children's perspective. Aim: The purpose of the literature study was to describe which coping strategies children with cancer use to manage the disease and its treatment. Method: The study is a descriptive literature study. The database search was conducted in PubMed. The search resulted in ten articles, eight of which were qualitative, one was qualitative with a mixed method and one was quantitative. The data were analyzed through thematic data analysis. Main results: Children with cancer used different coping strategies categorized as problem-focused, emotion-focused and meaning-making coping strategies. Problem-focused coping strategies included “Symptom relief and facilitation of treatment”, “Information, knowledge and insight” and “Adaptation and maintaining a normal everyday life”. In emotion-focused coping the strategies found were “Support and emotion management”, “Distraction and avoidance” and “Acceptance, motivation and hope for the future”. Meaning-focused coping strategies were “Positive reappraisal” and “Personal development and seeing the disease as a challenge”. Conclusion: Children with cancer use different coping strategies to deal with their illness and its treatment. The strategies are applied alternately depending on the situation and the purpose of using the chosen coping strategy is individual. Through increased awareness of the subject, children affected by cancer can be offered person-centred care and appropriate support.

Bakgrund: Tidigare forskning visar att patienter som kommer i kontakt med psykiatrin eftersuicidförsök ofta upplever känslor av skam och rädsla. Det första mötet med sjuksköterskan är ofta avgörande för hur vårdtiden av patienten utvecklas. Upplever patienten sig inte tagen på allvar, sedd eller hörd kan detta leda till flyktkänslor eller att man drar sig undan. Syfte: Syftet med studien är att utifrån vetenskaplig litteratur beskriva patienter och sjuksköterskors upplevelser av att få samt ge vård efter ett suicidförsök. Metod: Kvalitativ forskningsöversikt inkluderat åtta vetenskapliga studier från databaserna CINAHL och PsychINFO. Data har analyserats med stöd av Evans fyrstegsanalys. Resultat: Resultatet visar att patienter har ett behov att känna sig tagna på allvar för att lindra lidande. Resultatet visar även att sjuksköterskan upplever svårigheter i mötet med den suicidala patienten. Sjuksköterskans bemötande och engagemang i patienten har en central roll för patientens möte med psykiatrisk vård efter ett suicidförsök. Diskussion: Mötet mellan patienten och sjuksköterskan avspeglar sig i sjuksköterskans bemötande och engagemang i patienten, genom att ta patienten på allvar kan lidande lindras och patientens välbefinnande kan ökas. Genom engagemang stöttas patienten och genom eliminering av negativa upplevda känslor kan sjuksköterskan nå patienten på ett sätt som gör att patienten kan inspireras att förändra sin livssituation. / Background: Previous researches shows patients who come in contact with a psychiatric ward after suicide attempt often experience feelings of shame and fear. The first meeting is determined by how the time at the ward develops. If a patient experience not being taken seriously or heard it usually leads to feelings of escaping or withdrawing. Aim: The purpose of the study is based on scientific literature describing patients and nurses' experiences in receiving and providing care after a suicide attempt. Method: Qualitative research review included eight scientific studies from the databases CINAHL and PsychINFO. Data were analyzed with the aid of Evans four steps analysis. Results: The results show that patients have a need to feel that they are being taken seriously in order to alleviate suffering. The result also shows that nurses are experiencing difficulties in meeting with the suicidal patient. The nurse's attitude and commitment to the patient has a central role in the patient's encounter with psychiatric care after a suicide attempt. Discussion: The meeting between the patient and the nurse is reflected in the nurse's attitude and commitment to the patient, by taking the patient seriously suffering can be alleviated and the patient's well being can be increased. Through dedication supported the patient and by the elimination of negative emotions experienced nurse can reach the patient in a way that allows a patient to be inspired to change their lives.

The Swedish mental hospitals existed for about one hundred years, the period around 1880-1980. The research is intended to be from a local setting perspective to study the local approach used to meet requirements from Furunäsets mental hospital principals 1960 - 1972, the effect this had on the care and treatment of mentally ill patients and how Swedish society's changing approach to mental health influenced the process. The results of the research showed that Furunäset searched for ways to meet the principals' requirements which often went against the patients’ personal best. Furunäsets mental hospital strove to fulfill its institutional goals in them selves rather than giving patients the care and treatment they needed. The Swedish society's attitude to mental illness changed during the 1960s and 70s as a result of a massive social criticism which came from the radical left. The psychiatric treatment was changed by the humanistic psychology breakthrough in the late 1950s and early 60s. This meant that the focus shifted from treating patients as objects to be seen as people with human qualities. These changes created a conflict between the society's belifs and the mental hospital's, regarding the function of Furunäsets Mental Hospital. The conflict led to the Swedish government taking the first step towards reorganizing mental health services by building hospitals in the early 1970s that combined somatic and psychiatric care.

The aim of this thesis was to expand the knowledge of victimization in children and youth in Sweden. Victimization, prevalence, health and peritraumatic reactions were explored in a cross sectional, representative sample of 5,960 second grade high school students in Sweden. A computerized survey was developed and administered in class room setting. Lifetime victimization was found in 84.1% of the sample (m=83.0%, f=85.2%), and, in relation to the five domains, 66.4% had experienced conventional crime, 24% child maltreatment, 54.4% peer and sibling victimization, 21.8% sexual victimization, and 54% had experienced witness victimization. Females experienced significantly more child maltreatment, peer and sibling victimization, sexual victimization, and witnessed victimization, males more conventional crime (p<0.001). Using logistic regression risk factors for victimization were confirmed by a significant increase OR regarding gender, environment and lack of both parents. Symptoms (TSCC), were clearly associated with both victimizations per se and the number of victimizations. The results indicated a relatively linear increase in symptoms with an increase in number of events experienced. Mental health of the polyvictimized group was significantly worse than that of the non-polyvictimized group, with significantly elevated TSCC scores (t<0.001). Hierarchical regression analysis resulted in beta value reduction when polyvictimization was introduced supporting the independent effect on symptoms. Social anxiety was found in 10.2 % (n = 605) of the total group (n = 5,960). A significant gender difference emerged, with more females than males reporting social anxiety. Elevated PTSS was found in 14.8 % (n=883). Binary logistic regression revealed the highest OR for having had contact with child and adolescent psychiatry was found for the combined group with social anxiety and elevated PTSS (OR = 4.88, 95 % CI = 3.53–6.73, p<001). Significant associations were also found between use of child and adolescent psychiatry and female gender (OR = 2.05, 95 % CI = 1.70–2.45), Swedish birth origin (OR = 1.68, 95 % CI = 1.16–2.42) and living in a small municipality (OR = 1.33, 95 % CI = 1.02–1.73). Mediation models used peritraumatic reactions (PT): total, physiological arousal (PA), peritraumatic dissociation (PD), and intervention thoughts (IT) and JVQ and TSCC. Of the n=5,332 cases, a total of n=4,483 (84.1%) reported at least one victimizing event (m = 83.0%, f = 85.2%). Of these, 74.9% (n=3,360) also experienced a PT reaction of some kind. The effect mediated by PT tot was b= 0.479, BCa CI [0.342 – 0.640], representing a relatively small effect of 7.6%, κ2=0.076, 95% BCa CI [0.054- 0.101]. The mediating effect of JVQ on TSCC was mediated by PD more for males (b=0.394 BCa CI [0.170-0.636]) than for females (b=0.247, BCa CI [0.021-0.469]). The indirect effect of the JVQ on the TSCC tot mediated by the different PT reactions was significant for PD (b=0.355, BCa CI [0.199- 0.523]. In males a mediating effect of PD could be seen in the different models, while females had a more mixed result. IT did not show any indirect effect in males, but had a mixed effect for females. The empirical findings in this thesis lead to the conclusion that victimization is highly prevalent in children and youth and is related to health issues. The association of victimization on symptoms was mediated by peritraumatic reactions. Using a comprehensive instrument such as the JVQ provides the researcher or clinician the opportunity to acquire more complete measurement and also makes it possible to identify polyvictimization, a high-level category of events with severe impact on health.

Bakgrund: Det framkommer centrala aspekter vid omvårdnaden av patienter som skadar sig själva som i sin tur ställer krav på vårdpersonalens förmåga att förhålla sig till mötet med dessa patienter. Syfte: Syftet med litteraturstudien var att belysa psykiatrisk vårdpersonals upplevelser i mötet med patienter som skadar sig själva. Metod: En systematisk litteraturstudie baserad på Evans analysmetod och resultatet grundar sig på 22 artiklar av kvalitativ ansats. Resultat: Vårdpersonalens möten med patienter som skadar sig själva redovisas sex teman; Att utmanas av negativa känslor, Att stänga av sin empatiska förmåga, Att vara osäker på vad som komma skall, En svår balansgång, Ett gynnsamt möte och Professionell utveckling. Slutsats: Resultatet visade på att vårdpersonal i psykiatrisk vård har att hantera flera negativa känslor i sina möten med patienter som skadar sig själva. Kontinuerlig fortbildning och handledning framstår som nödvändiga förutsättningar för att möjliggöra gynnsamma möten med patientgruppen. / Background: It appears to be central aspects regarding the care of patients who self-harm and these aspects set requirements on psychiatric health care personnel's ability to relate to the meeting with the patients. Aim: To illustrate psychiatric health care personnel's experiences of meeting with patients who self-harm. Method: A systematic literature review based on a method described by Evans with a result based on 22 articles of qualitative design. Result: To meet patients who self-harm can be seen out of the six themes described in the result of the present study; To be challenged by negative emotions, To disconnect from your empathic ability, To be unsure of what´s to come, A difficult balancing act, A favorably meeting and Professional development. Conclusion: The result of the present study shows that the negative emotions were prominent. Continuous further training and tutorial appears necessary conditions to enable favorable meetings with the patient group.

Anxiety disorders share the feature of excessive fear, anxiety and related behavioural disturbances. Fear is defined as the emotional response to a real or a perceived imminent threat and anxiety is the anticipation of a future threat. The anxiety disorders covered in this thesis are panic disorder with or without agoraphobia, social phobia, post-traumatic stress disorder, generalized anxiety disorder and anxiety disorder not otherwise specified. Cognitive behavioural treatment protocols are typically designed to target one specific disorder and falls under the definition of disorder-specific cognitive behavioural therapy. It is however unclear if this is the most optimal approach in regards to the high comorbidity between anxiety disorders and depressive disorders. Internet-based cognitive behavioural therapy has in the past generally been disorder-specific and from above mentioned predicament two alternative treatment approaches emerged, the tailored and the transdiagnostic approach that aims to simultaneously treat both principal and comorbid disorders. Previous trials on internet-based cognitive behavioural therapy have targeted adults in general and relatively few target adolescents, young adults and older adults. The aims of this thesis were to further develop and test the effects of tailored internet-based cognitive behavioural therapy on the basis of age, for adolescents, young adults and older adults. Specifically by developing and testing the effects of individually tailored internet-based cognitive behavioural therapy for adolescents with anxiety and comorbid depressive symptoms and by adapting and testing the effects of individually tailored internet-based cognitive behavioural therapy for young adults and older adults with anxiety and comorbid depressive symptoms. These aims were tested in two pilot effectiveness studies (Paper I and III) and two efficacy randomised controlled trials (Paper II and IV). The results from these four trials showed significant results across all outcome measures with overall moderate to large effect sizes. The tentative conclusion based on these results is that tailoring internet-based cognitive behavioural therapy can be a feasible approach in the treatment of anxiety symptoms and comorbid depressive symptoms for adolescents, young adults and older adults. Despite the positive findings of the studies in this thesis, there is a need for more research examining the acceptability and effectiveness of internet-based cognitive behavioural therapy for adolescents, young adults and older adults with anxiety and depression before implementation on a larger scale.