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decreases in the use of avoidant coping from baseline to 2‐month follow‐up. The engagement with the intervention was about 20 min higher than in a previous study that used the same platform. 40 Higher proportion of completers with at least a bachelor's degree suggests that non‐completers could have potentially struggled with the reading involved. Future research can benefit from evaluating and improving language and accessibility. Higher proportion of non‐ completers with greater HADS‐D suggests that they may benefit more from high‐intensity treatments. This is also the first study that explored survivors' preference for carer access in iCBT and indicated low preference. Three out of four carers who had access did not engage. It is unknown whether this was due to carers' high responsibilities and lack of time or because the programme designed mainly for survivors was not feasible for carers. 4.1 | Limitations The study included survivors who completed their primary cancer treatment and were mostly educated, limiting its generalisability for different demographic and health characteristics. Despite these lim- itations, the sample was heterogeneous in terms of age, education levels, and range of times passed after treatment completion. Recruitment through social media could also bias findings and limit generalisability. The low reliability of the avoidant coping measure and small sample size might have reduced the statistical power to detect effects on secondary outcomes and mediators. The lack of significant mediating effects of active and avoidant coping could suggest that the effects of iCBT on distress were achieved via another mechanism. Research investigating which cancer survivors at what time in their recovery benefit from this programme and with long‐term follow‐up is needed to expand on these findings. 4.2 | Clinical implications The iCBT programme was effective in decreasing overall distress. If proven effective in a larger trial, it could be offered as an easily accessible alternative for those who have no access to psychotherapy or are on a waiting list. Although the reductions in overall distress did not reach significance post‐intervention, iCBT indicated its benefits with large and significant reductions at 2‐month follow‐up. This may be explained by the skills developed and built over time with the practice of modules and tools. 5 | CONCLUSION The results provide preliminary evidence for the effectiveness of an iCBT programme in decreasing depression and anxiety symptoms of breast cancer survivors. Positive findings about the current version of the programme suggest the value of conducting a larger trial investigating the short and long‐term impact of iCBT with a wider sample of survivors screened for depression and anxiety. If proven effective, the programme can be offered as an effective and easily accessible alternative for people with cancer following treatment and long‐term survivors. Future studies exploring the possible mecha- nisms of change in iCBT interventions for cancer survivors are also needed. ACKNOWLEDGEMENTS The authors would like to acknowledge with great appreciation the contributions of Dr. Charlotte Wilson and Dr. Sonia Collier in the adaptation of the iCBT intervention content. We would like to thank SilverCloud Health for collaborating on this project. We also would like to thank all the people who participated in this study and sup- porters who provided weekly guidance and feedback to iCBT re- cipients. The authors would like to thank the peer reviewers for their helpful comments and fair review of this work. Dr. Selin Akkol Sol- akoglu was supported by the Trinity College Dublin Postgraduate Research Award. Prof. David Hevey received no funding and is an employee of Trinity College Dublin. Open access funding provided by IReL. CONFLICT OF INTEREST Dr. Selin Akkol Solakoglu is currently an employee of SilverCloud Health. SilverCloud Health is a subsidiary of Amwell. Dr. Selin Akkol Solakoglu hold shares with Amwell. Findings were analysed and written before her employment. Prof. David Hevey declares no conflict of interest. DATA AVAILABILITY STATEMENT Data that support the findings of this study are available from the corresponding author upon reasonable request. ETHICS STATEMENT All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/ or national research committee and with the 1964 Helsinki declara- tion and its later amendments or comparable ethical standards. The study was approved by the Trinity College Dublin School of Psychol- ogy Research Ethics Committee (Approval ID: SPREC022020‐09). Informed consent was obtained from all individuals who participated in this study. ORCID Selin Akkol‐Solakoglu https://orcid.org/0000-0002-9720-5517 REFERENCES 1. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209‐249. https://doi.org/10.3322/caac.21660 2. Hopko DR, Clark CG, Cannity K, Bell JL. Pretreatment depression severity in breast cancer patients and its relation to treatment 454 - AKKOL‐SOLAKOGLU AND HEVEY 10991611, 2023, 3, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/pon.6097, Wiley Online Library on [28/06/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License