cCBT Provides Little Or No Benefits For Depression
The largest study of its kind found computer assisted cognitive behavioral therapy (cCBT) to be largely ineffective treatment for depression.
In the largest study of its kind, carried out by the University of York, researchers found that computer assisted cognitive behavioral therapy is ineffective treatment for depression, not because of poor quality materials or the ineffectiveness of the materials, but because of low patient adherence and engagement.
Even though cognitive behavioral therapy is considered an effective “talking treatment” for depression - numerous studies have found talk therapy to be the "gold standard" for depression treatment - it's not widely available in many locations throughout the world.
To meet the need for this type of treatment, organizations have been producing computer assisted cognitive behavioral therapy (cCBT) programs for online delivery. So researchers wanted to find out how effective these types of programs were in comparison to in-person settings. What a team of researchers from the University of York found out was that even though the materials were effective, results were not. In fact, the study revealed cCBT provided little to no benefit in the treatment of depression.
These researchers also discovered that the reason these types of programs were ineffective was not because of the quality of materials, their effectiveness, or the delivery mechanisms but because very few – only 16% to 18% of participants - followed through and completed the entire program.
According to the published results, most participants dropped out of the programs well before they were completed.
The study found that patients were "generally unwilling to engage with computer programmes, and highlighted the difficulty in repeatedly logging on to computer systems when clinically depressed."
"Participants wanted a greater level of clinical support as an adjunct to therapy, and in absence of this support, they commonly disengaged with the computer programmes," explain the authors.
In an accompanying editorial, Professor Christopher Dowrick at the University of Liverpool says the evidence from this trial "is not in itself sufficient to overturn existing guidelines" but the findings "do have important implications."
He argues that many depressed patients "do not want to engage with computers, they prefer to interact with human beings" and believes the lack of patient engagement "suggests that guided self help is not the panacea that busy GPs and cost conscious clinical commissioning groups would wish for."
The results of this study are similar to previous studies done on anxiety. Researchers in these previous studies found that while many people owned anxiety self-help books and materials, few actually completed any of the materials they owned. And for those that did, they found that a lack of personal touch rendered these materials relatively ineffective.
That's not to say that self-help materials can't be helpful, because they can and can be considered an important part of the overall treatment for anxiety and depression. But that self-help materials alone generally produce unsatisfactory results.
The above research echoes our professional experiences with helping people overcome anxiety and depression. We found that the vast majority of people require personal and professional care if successful and lasting results are to be attained.
This research was recently published in The BMJ (British Medical Journal).
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