Monday, April 20, 2009

The computer will see you now ...

Cognitive behaviour therapy (CBT) is now the most commonly practised psychotherapy in the NHS. However, demand for it is much greater than the NHS can supply and many services are only open in the day making them inaccessible to many users. Computerised cognitive behaviour therapy (cCBT) aims to offer CBT to people while reducing the number and costs of therapists needed, and has been recommended for use for people with mild-to-moderate depression and anxiety. However, there has been little research into the barriers that might stop people using it. Researchers at St John's Hospital in Scotland and at the University of York reviewed studies into the effectiveness of cCBT to see if they could find any clues. They found that large numbers of people dropped out of the trials with little explanation. In trials comparing cCBT to other treatments participants receiving cCBT were twice as likely to drop out. Only a median* of 56% of people in the trials completed a full course of cCBT and 'personal circumstance' was a more common cause of dropout than difficulties with the technology or social background. The risks of cCBT were rarely assessed in the majority of programmes and significant staff time was needed to support the participants. Therapists were actually more negative about cCBT than those receiving it.

Waller, R. and Gilbody, S. - Barriers to the uptake of computerized cognitive behavioural therapy: a systematic review of the quantitative and qualitative evidence Psychological Medicine May 2009, 39(5), 705-712

*see here for an explanation of the statistical term median

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