computer-assisted therapy

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For Depression, Computer-Assisted Therapy Offers Little Benefit, Study Finds

It’s unlikely that your therapist will be replaced by a computer program anytime soon.

That’s the takeaway of recent study out of Britain looking at the effectiveness of computer-assisted therapy for depression.

The bottom line: The computer programs offered little or no benefit compared to more typical primary care for adults with depression. That’s largely because the patients were generally “unwilling to engage” with the programs, and adherence faltered, researchers conclude, adding that the study “highlighted the difficulty in repeatedly logging on to computer systems when [patients] are clinically depressed.”

In an accompanying editorial, Christopher Dowrick, a professor of primary care medicine at the University of Liverpool, stated what may seem obvious: Many depressed patients, he wrote, don’t want to interact with computers; rather, “they prefer to interact with human beings.” He noted that the poor result “suggests that guided self help is not the panacea that busy [primary care doctors] and cost conscious clinical commissioning groups would wish for.”

(Lloyd Morgan/Flickr)

(Lloyd Morgan/Flickr)

As part of the study, published in the BMJ, 691 patients suffering from depression were randomly assigned to receive the usual primary care, including access to mental health care, or the usual care plus one of two computer-assisted options that offer cognitive behavior therapy (CBT), a form of therapy that encourages patients to reframe negative thoughts. Patients were assessed at four, 12 and 24 months; those using the computer programs (one called “Beating the Blues” and the other “MoodGYM“) were also contacted weekly by phone and offered encouragement and technical support.

The context of all this is that demand for mental health services generally exceeds supply around the globe, and health systems are seeking ways to bridge the gap. According to the new paper, demand for cognitive behavioral therapy, for instance, “cannot be met by existing therapist resources.” So, the thinking goes, maybe a computer can ease some of the caseload. And in some cases, it works. Indeed, Britain’s National Institute of Health and Care Excellence (NICE) guidelines recommend computerized CBT as an “initial lower intensity treatment for depression….” based on studies that showed it can be effective.

However, results of this latest study may nudge clinicians and policymakers to rethink the computer’s role in therapy.

Here are the results, summed up in BMJ news release:

Results showed that cCBT offered little or no benefit over usual GP care. By four months, 44% of patients in the usual care group, 50% of patients in the Beating the Blues group, and 49% in the MoodGYM group remained depressed…. Continue reading