Computer guided CBT may improve treatment of depression?

Computer guided CBT may improve treatment of depression? - In the United States, depression is the leading cause of disability, but only 21% of patients diagnosed with major depression receive treatment that meets the guidelines of the American Psychiatric Association. 

Of people seeking treatment for depression who would be treated with psychotherapy Live outnumber those who would be treated with drugs three to one, but those who often want to live not a therapy they receive. 

Access to psychotherapy is limited by the number of professionals from the region itself, the cost and logistics - not to mention the stigma. And when people receive the therapy, therapists can not provide care based on evidence.

One way to get high quality psychotherapy to people in need is to automate and computerize the treatment process and provide via websites and applications. This could provide guidelines on the basis of everyone, everywhere, at any time, at a low cost treatment. 

Stand-alone computerized cognitive behavioral therapy (CBT) has been found to be effective for treating depression, and is now available in a few entities. But it remains unclear how much, if anything, CCTB improve the treatment of depression in primary care, so that a group of UK researchers recently tested the benefits of adding CCTB to standard treatment. 

They randomly assigned 691 people with depression in three different groups. One group received standard care, and the others received standard care plus a two CCTB programs online.

CCTB over standard care for depression 

Consequently, the standard treatment of depression in primary care in the UK is pretty good. Citizens are routinely offered antidepressants, psychotherapy, and access to community mental health teams, psychologists, psychiatrists and counselors - a range of both rare resources available in primary care practices in the United States. 

There was a lot of crossover between the study groups. In the group "standard of care", 19% ended up using CBT although they are not specifically assigned to this treatment. Between 77% and 84% of the three groups used to treat depression and drugs "Live" mental health specialists were seen by 17% annually and 24% of the other group CARE. 

In this context - with many participants CCTB groups also receive specialized mental health treatment and 19% of the group receiving the usual practice CBT-- no significant differences in treatment outcomes of depression. However, the United States, the results might have been different, given the limited resources of mental health in most established primary care clinics. 

It would be more interesting and more importantly, know the advantage of using CCTB for patients receiving no more - without drugs and without access to specialists in mental health. It is for these patients that CCTB might be most beneficial.

Challenges to get people to use CCBT to treat depression 

The two sites of the CCBT has been tested in previous clinical trials, and both have proven to be effective treatments - but they are only useful if people use them. Although both independent sites CCTB were designed to be used on 6 or 8 "sessions", most people only used once or twice, although the study provided reminder calls to participants. 

People with depression may experience fatigue, impaired concentration, and feelings of hopelessness. Make websites use systematic CCTB on your own schedule is a challenge - even if these programs could be useful in the end. More structure may be needed to keep people using CCTB.

What is the take home? The biggest challenge is not building a CBT program that works; He built one that people will use. Just as you need to entertain while educating before CBT program must be extremely involving users - and provide immediate value of the first session. 

And while the concept of treatment anywhere, anytime is attractive, confident people to plan CCTB themselves in their own time, in their own homes, can lead to high levels of downhill; after all, you can always get around to it later. 
By: James Cartreine, Phd.