Computerised cognitive behaviour therapy recommended for depression, panic and phobia

March 1, 2006

Computerised cognitive behaviour therapy has been recommended as a effective way to help people with mild or moderate depression, panic attacks or phobias.

The government's National Institute for Health and Clinical Excellence has recommended a programme, Beating the Blues, for depression and the FearFighter programme for panic attacks and phobia

Computerised Cognitive Behaviour Therapy (CCBT) can be delivered on a personal computer, over the internet or via the telephone using interactive voice response systems.

Beating the Blues, for example, consists of a 15-minute introductory video and eight one-hour interactive computer sessions.

The sessions are usually at weekly intervals and are completed at GP surgeries.

Homework projects are undertaken between sessions and weekly progress reports are delivered to the GP or other healthcare professional at the end of each session.

The progress reports include anxiety and depression ratings and reported suicidality.

Read for yourself:
The National Institute for Health and Clinical Excellence guidelines on computerised cognitive behaviour therapy (pdf)

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CCBT is dehumanising

Comment by: Steve Halford, clinical psychologist, The Gordon Hospital, London
Date: March 2, 2006

I find this alarming. CCBT dehumanises therapeutic intervention, with much research indicating that it's the therapeutic relationship that mediates much distress and can influence outcome.

CCBT may be helpful within a very specific context i.e. where the patient is monitored and perhaps is about to start a course of CBT with a therapist and this is preliminary, or as a waiting list measure before meeting another therapist.

I imagine, in an economics driven health care system, that the value of human interaction will be diminished leaving many patients at further risk.

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But CCBT helps people to cope

Comment from: Paul Burns, private-practice psychotherapist, Wembley Park, London
Date: March 14, 2006

It is easy for me to imagine ways in which computer-based CBT could be dehumanising. For example, when it is offered without a careful assessment of whether it is appropriate or there is no qualified person with whom to discuss concerns about how it is progressing. In a cash-strapped NHS with its focus on targets these are well-founded fears.

Yet, as much as I don’t like the idea of being replaced by a machine if CCBT can help someone to cope better with depression, panic or any other condition I wish them well and congratulate those who have developed the software. I trust the software includes ways of evaluating over time.

While I think the therapeutic relationship is important for certain people as a means of changing their attitudes about self and others, there are other beliefs that are not so intractable. My training and orientation are not CBT but I cannot ignore the evidence of its effectiveness.

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Dehumanising can be an advantage

From: Tina Connolly, self employed, Coventry
Date: July 10, 2009

I am at the assessment stage for this treatment. I have tried drug therapies and have had a bad reaction to them. Waiting for CBT will take months.

It is interesting that there is a view that all people will benefit from face-to-face therapies. Those that attend such sessions may well benefit but I prefer something less personal.

Computerised assessment is dehumanising but that in itself is an advantage. It cuts out talking personally to a stranger, which can feel embarrassing. Sitting at a computer collecting your thoughts and punching them onto a screen could be less stressful, which would cut out a confounding variable from the CBT process.

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