Abstract
There has been a recent acceleration in the development and testing of programs for computer-assisted cognitive-behavioral therapy (CCBT). Programs are now available for treatment of depression, anxiety disorders, and other psychiatric conditions. Technology for delivery of CCBT includes multimedia programs, virtual reality, and handheld devices. Research on CCBT generally has supported the efficacy of computer-assisted therapy and has shown patient acceptance of computer tools for psychotherapy. Completion rates and treatment efficacy typically have been higher when clinicians prescribe and support the use of psychotherapeutic computer programs than when programs are delivered in a self-help format without clinician involvement. CCBT seems to have the potential to improve access to evidence-based therapies while reducing the demand for clinician time.
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as: • Of importance
Wright JH, Beck AT, Thase ME: Cognitive therapy. In American Psychiatric Publishing Textbook of Psychiatry, edn 5. Edited by Hales RE, Yudofsky SC, Gabbard G. Arlington, VA: American Psychiatric Publishing; 2008:1211–1256.
Wright JH: Computer-assisted cognitive-behavior therapy. In Cognitive-Behavior Therapy. Edited by Wright JH. Washington, DC: American Psychiatric Publishing; 2004:55–82.
Kenwright M, Liness S, Marks I: Reducing demands on clinicians’ time by offering computer-aided self help for phobia/panic: feasibility study. Br J Psychiatry 2001, 179:456–459.
McCrone P, Knapp M, Proudfoot J, et al.: Cost-effectiveness of computerised cognitive-behavioral therapy for anxiety and depression in primary care: randomised controlled trial. Br J Psychiatry 2004, 185:55–62.
Proudfoot J, Ryden C, Everitt B, et al.: Clinical efficacy of computerized cognitive-behavioral therapy for anxiety and depression in primary care: randomised controlled trial. Br J Psychiatry 2004, 185:46–54.
Marks IM, Cavanagh K, Gega L: Computer-aided psychotherapy: revolution or bubble? Br J Psychiatry 2007, 191:471–473.
Palmqvist B, Carlbring P, Andersson G: Internet-delivered treatments with or without therapist input: does the therapist factor have implications for efficacy and cost? Expert Rev Pharmacoecon Outcomes Res 2007, 7:291–297.
Wright JH, Wright AS, Albano AM, et al.: Computer-assisted cognitive therapy for depression: maintaining efficacy while reducing therapist time. Am J Psychiatry 2005, 162:1158–1164.
Wright JH, Wright AS, Salmon P, et al.: Development and initial testing of a multimedia program for computer-assisted cognitive therapy. Am J Psychother 2002, 56:76–86.
Good Days Ahead: The Multimedia Program for Cognitive Therapy [computer program]. Louisville, KY: Mindstreet LLC; 2004.
Gregg L, Tarrier N: Virtual reality in mental health—a review of the literature. Soc Psychiatry Psychiatr Epidemiol 2007, 42:343–354.
Rothbaum BO, Hodges L, Smith S, et al.: A controlled study of virtual reality exposure therapy for the fear of flying. J Consult Clin Psychol 2000, 60:1020–1026.
Rothbaum BO, Hodges LF, Kooper R, et al.: Effectiveness of computer-generated (virtual reality) graded exposure in the treatment of acrophobia. Am J Psychiatry 1995, 152:626–628.
Rothbaum BO, Hodges LF, Ready D, et al.: Virtual reality exposure therapy for Vietnam veterans with posttraumatic stress disorder. J Clin Psychiatry 2001, 62:617–622.
Rothbaum BO, Hodges LF: The use of virtual reality exposure in the treatment of anxiety disorders. Behav Modif 1999, 23:507–525.
Newman MG, Kenardy J, Herman S, Taylor CB: Comparison of palmtop-computer assisted brief cognitive-behavioral treatment to cognitive-behavioral treatment for panic disorder. J Consult Clin Psychol 1997, 65:178–183.
Gruber K, Moran PJ, Roth WT, Taylor CB: Computer-assisted cognitive behavioral group therapy for social phobia. Behav Ther 2001, 32:155–165.
Bauer M, Grof P, Gyulai L, et al.: Using technology to improve longitudinal studies: self-reporting with ChronoRecord in bipolar disorder, Bipolar Disord 2004, 6:67–74.
Greist JH, Marks IM, Baer L, et al.: Behavior therapy for obsessive-compulsive disorder guided by a computer or by a clinician compared with relaxation as a control. J Clin Psychiatry 2002, 63:138–145.
Colby KM, Gould RL, Aronson G: Some pros and cons of computer-assisted psychotherapy. J Nerv Ment Dis 1989, 177:105–108.
Waller R, Gilbody S: Barriers to the uptake of computerized cognitive behavioural therapy: a systematic review of the quantitative and qualitative evidence. Psychol Med 2009, 39:705–712.
• Carlbring P, Gunnarsdottir M, Hedensjo L: Treatment of social phobia: randomized trial of Internet-delivered cognitive-behavioural therapy with telephone support. Br J Psychiatry 2007, 190:123–128. This article is an example of newer research on CCBT that demonstrates the efficacy of clinician-supported treatment.
• Litz BT, Engel CG, Bryant RA, Papa A: A randomized, controlled proof of concept trial of an internet-based, therapist-assisted self-management treatment for post-traumatic stress disorder. Am J Psychiatry 2007, 164:1676–1683. This article shows preliminary evidence for the effectiveness of CCBT in the treatment of PTSD.
Christensen H, Griffiths K, Groves C, et al.: Free range users and one hit wonders: community users of an internet-based cognitive behaviour therapy program. Aust N Z J Psychiatry 2006, 40:59–62.
Eysenbach G: The law of attrition. J Med Internet Res 2005, 7:e11.
Selmi PM, Klein MH, Greist JH, et al.: Computer-administered cognitive-behavioral therapy for depression. Am J Psychiatry 1990, 147:51–56.
Proudfoot J, Goldberg D, Mann A, et al.: Computerised, interactive, multimedia cognitive behavioural therapy reduces anxiety and depression in general practice: a randomised controlled trial. Psychol Med 2003, 33:217–227.
Perini S, Titov N, Andrews G: The Climate Sadness Program of Internet-based treatment for depression: a pilot study. Electron J Appl Psychol 2008, 4:18–24. Available at http://ojs.lib.swin.edu.au/index.php/ejap/article/viewFile/135/153. Accessed August 20, 2010.
Spek V, Cuijpers P, Nyklicek I, et al.: Internet-based cognitive behavior therapy for symptoms of depression and anxiety: a meta-analysis. Psychol Med 2007, 37:319–328.
Ghosh A, Marks IM, Carr AC: Controlled study of self-exposure treatment for phobics: preliminary communication. J R Soc Med 1984, 77:483–487.
Carlbring P, Bohman S, Brunt S, et al.: Remote treatment of panic disorder: a randomized trial of Internet-based cognitive behavior therapy supplemented with telephone calls. Am J Psychiatry 2006, 163:2119–2125.
Kiropoulos LA, Klein B, Austin DW, et al.: Is Internet-based CBT for panic disorder and agoraphobia as effective as face-to-face CBT? J Anxiety Disord 2008, 22:1273–1284.
Klein B, Austin D, Pier C, et al.: Internet-based treatment for panic disorder: does frequency of therapist contact make a difference? Cogn Behav Ther 2009, 38:100–113.
Klein B, Mitchell J, Gilson K, et al.: A therapist-assisted Internet-based CBT intervention of posttraumatic stress disorder: preliminary results. Cogn Behav Ther 2009, 38:121–131.
Berger T, Hohl E, Caspar F: Internet-based treatment for social phobia: a randomized controlled trial. J Clin Psychol 2009, 65:1021–1035.
• Powers MB, Emmelkamp PMG: Virtual reality exposure therapy for anxiety disorders: a meta-analysis. J Anxiety Disord 2008, 22:561–569. This review summarizes important studies of VR exposure therapy.
Disclosure
Dr. Wright may receive royalties or other payments from sales of the Good Days Ahead computer program. He has an ownership interest in Mindstreet LLC and Empower, companies that produce software for behavioral health. No other potential conflicts of interest relevant to this article were reported.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Spurgeon, J.A., Wright, J.H. Computer-Assisted Cognitive-Behavioral Therapy. Curr Psychiatry Rep 12, 547–552 (2010). https://doi.org/10.1007/s11920-010-0152-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11920-010-0152-4