Is Computer-Assisted CBT Effective for Treating Depression?

Peter M. Yellowlees, MBBS, MD


September 11, 2018

This is the Medscape Psychiatry Minute. I'm Dr Peter Yellowlees. Computer-assisted cognitive-behavioral therapy (CCBT) is increasingly being offered to patients, as is it as efficacious and durable as standard CBT. Now, a team of investigators from the University of Pennsylvania have published a randomized trial of 154 medication-free patients with major depression who received 16 weeks of either standard CBT or CCBT using the "Good Days Ahead" program.[1]

The researchers determined [noninferiority of CCBT to CBT on the Hamilton Depression Rating Scale at week 16 of the protocol], with both groups also having similar remission rates. The authors concluded that CCBT, which provided about 5 hours of therapeutic contact, was noninferior to conventional CBT, which provided over 8 additional hours of therapist contact. The researchers called for future studies focusing on dissemination and optimization of therapist support methods to amplify the public health significance of CCBT.

Where does this leave us? This study demonstrates two outstanding clinical findings. First, CBT, in computerized or in-person formats, is effective for treating major depression. Second, CCBT is noninferior to CBT and may be performed with substantial savings in therapist time and better access to care.

These are important findings for us all due to the shortage of psychiatrists and CBT therapists, and the large, well-documented amount of patient needs. All clinicians need to think seriously about how best the practice of CCBT can help our patients as we increasingly move towards more team-based care.

Thank you for listening to this Medscape Psychiatry Minute. Do continue to enjoy your practice.


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