COMMENTARY

Computerized Cognitive-Behavioral Therapy Used Alone Is Safe, Effective, and Well Liked

Peter M. Yellowlees, MBBS, MD

Disclosures

October 22, 2018

This is the Medscape Psychiatry Minute. I'm Dr Peter Yellowlees. We know that computer-based cognitive-behavioral therapy (CBT) is helpful as an add-on to standard outpatient care in a range of treatment-seeking populations, but is it effective when used alone?

Now, a team of investigators from the Yale University School of Medicine have performed a 6-month follow-up, randomized clinical trial, in which 137 individuals who met DSM-IV-TR criteria for current substance abuse or dependence were randomly assigned to receive treatment as usual, weekly individual CBT, or computerized CBT with brief weekly monitoring.[1]

The researchers found that computerized CBT as a virtual stand-alone intervention was safe, effective, and durable compared with standard treatment approaches and was well liked by participants. On the other hand, clinician-delivered individual CBT, though efficacious within the treatment period, was unexpectedly associated with a higher dropout rate and lower effects at 6-month follow-up.

So where does this leave us? This is an interesting, small, initial study that needs replicating but which has promising results. If it can be supported further that CBT can be delivered effectively with minimal clinical input, as this study suggests, then this finding is potentially practice-changing and provides good news for patients who have great difficulty accessing CBT therapists.

An online CBT industry is beginning to emerge with many differing models of CBT being offered, and there will be a large number of clinical trials of similar software in the future, encouraged by results like this. It is good to see this form of treatment developing and becoming more accessible to patients.

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

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