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Computer-Assisted Treatment and Mobile Apps for Depression

     

computer - woman.jpgTechnology is increasingly assisting us in many aspects of our lives, and mental health treatment is no exception. Research continues to show the benefits of computer-assisted cognitive behavioral therapy (CCBT) for treating depression and the potential of mental health mobile apps to help.

A new review of these technologies in the APA journal Focus, notes that CCBT has been studied in many randomized controlled trials demonstrating that its effectiveness matches that of standard, face-to-face CBT when supported by a clinician. For example, one study found no difference between supported CCBT and a full course of 16–20 sessions of standard CBT for depression, except the computer-assisted program was better at improving CBT knowledge.


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CCBT involves the individual in therapy completing a series of computer modules, with information, exercises, and assignments, over a period of about three to four months, usually along with direct support from a clinician. The clinician typically provides about four hours of support (via phone, video or in person) over the course of treatment. The intent is for the computer-assisted portion and the therapist portion to work together for better outcomes. 

CBT is an effective psychotherapy treatment for depression, and surveys suggest that many depressed people would rather be treated with psychotherapy than medication. (2) Yet several barriers prevent many from accessing CBT—it can be expensive and time-consuming to participate in the series of sessions and many areas lack available trained clinicians. CCBT can help overcome some of the barriers. It can be much more convenient, offers access where clinicians may not be available, requires fewer clinician hours, and can be less expensive.  

 The Focus review looked at several computer-assisted CBT programs that have been assessed in multiple randomized controlled trials, including Beating the Blues, Deprexis , Good Days Ahead, Mood Gym, and Sadness Program.  Ongoing efforts to improve CCBT aim to make the treatment more personalized and to make the communication more conversational. 

Although study authors Jesse H. Wright, M.D., Ph.D., and Matthew Mishkind, Ph. D are optimistic about the use of apps in psychiatric treatment in the future, they raise several concerns. While mobile apps to help with mental health are readily available—there are more than 10,000 mental health apps—there is little research supporting their quality and effectiveness. The researchers note concerns with inadequate security protection and data management and a lack of rigorous testing with actual patient populations. They note, for example, in a study of 117 apps referencing use of CBT methods for depression, just 10% had content consistent with CBT methods and most lacked information on privacy, safety and usability.

Wright and Mishkind suggest that if apps are going to be used for depression treatment, that they be used in conjunction with other treatment and coordinated with the mental health clinician. They conclude that “Many advances in the development of CCBT and mobile apps suggest these technologies offer potential for enhancing the treatment of depression” and becoming a “basic tool in individual therapy and team-based care.”

References

  1. Wright, JH and Mishkind, M. Computer-Assisted CBT and Mobile Apps for Depression: Assessment and Integration Into Clinical Care.  Focus 2020; 18:162–168; doi: 10.1176/appi.focus.20190044
  2. Thase, ME. Is Computer-Assisted Cognitive Therapy a Viable Solution for Cognitive Therapy’s Dissemination Problems? A Brief Review and Some New Data. Anxiety and Depression Association of America Blog.
  3. Wright, JH., Computer-Assisted Cognitive-Behavior Therapy and Mobile Apps for Depression and Anxiety. Psychiatry in the Digital Age. June 2019.

     

DepressionPatients and Families

 

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