Cognitive behavioral therapy (CBT) is the most preferred treatment for depression. But a computerized version of cognitive behavioral therapy (cCBT) is more likely to be ineffective in the treatment of depression, revealed a new study.
The study called REEACT trial was conducted at the University of York and it was led by Dr. Simon Gilbody from York's Department of Health Sciences and the Hull York Medical School.
‘People with depression tend to seek clinical support in addition to talk therapy from a therapist but this is absent when you use a computerized cognitive behavioral therapy.
The CBT or talk theray helps in treating depressed patients through communication with a trained therapist. NHS does not immediately offer this treatment to patients in the UK. Rather it prefers to give computerized CBT, ie, talk therapy via online communication through specially designed computer programs.
The researchers have conducted this trial to test the effectiveness of the computerized CBT when compared to the usual CBT. This trial is considered to be the largest randomized control trial till date.
The REEACT trial included 691 patients with depression carefully selected from 83 general practices across England. Results showed that cCBT offered little or no benefit over usual CBT.
Dr Elizabeth Littlewood, who managed the REEACT trial, said, "Current NICE guidelines recommend the use of cCBT as a treatment for depression, but there was a need to carry out a large trial to judge the value of these treatments as they are offered in the NHS. Our findings show that cCBT is likely to be an ineffective form of low-intensity treatment for depression and an inefficient use of finite healthcare resources."
Patients generally did not engage with computer programs on a sustained basis, and they highlighted the difficulties of repeatedly logging on to computer systems when clinically depressed.
"Despite the high level of technical support and weekly encouragement to use the computer packages, there was general low adherence and engagement with this form of treatment. It seems that participants often want more clinical support in addition to therapy," she added.
Professor Gilbody, Director of the York Mental Health and Addictions Research Group (MHARG) and Chief Investigator of the REEACT study, added, "These findings have important implications for those who commission services and purchase commercial products on behalf of publicly funded health services. Depression is a treatable condition and there a number of effective interventions that can be offered. We know that CBT works very well for depression but this research make us less sure that it can be treated when computers alone are used to deliver this treatment."