Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-25T01:38:37.590Z Has data issue: false hasContentIssue false
  • English
  • Français

The acceptability to patients of computerized cognitive behaviour therapy for depression: a systematic review

Published online by Cambridge University Press:  21 January 2008

E. Kaltenthaler ,
P. Sutcliffe ,
G. Parry ,
C. Beverley ,
A. Rees  and
M. Ferriter
E. Kaltenthaler*
Affiliation:
School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
P. Sutcliffe
Affiliation:
School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
G. Parry
Affiliation:
School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
C. Beverley
Affiliation:
Adult Social Care Directorate, Cumbria County Council, Rickergate, Carlisle, UK
A. Rees
Affiliation:
School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
M. Ferriter
Affiliation:
Department of Research and Development, Nottinghamshire Healthcare NHS Trust, Rampton Hospital, Woodbeck, Notts, UK
*
*Address for correspondence: Dr E. Kaltenthaler, School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Cognitive behaviour therapy (CBT) is widely used to treat depression. However, CBT is not always available to patients because of a shortage of therapists and long waiting times. Computerized CBT (CCBT) is one of several alternatives currently available to treat patients with depression. Evidence of its clinical effectiveness has led to programs being used increasingly within the UK and elsewhere. However, little information is available regarding the acceptability of CCBT to patients.

Method

A systematic review of sources of information on acceptability to patients of CCBT for depression.

Results

Sources of information on acceptability included: recruitment rates, patient drop-outs and patient-completed questionnaires. We identified 16 studies of CCBT for the treatment of depression that provided at least some information on these sources. Limited information was provided on patient take-up rates and recruitment methods. Drop-out rates were comparable to other forms of treatment. Take-up rates, when reported, were much lower. Six of the 16 studies included specific questions on patient acceptability or satisfaction although information was only provided for those who had completed treatment. Several studies have reported positive expectancies and high satisfaction in routine care CCBT services for those completing treatment.

Conclusions

Trials of CCBT should include more detailed information on patient recruitment methods, drop-out rates and reasons for dropping out. It is important that well-designed surveys and qualitative studies are included alongside trials to determine levels and determinants of patient acceptability.

Keywords

CCBTcomputer programspatient acceptability
Type
Review Article
Information
Psychological Medicine , Volume 38 , Issue 11 , November 2008 , pp. 1521 - 1530
Copyright
Copyright © 2008 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andersson, G, Bergström, J, Holländare, F, Carlbring, P, Kaldo, V, Ekselius, L (2005). Internet-based self-help for depression: randomised controlled trial. British Journal of Psychiatry 187, 456–461.CrossRefGoogle ScholarPubMed
Barbui, C, Hotopf, M, Freemantle, N, Boynton, J, Churchill, R, Eccles, MP, Hardy, R, Lewis, G, Mason, JM (2004). Treatment discontinuation with selective serotonin reuptake inhibitors (SSRIs) versus tricyclic antidepressants (TCAs). Cochrane Database of Systematic Reviews. Issue 4, Art. No.: CD002791.Google Scholar
Bower, P, Rowland, N (2006). Effectiveness and cost effectiveness of counselling in primary care. Cochrane Database of Systematic Reviews. Issue 3, Art No.: CD001025.Google Scholar
Cavanagh, K, Shapiro, D, Van Den Berg, S, Swain, S, Barkham, M, Proudfoot, J (2006). The effectiveness of computerised cognitive behavioural therapy in routine care. British Journal of Clinical Psychology 45, 499–514.CrossRefGoogle ScholarPubMed
Cavanagh, K, Shapiro, D, Zack, J (2003). The computer plays therapist: the challenges and opportunities of psychotherapeutic software. In Technology in Counselling and Psychotherapy (ed. Goss, S. and Anthony, K.), pp. 165–194. Palgrave Macmillan: Suffolk, UK.CrossRefGoogle Scholar
Christensen, H, Griffiths, K, Groves, C, Korten, A (2006 b). Free range users and one hit wonders: community users of an Internet-based cognitive behaviour therapy program. Australian and New Zealand Journal of Psychiatry 40, 59–62.CrossRefGoogle ScholarPubMed
Christensen, H, Griffiths, KM, Jorm, AF (2004 a). Delivering interventions for depression by using the internet: randomised controlled trial. British Medical Journal 328, 265–268.CrossRefGoogle ScholarPubMed
Christensen, H, Griffiths, KM, Korten, AE, Brittliffe, K, Groves, C (2004 b). A comparison of changes in anxiety and depression symptoms of spontaneous users and trial participants of a cognitive behaviour therapy website. Journal of Medical Internet Research 6, e46.CrossRefGoogle ScholarPubMed
Christensen, H, Griffiths, KM, Mackinnon, AJ, Brittliffe, K (2006 a). Online randomized controlled trial of brief and full cognitive behaviour therapy for depression. Psychological Medicine 36, 1737–1746.CrossRefGoogle ScholarPubMed
Clarke, G, Eubanks, D, Reid, E, Kelleher, C, O'Connor, E, DeBar, LL, Lynch, F, Nunley, S, Gullion, C (2005). Overcoming Depression on the Internet (ODIN) (2): a randomized trial of a self-help depression skills program with reminders. Journal of Medical Internet Research 7, e16.CrossRefGoogle Scholar
Clarke, G, Reid, E, Eubanks, D, O'Connor, E, DeBar, LL, Kelleher, C, Lynch, F, Nunley, S (2002). Overcoming Depression on the Internet (ODIN): a randomized controlled trial of an Internet depression skills intervention program. Journal of Medical Internet Research 4, e14.CrossRefGoogle Scholar
Eysenbach, G (2005). The law of attrition. Journal of Medical Internet Research 7, e11.CrossRefGoogle ScholarPubMed
Ghosh, A, Marks, IM, Carr, AC (1988). Therapist contact and outcome of self-exposure treatment for phobias. British Journal of Psychiatry 152, 234–238.CrossRefGoogle ScholarPubMed
Griffiths, KM, Christensen, H (2006) Review of randomised controlled trials of Internet interventions for mental disorders and related conditions. Clinical Psychologist 10, 16–29.CrossRefGoogle Scholar
Grime, PR (2004). Computerised cognitive behavioural therapy at work: a randomized controlled trial in employees with recent stress-related absenteeism. Occupational Medicine 54, 353–359.CrossRefGoogle Scholar
Kaltenthaler, E, Brazier, J, De Nigris, E, Tumur, I, Ferriter, M, Beverley, C, Parry, G, Rooney, G, Sutcliffe, P (2006). Computerised cognitive behaviour therapy for depression and anxiety update: a systematic review and economic evaluation. Health Technology Assessment 10, 1–186.CrossRefGoogle ScholarPubMed
Kaltenthaler, E, Parry, G, Beverley, C (2004). Computerised cognitive behaviour therapy: a systematic review. Behavioural and Cognitive Psychotherapy 32, 31–55.CrossRefGoogle Scholar
Kaltenthaler, E, Shackley, P, Stevens, K, Beverley, C, Parry, G, Chilcott, J (2002). A systematic review and economic evaluation of computerised cognitive behaviour therapy for depression and anxiety. Health Technology Assessment 6, 1–89.CrossRefGoogle ScholarPubMed
Keller, MB, McCullough, JP, Klein, DN, Arnow, B, Dunner, DL, Gelenberg, AJ, Markowitz, JC, Nemeroff, CB, Russell, JM, Thase, ME, Trivedi, MH, Zajecka, J (2000). A comparison of nefazodone, the cognitive-behavioral analysis system of psychotherapy and their combination for the treatment of chronic depression. New England Journal of Medicine 342, 1462–1470.CrossRefGoogle ScholarPubMed
Kenardy, JA, Johnston, DW, Thomson, A, Dow, MGT, Newman, MG, Barr Taylor, C (2003). A comparison of delivery methods of cognitive-behavioral therapy for panic disorder: an international multicenter trial. Journal of Consulting and Clinical Psychology 71, 1068–1075.CrossRefGoogle ScholarPubMed
Marks, IM, Mataix-Cols, D, Kenwright, M, Cameron, R, Hirsch, S, Gega, L (2003). Pragmatic evaluation of computer-aided self-help for anxiety and depression. British Journal of Psychiatry 183, 57–65.CrossRefGoogle ScholarPubMed
Maxwell, RJ (1992). Dimensions of quality revisited: from thought to action. Quality in Health Care 1, 171–177.CrossRefGoogle ScholarPubMed
Murray, K, Guadelupe, Pombo-Carril M, Bara-Carril, N, Grover, M, Reid, Y, Langham, C, Birchall, H, Williams, C, Treasure, J, Schmidt, U (2003). Factors determining uptake of a CD-ROM-based CBT self-help treatment for bulimia: patient characteristics and subjective appraisals of self-help treatment. European Eating Disorders Review 11, 243–260.CrossRefGoogle Scholar
Newman, MG, Consoli, A, Barr Taylor, C (1997 a). Computers in assessment and cognitive behavioral treatment of clinical disorders: anxiety as a case in point. Behavior Therapy 28, 211–235.CrossRefGoogle Scholar
Newman, MG, Kenardy, J, Herman, S, Barr Taylor, C (1997 b). Comparison of palmtop-computer-assisted brief cognitive-behavioral treatment to cognitive-behavioral treatment for panic disorder. Journal of Consulting and Clinical Psychology 65, 178–183.CrossRefGoogle ScholarPubMed
NICE (2006). Computerised cognitive behaviour therapy for depression and anxiety. Review of Technology Appraisal 51. National Institute for Health and Clinical Excellence Technology Appraisal 97 (www.nice.org.uk/nicemedia/pdf/TA097guidance.pdf). Accessed 1 March 2007.Google Scholar
Osgood-Hynes, DJ, Greist, JH, Marks, IM, Baer, L, Heneman, SW, Wenzel, KW, Manzo, PA, Parkin, JR, Spierings, CJ, Dottl, SL, Vitse, HM (1998). Self-administered psychotherapy for depression using a telephone-accessed computer system plus booklets: an open US-UK study. Journal of Clinical Psychiatry 59, 358–365.CrossRefGoogle Scholar
Proudfoot, J, Ryden, C, Everitt, B, Shapiro, D, Goldberg, D, Mann, A, Mann, A, Tylee, A, Marks, I, Gray, JA (2004). Clinical efficacy of computerised cognitive-behavioural therapy for anxiety and depression in primary care: randomised controlled trial. British Journal of Psychiatry 185, 46–54.CrossRefGoogle ScholarPubMed
Proudfoot, J, Swain, S, Widmer, S, Watkins, E, Goldberg, D, Marks, I, Mann, A, Gray, JA (2003). The development and beta-test of a computer therapy programs for anxiety and depression: hurdles and lessons. Computers in Human Behavior 19, 277–289.CrossRefGoogle Scholar
Robertson, L, Smith, M, Castle, D, Tannenbaum, D (2006). Using the Internet to enhance the treatment of depression. Australian Psychiatry 14, 413–417.CrossRefGoogle ScholarPubMed
Selmi, PM, Klein, MH, Greist, JH, Sorrell, SP, Erdman, HP (1990). Computer-administered cognitive-behavioral therapy for depression. American Journal of Psychiatry 147, 51–56.Google ScholarPubMed
Sharp, DM, Power, KG, Swanson, V (2004). A comparison of the efficacy and acceptability of group versus individual cognitive behaviour therapy in the treatment of panic disorder and agoraphobia in primary care. Clinical Psychology and Psychotherapy 11, 73–82.CrossRefGoogle Scholar
Van den Berg, S, Shapiro, DA, Bickerstaffe, D, Cavanagh, K (2004). Computerized cognitive-behaviour therapy for anxiety and depression: a practical solution to the shortage of trained therapists. Journal of Psychiatric and Mental Health Nursing, 11, 508–513.CrossRefGoogle Scholar
Watkins, E, Williams, R (1998). The efficacy of cognitive behavioural therapy. Cognitive Behaviour Therapy 8, 165–187.Google Scholar
Whitfield, G, Hinshelwood, R, Pashely, A, Campsie, L, Williams, W (2006). The impact of a novel computerized CBT CD Rom (Overcoming Depression) offered to patients referred to clinical psychology. Behavioural and Cognitive Psychotherapy 34, 1–11.CrossRefGoogle Scholar
Whitfield, G, Williams, CJ (2004). If the evidence is so good why doesn't anyone use them? Current uses of computer-based self-help packages. Behavioural and Cognitive Psychotherapy 32, 57–65.CrossRefGoogle Scholar
Zabinski, MF, Wilfley, DE, Clafas, KJ, Winzelberg, AJ, Barr Taylor, C (2004). An interactive psychoeducational intervention for women at risk of developing an eating disorder. Journal of Consulting and Clinical Psychology 72, 914–919.CrossRefGoogle ScholarPubMed