HOW EFFECTIVE IS ONLINE CBT THERAPY?
Written by Sylvia Buet
Created: 10 June 2013
BLOG: HOW EFFECTIVE IS COGNITIVE BEHAVIOURAL THERAPY?
You may be asking yourself ' how effective is CBT online compared with seeing a therapist in person? ' Well a number of research studies have been conducted to find the answer to that question. To date, positive results have been found indicating that online CBT therapy is particularly effective when delivered by a trained CBT therapist.
Online Cognitive Behavioural Therapy is effective for depression, OCD, health anxiety and panic disorder. Visit our website at www.cbttherapyonline.com to receive state-of-the-art interventions for mental health issues.
A study by Dr. Kessler and colleagues (2009) found that Cognitive behavioural therapy (CBT) was effective for the treatment of depression when delivered online in real time by a therapist. Dr. Kessler and colleagues concluded that "CBT online could be useful in areas where access to psychological treatment is scarce and for patients whose first language is not English. It could make access to psychotherapies more equitable by providing a service to patients in areas or even countries where psychological treatment is not readily available. Real-time online CBT offers the flexibility and responsiveness of face-to-face CBT and is appropriate for people with severe symptoms. It affords an opportunity for reflexion and review as part of the therapeutic process, which could enhance its effectiveness." (p.364)
Another study by researchers from the Karolinska Institutet in Stockholm found significant benefits of online CBT in the treatment of health anxiety. Using a sample of 81 participants, 41 of them were treated online by a CBT therapist. The rest were treated using a discussion forum. These participants acted as the control group. The researchers found that after 12 weeks, those that had access to the live therapist, 27 of 41 participants no longer met the criteria for health anxiety, with reports of significantly reduced anxiety and depressive symptoms. The control group obtained very poor results as only 2 of the 41 participants no longer met the criteria for health anxiety, the other 39 were as anxious as when they were assessed. Moreover, those participants who were treated by the live therapist, maintained their therapeutic gains after 6 months. The researchers concluded from that study that internet-based CBT therapy was an effective treatment in reducing symptomatology of health anxiety as well as general anxiety and depressive symptoms.
OBSESSIVE COMPULSIVE DISORDER (OCD)
Taylor and colleagues (2003) recently reported positive results among 33 OCD patients given telephone-delivered CBT. Effectiveness levels were similar to those obtained in other trials of CBT delivered via face-to-face, office-based sessions. Due to potential difficulties arising from the treatment of participants suffering from severe levels of depression and suicidality via the telephone, those patients were excluded from that trial. This limitation, although necessary, is significant given that approximately one quarter of treatment-seeking OCD patients meet concurrent criteria for major depression at intake (Brown, Campbell, Lehman, Grisham, & Mancill, 2001).
There is growing evidence that internet-delivered CBT is just as effective in the treatment of Panic disorder compared with a treatment delivered by a therapist in person. Two trials have been conducted to determine the effectiveness of Internet-based CBT and face-to-face therapy for panic disorder by Klein, Richards & Austin, 2006 and Richards, Klein, & Austin, 2006. The researchers found that 69.6% of participants allocated to the online treatment group were panic free compared with 72.5% of the face-to-face group. The authors concluded that there were no differences in the treatment of Panic Disorder either delivered online or office-based. Other independent research groups are finding similar results and to date, the output studies are pointing in the direction that online CBT therapy is proving to be just as effective as receiving CBT treatment in person (Andersson, 2009).
WHAT ABOUT THE THERAPEUTIC ALLIANCE?
It is myth what some believe may believe regarding the experience of online CBT therapy (I am not referring here to just online general counselling). Some may think that the therapeutic relationship and rapport may not be well developed between the client and the psychotherapist. From personal experience, I have not found this to be an issue. However, this is not just my view. A study by Manchanda & McLaren (1998) found that online therapy has no impact on the therapeutic relationship in terms of the therapist warmth, empathy and genuineness. Overall, Internet-based treatments tend to generate a strong therapeutic alliance (Knaevelsrud & Maercker, 2007).
So far, most of the research has found that CBT-based therapies that are delivered online by qualified cognitive behavioural psychotherapists via teleconferencing are just as effective as face-to-face interventions in treating a wide range of mood and anxiety disorders. Seeking CBT treatment online does not seem to affect therapy outcomes. Other factors were not affected either, including the all important therapeutic alliance.
Andersson, G. (2009).Using the Internet to provide cognitive behaviour therapy. Behaviour Research and Therapy, 47, 175-180.
Brown, T. A., Campbell, L. A., Lehman, C. L., Grisham, J. R., & Mancill, R. B. (2001). Current and lifetime cormorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. Journal of Abnormal Psychology,110,585-599.
Hedman, E., et al. (2013). Cost effectiveness and long-term effectiveness of Internet-based cognitive behaviour therapy for severe health anxiety. Psychological medicine 43.2, 363-74. ProQuest Research Library.
Kessler D., Lewis G., Kaur S., Wiles N., King M., Weich S., Sharp D.J, Araya R., Hollinghurst S., & Peters TJ. (2009). Therapist-delivered internet psychotherapy for depression in primary care: a randomised controlled trial. The Lancet, 374, 9690, 628-634.
Klein, B., Richards, J. C., & Austin, D.W. (2006). Efficacy of internet therapy for panic disorder. Journal of Behavior Therapy and Experimental Psychiatry,37,213-238.
Knaevelsrud, C., & Maercker, A. (2007). Internet-based treatment for PTSD reduces distress and facilitates the development of a strong therapeutic alliance: a randomized controlled clinical trial. BMC Psychiatry, 7, 13.
Manchanda, M., & Mclaren P. (1998). Cognitive behaviour therapy via interactive video. J Telemed Telecare, 4, 53.
Taylor, S., Thordarson, D. S., Spring, T., Yeh, A. H., Corcoran, K. M., Eugster, K., et al. (2003). Telephone-administered cognitive behavior therapy for obsessive-compulsive disorder. Cognitive Behavior Therapy,32,13-25.