The effectiveness of computerized cognitive behavioural therapy in routine care

• Published in: British journal of clinical psychology Vol. 45; no. 4; pp. 499 - 514
• Main Authors: Cavanagh, K., Shapiro, D. A., Van den Berg, S., Swain, S., Barkham, M., Proudfoot, J.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.11.2006; British Psychological Society
• Subjects: Adult; Aged; Anxiety; Anxiety Disorders - diagnosis; Anxiety Disorders - psychology; Anxiety Disorders - therapy; Behavior therapy. Cognitive therapy; Behavioural sciences; Biological and medical sciences; Clinical psychology; Cognitive therapy; Cognitive Therapy - instrumentation; Depression; Depressive Disorder - diagnosis; Depressive Disorder - psychology; Depressive Disorder - therapy; Female; Health care; Humans; Information and communication technologies; Intention; Internet; Male; Medical sciences; Mental health; Mental health services; Mental Health Services - statistics & numerical data; Mental stress; Middle Aged; Periodicity; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Social Adjustment; Surveys and Questionnaires; Therapy; Therapy, Computer-Assisted - methods; Treatment Outcome; Treatments; Workplace - psychology; United Kingdom; Europe; Mood disorder; Social environment; Human; Occupational adjustment; Cognitive therapy; Treatment efficiency; Multicenter study; Mental health; Anxiety disorder; Social adjustment; Depression; Symptomatology; Treatment; Follow up study; Behavior therapy; Computer aid; Public health
• ISSN: 0144-6657; 2044-8260
• DOI: 10.1348/014466505X84782

Objectives and design The efficacy of a Computerized Cognitive Behavioural Therapy (CCBT) package, Beating the Blues, has been demonstrated in a large randomized controlled trial. The current study tests the generalizability of this finding in a naturalistic non‐randomized trial. Method 219 patients with anxiety and/or depression were recruited to receive CCBT in routine care. The Clinical Outcomes in Routine Evaluation‐Outcome Measure (CORE‐OM) and Work and Social Adjustment scale (WSA) were administered pre‐treatment, immediately on completing treatment and at 6 months post‐treatment. Single‐item self‐report measures of anxiety and depression were also collected during each treatment session. Results Completer and intention‐to‐treat analysis demonstrated statistically and clinically significant improvements on the CORE‐OM, WSA and in self‐reported anxiety and depression. Intention‐to‐treat analysis indicated an average 0.29‐point drop on the CORE‐OM, equating to an uncontrolled pre‐post effect size of 0.50. Research completers achieved an average 0.61‐point drop equating to an uncontrolled pre‐post size of 1.00 on the same measure. Where data was available (18%), these benefits were maintained at week 32 (6 months follow‐up). Conclusion CCBT can be an effective first line tool within a stepped care framework for the management of common mental health problems.