Computer-assisted cognitive-behavior therapy for depression: a systematic review and meta-analysis
Computer-assisted cognitive-behavior therapy for depression: a systematic review and meta-analysis
Objective: To evaluate the efficacy of computer-assisted forms of cognitive-behavior therapy for major depressive disorder (MDD) and examine the role of clinician support and other factors that might affect outcomes.
Data sources: Ovid MEDLINE, PsycINFO, PubMed, and Scopus from their beginnings to July 18, 2016. Keywords were “randomized, controlled trials of computer-assisted cognitive-behavior therapy for depression” and “randomized, controlled trials of mobile apps for cognitive-behavior therapy of depression.”
Study selection: Of 223 studies identified in the search, 183 were excluded yielding a sample of 40 randomized, controlled investigations of computer-assisted cognitive-behavior therapy (CCBT) for depression.
Data extraction: Data were abstracted independently by two authors, and consensus was reached by discussion with a third author.
Results: The overall mean effect size for CCBT compared to control conditions was g = 0.502, a moderately large effect. Studies that provided support from a clinician or other person yielded significantly larger effects (g = 0.673) than studies in which no support was provided (g = 0.239). Completion rate and study setting also influenced outcomes. Lower mean effect sizes were observed in studies with lower completion rates and in studies conducted in primary care practices.
Conclusions: CCBT with a modest amount of support from a clinician or other helping person was found to be efficacious with relatively large mean effect sizes on measures of depressive symptoms. Self-guided CCBT for depression was considerably less effective. Future research should focus on enhancing the implementation of CCBT, including evaluating the amount and type of support needed for effective delivery, methods to improve engagement with computer-assisted therapies, and ways to improve treatment outcome in primary care settings.
online cbt, CBT, Depression, CCBT
e1-e22
Wright, Jesse H.
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Owen, Jesse J.
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Richards, Derek
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Eells, Tracy D.
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Richardson, Thomas
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Brown, Gregory K.
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Barrett, Marna
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Rasku, Mary Ann
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Polser, Geneva
c3d73718-1d96-4a47-83a1-888491ca0686
Thase, Michael E.
3381c1ef-e878-4449-8398-2d079089572c
19 March 2019
Wright, Jesse H.
aa6f7417-4443-4e0b-9831-bd62bfd39627
Owen, Jesse J.
6dacbab0-b034-46b0-8ede-715ff0cdfec7
Richards, Derek
e63ba07a-0fd6-4617-b0dc-7c5d6c3a4ce2
Eells, Tracy D.
7c5c919c-9279-49a5-8c41-d2aef7d10303
Richardson, Thomas
f8d84122-b061-4322-a594-5ef2eb5cad0d
Brown, Gregory K.
7ba838ea-e506-4e83-bf13-c59d6d58043c
Barrett, Marna
5661e060-025e-4543-81aa-4c8bb4a02af7
Rasku, Mary Ann
ea38cd1e-8f6a-4e2d-8555-ab5915a7f65d
Polser, Geneva
c3d73718-1d96-4a47-83a1-888491ca0686
Thase, Michael E.
3381c1ef-e878-4449-8398-2d079089572c
Wright, Jesse H., Owen, Jesse J., Richards, Derek, Eells, Tracy D., Richardson, Thomas, Brown, Gregory K., Barrett, Marna, Rasku, Mary Ann, Polser, Geneva and Thase, Michael E.
(2019)
Computer-assisted cognitive-behavior therapy for depression: a systematic review and meta-analysis.
The Journal of Clinical Psychiatry, 80 (2), , [18r12188].
(doi:10.4088/JCP.18r12188).
Abstract
Objective: To evaluate the efficacy of computer-assisted forms of cognitive-behavior therapy for major depressive disorder (MDD) and examine the role of clinician support and other factors that might affect outcomes.
Data sources: Ovid MEDLINE, PsycINFO, PubMed, and Scopus from their beginnings to July 18, 2016. Keywords were “randomized, controlled trials of computer-assisted cognitive-behavior therapy for depression” and “randomized, controlled trials of mobile apps for cognitive-behavior therapy of depression.”
Study selection: Of 223 studies identified in the search, 183 were excluded yielding a sample of 40 randomized, controlled investigations of computer-assisted cognitive-behavior therapy (CCBT) for depression.
Data extraction: Data were abstracted independently by two authors, and consensus was reached by discussion with a third author.
Results: The overall mean effect size for CCBT compared to control conditions was g = 0.502, a moderately large effect. Studies that provided support from a clinician or other person yielded significantly larger effects (g = 0.673) than studies in which no support was provided (g = 0.239). Completion rate and study setting also influenced outcomes. Lower mean effect sizes were observed in studies with lower completion rates and in studies conducted in primary care practices.
Conclusions: CCBT with a modest amount of support from a clinician or other helping person was found to be efficacious with relatively large mean effect sizes on measures of depressive symptoms. Self-guided CCBT for depression was considerably less effective. Future research should focus on enhancing the implementation of CCBT, including evaluating the amount and type of support needed for effective delivery, methods to improve engagement with computer-assisted therapies, and ways to improve treatment outcome in primary care settings.
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Accepted/In Press date: 24 July 2018
Published date: 19 March 2019
Keywords:
online cbt, CBT, Depression, CCBT
Identifiers
Local EPrints ID: 440863
URI: http://eprints.soton.ac.uk/id/eprint/440863
ISSN: 0160-6689
PURE UUID: 5b765efe-478d-45a7-81b5-76af19a17a85
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Date deposited: 20 May 2020 16:36
Last modified: 17 Mar 2024 04:02
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Author:
Jesse H. Wright
Author:
Jesse J. Owen
Author:
Derek Richards
Author:
Tracy D. Eells
Author:
Gregory K. Brown
Author:
Marna Barrett
Author:
Mary Ann Rasku
Author:
Geneva Polser
Author:
Michael E. Thase
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