United Kingdom

Computerised CBT does not benefit those with depression

December 2015


Depression is not alleviated by computerised cognitive behavioural therapy (CBT) alone, new research has revealed.

Despite CBT being offered as part of many health and wellbeing initiatives in UK workplaces, with the effectiveness of the traditional face-to-face methods being scientifically established, the computerised version is not as effective for those suffering with depression due - perhaps unsurprisingly - to low engagement levels.

According to Mark Witte, Senior Consultant at Aon Employee Benefits, the effective management of mental health conditions represents a 'significant challenge' to many UK employers, many of whom are able to utilise a 'wide range' of resources to help combat the condition.

"However, it is essential that employers carefully consider every aspect of the care pathway available to them, especially because of the considerable risk impact to the employer of an ineffective approach," he said.

According to the study which was carried out by the University of York, nearly 700 individuals were split into two randomly-assigned groups - those receiving normal GP care and those receiving normal GP care in addition to computerised CBT - and monitored over a period of time. The individuals assigned to receive computerised CBT were each assigned one of two programmes, Beating the Blues and MoodGYM.

The computerised CBT programmes involved either six or eight one-hour sessions as well as regular telephone support, but just 18 per cent of individuals completed all sessions of Beating the Blues and just 16 per cent completed all sessions offered by MoodGYM.

In addition, 24 per cent dropped out of the study all together by four months. When comparing the two groups of those receiving just GP care and those receiving GP care as well as computerised CBT, the results were also significant.

44 per cent in the usual care group remained depressed after four months whilst 50 per cent of those who had accessed the Beating the Blues group and 49 per cent of those who had accessed MoodGYM still presented with depression after four months.

Disengagement with the computer programmes, in addition to a need for greater clinical support were cited as some of the reasons that many individuals did not find the therapy beneficial.

Crucially, the commercial CBT programme, Beating the Blues, provided no obvious benefit over MoodGYM, the free-to-use one.

Commenting on the research in published editorial, Christopher Dowrick, Professor of Medical Care at the University of Liverpool explained: "Adherence to guided self-help tends to be lower than for face to face psychological therapy. Many depressed patients do not want to engage with computers, they prefer to interact with human beings."

Witte added: "Studies of this nature reinforce the value to employers of understanding how key health risks such as mental health can impact their business. If a risk can be acknowledged and the impact quantified, then this can help support investment from the employer to finance various forms of care.

"This could mean more up-front investment in preventative measures such as resilience training, line manager coaching or robust absence management pathways. It could also extend to greater investment in forms of treatment for those who need care that are clinically identified as being more effective in combatting the illness.

"Not to disregard the individual human impact, but with some studies showing over 35% of working days lost being attributable to mental health issues and a third of income protection claims arising from the condition, this is one issue that has to be firmly on the Employer's agenda."



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