Is internet (online) based therapy effective for depression? 

There is strong evidence that internet based mental health delivered via live video (telepsychiatry is effective) [1]. There is also strong evidence that self guided internet based therapies like Cognitive Behavioral Therapy (CBT) delivered via a computer can also be effective [2] but there is often concern that outside of research studies – many people are not able to stick with, and thus benefit from, these self guided therapies [3]. Thus if recommending a self guided internet based therapy to a patient – it is critical to make a plan for how the patient will remain adherent and complete all sessions. At the time of this writing – it is best to consider these self guided programs as adjudicative treatments for depression that should not supersede standard of care. While combined computer and in-person interventions may be useful, caution should be taken with only remote computer based interventions at this time.

REFERENCES

  1. Bashshur RL, Shannon GW, Bashshur N, Yellowlees PM (2016) The empirical evidence for telemedicine interventions in mental disorders. Telemedicine and e-Health, 22(2), 87-113.
  2. Hofman J, Pollitt A, Broeks M, Stewart K, van Stolk C. (2017) Review of Computerized Cognitive Behavioral Therapies: Products and Outcomes for People with Mental Health Needs. Rand Health Quarterly, 6(4), 12.
  3. Gilbody S, Littlewood E, Hewitt C, Brierley G, Tharmanathan P, Araya R, Barkham M, Bower P, Cooper C, Gask L, Kessler D. (2015) Computerized cognitive behavior therapy (cCBT) as treatment for depression in primary care (REEACT trial): large scale pragmatic randomised controlled trial. BMJ, 351:h5627.
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