Computer-Based Therapies: One Study Doesn't Speak for All

Posted on 02/03/16 02:35:pm

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An article (link is external)published by National Public Radio(link is external) (NPR) discusses a study based in the United Kingdom that researched two online programs that were created to treat depression. The results showed that the programs were ineffective, mostly because the patients weren’t likely to keep up with the program or remain engaged. The article goes on to suggest that face-to-face, traditional psychotherapy should be the method of choice for consumers. At the same time, other recent blogs and articles claim that online therapy is becoming more desirable among patients. So what should you believe? Bradley Riemann, PhD, clinical director of the OCD Center and cognitive behavioral therapy (CBT) services at Rogers Memorial Hospital—Oconomowoc, explains how there are two sides to every coin.

“The biggest issue that people have to be aware of is that you can’t generalize all computer programs, applications and other software into one pile. Just because these particular programs were found to be unsuccessful, doesn’t mean others wouldn’t be,” says Dr. Riemann. “The first thing you have to sort out is whether there is any data supporting the application you’re interested in. When we go to a doctor and ask for an antidepressant, we’re going to get a medication that has been thoroughly studied and found to be helpful for most people. But when purchasing an application or online therapy, that luxury is not automatically given to us and we have to be proactive and savvy consumers.”

Besides researching the program, Dr. Riemann recommends that consumers:

  • Explore the computer program’s website
  • Look for published outcomes, journals or articles on their website
  • Stay away from programs that use unclear language to describe their outcomes
  • Remember that if a group says their product is tested, it doesn’t mean their outcomes were positive in that test

Dr. Riemann explains that if the researchers from the U.K. would have changed certain variables in their study, they may have found different results, possibly showing that the programs could be successful under different circumstances. “If the researchers had gotten their subjects from a psychological clinic, versus a primary care clinic, those seeking that type of treatment might be more likely to do the computer-based treatment and you might find very different outcomes. The programs might not have worked in this design, but they might work in a different design.”

Some claim that online therapies will cause patients, especially those suffering from depression, to isolate themselves even more than their condition causes them to—but Dr. Riemann presents an alternate possibility. “If a person is depressed and isolating themselves as a result of that depression, they may not be able to go out and seek ongoing counseling or even leave their house. Classic, traditional forms of psychotherapy or even going to a psychiatrist’s office for medications may be very difficult if not impossible,” says Dr. Riemann. “But, if a program works, it’s going to lower their depression enough to allow them to leave their house and seek further treatment.”

Although online therapy could be a useful tool, Dr. Riemann explains there is natural healing aspect to social interaction. “Human interaction is helpful for more than just treating depression, it’s helpful for any psychiatric condition because we’re social beings by nature. Social support, whether it be friends, family or licensed clinicians, helps us to cope with our problems and buffers us from the stressors of the day,” he says.

However, our current technology has begun to blur the lines of what is considered human interaction. “Telepsychiatry, a therapy method which allows a patient to talk with their doctor on a television or computer screen, who could be thousands of miles away in theory, has been found to be quite helpful for patients,” says Dr. Riemann. “I’m not recommending telepsychiatry be used as a replacement for traditional therapy, but there are some people who can’t access face-to-face therapy because they don’t live near therapists, costs are too high or their condition doesn’t allow them to leave the house.”

He goes on to explain that increasing access to therapy, no matter the mode, may be helpful for many. “The fact of the matter is: the vast majority of people have access to computers, smartphones and tablets, but some people don’t have access to well-trained clinicians and psychiatrists. As a result, anything we can do to increase access to treatment is a positive thing, as long as that treatment has been found to work.”

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