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Internet-based psychotherapy is the latest treatment for a wide range of conditions. But does it work? And what of concerns that it may not be as safe or effective as it's said to be?

Computer-based psychotherapy is on the rise, with many seeing it as a way for patients to access the therapy they need in a speedy and cost-effective manner. An increasing number of practitioners are offering computer-based Cognitive Behavioural Therapy for a range of conditions, including depression, anxiety disorders, and Post-Traumatic Stress Disorder.

A recent study found there to be 97 computer-based psychotherapy systems in 9 different countries across the world.


Computer-based what?

In computer-based psychotherapy, patients talk to a therapist over the internet, who then assigns individual activities or exercises. Depending on the nature of the therapy, these exercises may vary.

There are also interactive computer programs designed to help sufferers of anxiety, Obsessive-Compulsive Disorder, phobias, and panic disorder.

But isn't all psychotherapy pretty much the same?


There are several different types, and they may suit different conditions. Common types include:

Computer-based Cognitive Behavioural Therapy

Computer-based CBT works in the same way as face-to-face CBT, to change the way you think about things, and altering maladaptive behaviours into healthier ones. In Computer-based CBT, you may be asked to write logs of your negative emotions and their triggers between sessions.

CBT is used for a wide range of conditions, from anxiety to eating disorders.

Mindfulness training

In mindfulness training, participants are taught how to be calm and aware. They may be led through a series of training modules, and asked to perform mindfulness exercises several times a week between sessions.

Mindfulness training can be used for anxiety disorders if CBT is found ineffective.

But does any of this work?

In recent years, there have been a number of comparative studies, which have compared computer-based interventions with face-to-face therapy.

Computer-based CBT and Depression

In 2014, Wagner and colleagues tested 62 adults with depression. 32 had computer-based CBT and 30 had face-to-face psychotherapy. When treatment ended, both groups showed significant improvement in symptoms.

However, it's worth noting that - while the computer-based group was still seeing the benefit three months later - the face-to-face group had already started to suffer worsening symptoms of depression by that time.

Computer-based CBT and PTSD

A 2003 experiment by Lange and colleagues found that 69 patients with Post-Traumatic Stress Disorder benefitted significantly from computer-based CBT, rather than waiting for a face-to-face appointment.

Furthermore, more than 50% of participants showed long-term change and significant improvement.

Computer-based CBT and Panic Disorder

A 2010 study by Bergström and colleagues placed 113 patients with panic disorder into two groups. 53 had computer-based CBT, while 60 had traditional group-based CBT. 9 patients dropped out immediately (3 from the computer-based group, and six from the group-based group).

After research concluded, the rates at which Panic Disorder were relieved were roughly equal (60% for the computer-based group; 63% for the group based group). However, at the follow-up six-months later, the percentage of participants now free of Panic Disorder was substantially different (70% for the computer-based group; 59% for the group-based group).

Computer-based CBT and Generalised Anxiety Disorder

In a 2011 study, Paxling and colleagues randomised participants into two groups. One (the trial group of 44) had computer-based CBT. The other (the control-group of 45) waited for a face-to-face appointment. Of the participants who completed the computer-based CBT (13.6% didn't), almost all aspects of the participants' lives considerably improved (except quality of life).

This improvement was maintained (and, in some cases, improved) at one-year and three-year follow-ups.

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