Previous studies have suggested that cognitive assessments of adult psychiatric patients can be carried out as reliably via teleconsultation as they can face to face. However, the designs of these studies have often been less than satisfactory. The present study used videoconferencing at 128 kbit/s for the cognitive assessment of individuals with a history of alcohol abuse. Twenty-seven participants were given a range of assessments with two equivalent forms. One of the forms was given via videoconferencing and the other face to face. All participants were assessed using both media and the order of presentation was balanced across participants. Aspects of participant satisfaction with teleconsultations were also assessed, on 10-point scales. The teleconsultations were significantly longer (mean 40.7 min, SD 6.4) than the face-to-face sessions (mean 33.0 min, SD 5.3). For most of the outcome measures, cognitive assessment via teleconsultation produced similar results to face-to-face assessment. Most participants expressed high overall satisfaction with the teleconsultation (mean rating 8.2). The average ratings for the sound quality (mean 7.6) and visual quality of the equipment (mean 7.9) were also high. The findings imply that it is not necessary for patients and neuropsychologists to be present at the same location for cognitive assessments to be carried out.

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Evaluations of computer-guided CBT (CCBT) suggest that this is a promising approach to closing the gap between the demand for, and the supply of, CBT. However, additional studies are required that are conducted by researchers independent of the programme developers, and include a wider range of participants. This independent study examined the viability of CCBT for panic and phobic anxiety in an unselected sample of referrals in remote and rural areas of Scotland. Outcome was assessed by a wide range of outcome measures, completed before and after treatment, and at 4-month follow-up. Participants experienced few difficulties in using the programme, and GPs and participants regarded CCBT as acceptable and useful. Major improvements were obtained, with several large effect sizes, which remained at follow-up. It was concluded that computer-guided CBT can play a useful part in delivering CBT services in rural areas; and that self-help CBT may be the only treatment option available to some sufferers.

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