A comparison of computer-based versus traditional individual psychotherapy.

Abstract

Professional psychologists are challenged to determine the appropriate use of interactive computer therapy programs. Although such programs have the potential of enhancing delivery of mental health services and reaching ever broader audiences, they raise serious clinical, legal, ethical, and practical concerns. This article reports on a controlled clinical trial comparing short-term traditional individual therapy with a computer-based intervention overseen by a therapist. Results were favorable and comparable in both conditions, with individual therapy outperforming computerbased therapy on some measures. The practitioner's use of computer-based psychotherapy interventions is discussed and some guidelines offered. Computer technology is changing the face of psychotherapy. Should interactive programs be used as an adjunct to treatments? Should they be recommended for use without other treatment? If so, for what diagnostic groups and with what precautions should they be recommended? Should some clients explicitly be warned against unsupervised interventions? An American Psychological Association task force (Nickelson, 1997) report has cited a minefield of legal, ethical, and financial issues of concern to psychologists interested in these new technologies.

Delivering interventions for depression by using the internet: randomised controlled trial

“…The mechanisms for this effect are unclear, although research from general practice15 indicates higher recovery rates in patients who receive educational material. The size of the treatment effect in patients with a clinical level of symptoms (pre-post effect of 0.9 for cognitive behaviour therapy) was comparable, although smaller than brief cognitive therapy assisted by a therapist, self directed manualised computer therapy, and bibliotherapy, where pre-post effect sizes have ranged from about 0.70 to 1.20 standard deviation units for mixed or depressed samples 16 17. Computer assisted cognitive behaviour therapy in general practice has produced pre-post effect sizes of approximately 1.20 7.…”

Computer‐Aided Psychotherapy for Anxiety Disorders: A Meta‐Analytic Review

“…We excluded studies that compared two active CP treatments with one another (e.g. Fraser, Kirby, Daniels, Gilroy, & Montgomery, 2001;Newman et al, 1997;Schneider et al, 2005), as well as studies that also included patients with subclinical or nondiagnostic anxiety and stress-related problems (Dolezal-Wood, Belar, & Snibbe, 1998;Wagman & Kerber, 1984;Zetterqvist, Maanmies, Strö m, & Andersson, 2003), studies that were aimed at children or adolescents (Dewis et al, 2001;Spence, Holmes, March, & Lipp, 2006), and studies that were not clearly aimed at patients with anxiety disorders (Jacobs et al, 2001;Slack, Porter, Balkin, Kowaloff, & Slack, 1990).…”

The machine as psychotherapist: impersonal communication with a machine

“…In one rare study, individuals reporting stress symptoms were randomly allocated to a student acting as a therapist or a student assisting the client to use a computer to follow the Therapeutic Learning Program (Gould, 1989). Improvement in the computer-using group was of the same order as that in the student-therapist group at the end of therapy, but it did not persist at 6 months (Jacobs et al, 2001), suggesting that there were, in fact, substantive differences between the computer and the therapist.…”