Saving clinicians' time by delegating routine aspects of therapy to a computer: a randomized controlled trial in phobia/panic disorder

Marks, Isaac; Kenwright, Mark; McDonough, Michael; Whíttaker, Mary; Mataix‐Cols, David

doi:10.1017/s003329170300878x

Cited by 208 publications

(179 citation statements)

References 18 publications

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“…Only eight reported allocation to conditions by an independent party. Blinding of assessors was reported in seven studies (Bornas, TortellaFeliu, & Llabrés, 2006;Carlbring et al, 2005Carlbring et al, , 2006Ghosh et al, 1988;Greist et al, 2002;Marks et al, 2004). Dropout ranged from 2 to 29% (two studies did not report dropout; Bornas, Tortella-Feliu, Llabrés, & Fullana, 2001;Hassan, 1992).…”

Section: Quality Of Included Studiesmentioning

confidence: 99%

“…Dropout ranged from 2 to 29% (two studies did not report dropout; Bornas, Tortella-Feliu, Llabrés, & Fullana, 2001;Hassan, 1992). In 11 studies Carlbring, Ekselius, & Andersson, 2003;Carlbring, Westling, Ljungstrand, Ekselius, & Andersson, 2001;Carlbring et al, 2005Carlbring et al, , 2007Greist et al, 2002;Kenardy et al, 2003;Knaevelsrud et al, 2007;Marks et al, 2004; Note. CAVE5computer-aided vicarious exposure; CAFFT5computer-assisted fear of flying treatment; CBSM5computer-based symbolic modeling; NR5not reported; SHTC5self-help program for traumatic event-related consequences; SBT5cognitive behavioural therapy; PTSD5posttraumatic stress disorder; OCD5obsessive-compulsive disorder; FTF5face to face; IVR5interactive voice response.…”

Section: Quality Of Included Studiesmentioning

confidence: 99%

“…Some CP systems are as effective as face-to-face care despite requiring far less therapist time (e.g. Carlbring et al, 2005;Ghosh, Marks, & Carr, 1988;Kenardy, McCafferty, & Rosa, 2003;Marks, Kenwright, McDonough, Whittaker, & Mataix-Cols, 2004). They may also speed access, allow patients to work at their own pace, and abolish the need to schedule appointments with a therapist .…”

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confidence: 99%

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

Cuijpers

Marks

Straten

et al. 2009

Cognitive Behaviour Therapy

392

263

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Abstract. Computer-aided psychotherapy (CP) is said to (1) be as effective as face-to-face psychotherapy, while requiring less therapist time, for anxiety disorder sufferers, (2) speed access to care, and (3) save traveling time. CP may be delivered on stand-alone or Internet-linked computers, palmtop computers, phone-interactive voice response, DVDs, and cell phones. The authors performed a meta-analysis of 23 randomised controlled studies (RCTs) that compared CP with non-CP in anxiety disorders: phobias, n510; panic disorder/agoraphobia, n59; PTSD, n53; obsessivecompulsive disorder, n51. Overall mean effect size of CP compared with non-CP was 1.08 (95% confidence interval: 0.84-1.32). CP and face-to-face psychotherapy did not differ significantly from each other (13 comparisons, d520.06). Much caution is needed when interpreting the findings indicating that outcome was unrelated to type of disorder, type of comparison group, mode of CP delivery (Internet, stand-alone PC, palmtop), and recency of the CP system and that effect size decreased when more therapist time was replaced by the computer. Because CP as a whole was as effective as face-to-face psychotherapy, certain forms of CP deserve to be integrated into routine practice.

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Section: Quality Of Included Studiesmentioning

confidence: 99%

Section: Quality Of Included Studiesmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

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

Cuijpers

Marks

Straten

et al. 2009

Cognitive Behaviour Therapy

392

263

View full text Add to dashboard Cite

show abstract

“…In Marks et al, (2004), a computer-aided CBT (CCBT) is described for delivering selfhelp for sufferers with phobic, panic, anxiety, obsessive-compulsive and depressive disorders. Although the approach greatly reduced the demand on therapist's time, it lacked the patient -doctor feedback mechanism which is crucial for depression therapy.…”

Section: Related Workmentioning

confidence: 99%

Intelligent Decision Support System for Depression Diagnosis Based on Neuro-fuzzy-CBR Hybrid

Ekong¹,

Inyang²,

Onibere³

2012

MAS

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Depression disorder is common in primary care, but its diagnosis is complex and controversial due to the conflicting, overlapping and confusing nature of the multitude of symptoms, hence the need to retain cases in a case base and reuse effective previous solutions for current cases. This paper proposes a neuro-fuzzy-Case Base Reasoning (CBR) driven decision support system that utilizes solutions to previous cases in assisting physicians in the diagnosis of depression disorder. The system represents depression disorder with 25 symptoms grouped into five categories. Fuzzy logic provided a means for handling imprecise symptoms. Local similarity between the input cases and retrieved cases was achieved using the absolute deviation as the distance metric, while adaptive neuro-fuzzy inference system handled fuzzy rules whose antecedents are the mapped local similarities of each category of symptoms for global similarity measurement, upon which the retrieved cases are ranked. The 5 best matched cases are subjected to the emotional filter of the system for diagnostic decision making. This approach derives strengths from the hybridization since the tools are complementary to one another.

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“…These treatment approaches include guided relaxation, instructionalbased self-exposure (Marks, Kenwright, McDonough, Whittaker, & Mataix-Cols, 2004), vicarious exposure (Gilroy, Kirkby, Daniels, Menzies, & Montgomery, 2003), virtual reality (Krijn, Emmelkamp, Olafsson, & Biemond, 2004) and symbolic exposure via images and videos (Bornas et al, 2002;Matthews, Scanlan, & Kirkby, 2012;Vansteenwegen et al, 2007). A recent metaanalysis concluded that exposure-based interventions were more effective than placebo, or alternative psychotherapeutic interventions, and that in vivo exposure (involving direct contact with the phobic stimulus) was more effective than 'other' exposure-based interventions (e.g., imaginal, virtual reality) at post-treatment but not at follow-up (Wolitzky-Taylor et al, 2008).…”

Section: Introductionmentioning

confidence: 99%