Improving the Efficiency of Psychotherapy for Depression: Computer-Assisted Versus Standard CBT

Thase, Michael E.; Wright, Jesse H.; Eells, Tracy D.; Barrett, Marna S.; Wisniewski, Stephen R.; Balasubramani, G.K.; McCrone, Paul; Brown, Gregory K.

doi:10.1176/appi.ajp.2017.17010089

Cited by 132Digital Mental Health InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychotherapy Techniques and Applications

Improving the Efficiency of Psychotherapy for Depression: Computer-Assisted Versus Standard CBT

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Thase, Michael E., Wright, Jesse H., Eells, Tracy D., Barrett, Marna S., Wisniewski, Stephen R., Balasubramani, G.K., McCrone, Paul, Brown, Gregory K.·2018·American Journal of Psychiatry

DOI 10.1176/appi.ajp.2017.17010089PMC PMC5848497

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Abstract

OBJECTIVE: The authors evaluated the efficacy and durability of a therapist-supported method for computer-assisted cognitive-behavioral therapy (CCBT) in comparison to standard cognitive-behavioral therapy (CBT). METHOD: A total of 154 medication-free patients with major depressive disorder seeking treatment at two university clinics were randomly assigned to either 16 weeks of standard CBT (up to 20 sessions of 50 minutes each) or CCBT using the "Good Days Ahead" program. The amount of therapist time in CCBT was planned to be about one-third that in CBT. Outcomes were assessed by independent raters and self-report at baseline, at weeks 8 and 16, and at posttreatment months 3 and 6. The primary test of efficacy was noninferiority on the Hamilton Depression Rating Scale at week 16. RESULTS: Approximately 80% of the participants completed the 16-week protocol (79% in the CBT group and 82% in the CCBT group). CCBT met a priori criteria for noninferiority to conventional CBT at week 16. The groups did not differ significantly on any measure of psychopathology. Remission rates were similar for the two groups (intent-to-treat rates, 41.6% for the CBT group and 42.9% for the CCBT group). Both groups maintained improvements throughout the follow-up. CONCLUSIONS: The study findings indicate that a method of CCBT that blends Internet-delivered skill-building modules with about 5 hours of therapeutic contact was noninferior to a conventional course of CBT that provided over 8 additional hours of therapist contact. Future studies should focus on dissemination and optimizing therapist support methods to maximize the public health significance of CCBT.

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Research has shown that bCBT achieves similar outcomes to traditional CBT, despite reduced face-to-face time with therapists.
“research has shown that bCBT achieves similar outcomes to traditional CBT, despite reduced face-to-face time with therapists [27,33-35].”
From Barriers to and Facilitators of a Blended Cognitive Behavioral Therapy Program for Depression and Anxiety Based on Experiences of University Students: Qualitative Interview Study (2023) · cites this paper as [34]
cCBT is an effective alternative to CBT for the treatment of mild to moderate depression and anxiety.
“Computerized CBT (cCBT) was proven to be an effective alternative to CBT and does not require face-to-face therapy between a therapist and the patient, which suited the COVID-19 pandemic response.”
From The Efficacy of Computerized Cognitive Behavioral Therapy for Depressive and Anxiety Symptoms in Patients With COVID-19: Randomized Controlled Trial (2021) · cites this paper as [18]

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Authors: Thase, M. E., Wright, J. H., Eells, T. D., Barrett, M. S., Wisniewski, S. R., Balasubramani, G. K., McCrone, P., & Brown, G. K.
Affiliations: University of Louisville (US)
ORCID: Thase, Michael E.
Wright, Jesse H.
Eells, Tracy D.
Wisniewski, Stephen R.
Balasubramani, G.K.
McCrone, Paul
Brown, Gregory K.
Venue: American Journal of Psychiatry
Publisher: American Psychiatric Association Publishing
Published: 2018-03
Volume: 175
Issue: 3
Pages: 242-250
ISSN: 0002-953X (ISSN-L)
1535-7228
DOI: 10.1176/appi.ajp.2017.17010089
PMC: PMC5848497
OpenAlex: W2760933138
Semantic Scholar: 0e34af550c7edc4661c24000493d22f2f7d6b340
Cited by: 131
References: 45
Citations by year: 2026: 6 · 2025: 15 · 2024: 14 · 2023: 17 · 2022: 20 · 2021: 15 · 2020: 19 · 2019: 13 · 2018: 11 · 2017: 1
FWCI: 13.77
Type: journal article
Language: en
Open access: green
europepmc.org
Locations: American Journal of Psychiatry (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Mental Health (R01MH082794, R01MH082762)
Topics: Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords: cognitive behavioral therapy, major depressive disorder, online therapy, treatment efficacy, remission, treatment durability, non-inferiority
MeSH terms: Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Therapy, Computer-Assisted, Cognitive Behavioral Therapy

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Improving the Efficiency of Psychotherapy for Depression: Computer-Assisted Versus Standard CBT

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