Clinician‐assisted computerised versus therapist‐delivered treatment for depressive and addictive disorders: a randomised controlled trial
Abstract
Objective To compare computer-delivered and therapist-delivered treatments for people with depression and comorbid addictive disorders. Design Randomised controlled clinical trial. Setting and participants Our study was conducted between January 2005 and August 2007 at seven study clinics in rural and urban New South Wales. Participants were 274 people who had a Beck Depression Inventory II (BDI-II) score ≥ 17 and were using alcohol and/or cannabis at harmful levels in the month before baseline. They were self-referred or referred from other sources such as outpatient drug treatment clinics, general practices and non-government support agencies. Interventions Participants were randomly allocated to receive (1) integrated cognitive behaviour therapy and motivational interviewing (CBT/MI) delivered by a therapist; (2) integrated CBT/MI delivered by computer, with brief therapist assistance at the end of each session (clinician-assisted computerised [CAC] treatment), or (3) person-centred therapy (PCT), consisting of supportive counselling given by a therapist (the control group). All three treatments were delivered according to a manual developed specifically for the study. Main outcome measures Changes in depression, alcohol use and cannabis use at 3 months after baseline; significant predictors of change in the primary outcome variables. Results Compared with computer- or therapist-delivered CBT/MI, PCT was associated with significantly less reduction in depression and alcoho…
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Eight papers regarding six different trials measured rural location as a predictor of outcomes, adherence, or acceptability.
“Eight papers regarding six different trials measured rural location as a predictor of outcomes, adherence, or acceptability [38-45].”
From Computerized cognitive behavior therapy for anxiety and depression in rural areas:a systematic review (2015) · cites this paper as [40]
Across the RCTs included in this review, the risk of bias was rated as low for two studies, and moderate for two studies.
“Across the RCTs included in this review, the risk of bias was rated as low for two studies [38,40], and moderate for two studies [41,47].”
From Computerized cognitive behavior therapy for anxiety and depression in rural areas:a systematic review (2015) · cites this paper as [40]
Kay-Lambkin and colleagues reported that almost half of their sample self-referred to CCBT.
“In further support of its acceptability among rural mental health patients, Kay-Lambkin and colleagues reported that almost half of their sample self-referred to CCBT [40].”
From Computerized cognitive behavior therapy for anxiety and depression in rural areas:a systematic review (2015) · cites this paper as [40]
Rural participants are more likely to have been referred to CCBT by their GPs than urban participants-23% versus 2% referred by a GP, respectively (P<.001).
“Rural participants are more likely to have been referred to CCBT by their GPs than urban participants—23% versus 2% referred by a GP, respectively (P<.001) [40].”
From Computerized cognitive behavior therapy for anxiety and depression in rural areas:a systematic review (2015) · cites this paper as [40]
Three papers, regarding two trials, reported clinical efficacy data disaggregated by location.
“Three papers, regarding two trials, reported clinical efficacy data disaggregated by location [40,41,44].”
From Computerized cognitive behavior therapy for anxiety and depression in rural areas:a systematic review (2015) · cites this paper as [40]
In Kay-Lambkin and colleagues' trial, less than 9% (54) of 617 participants assessed for eligibility refused to participate.
“In Kay-Lambkin and colleagues’ trial [40], less than 9% (54) of 617 participants assessed for eligibility refused to participate.”
From Computerized cognitive behavior therapy for anxiety and depression in rural areas:a systematic review (2015) · cites this paper as [40]
Staff who are not trained mental health practitioners are able to provide the guidance required by some CCBT programs without significantly reduced clinical effect.
“Staff who are not trained mental health practitioners are able to provide the guidance required by some CCBT programs without significantly reduced clinical effect [32,40,55,56].”
From Computerized cognitive behavior therapy for anxiety and depression in rural areas:a systematic review (2015) · cites this paper as [40]
The rates of uptake among several studies included in this review were much higher-44% and 56% in studies by Kay-Lambkin et al and Hayward et al, respectively.
“The rates of uptake among several studies included in this review were much higher—44% and 56% in studies by Kay-Lambkin et al [40] and Hayward et al [39], respectively.”
From Computerized cognitive behavior therapy for anxiety and depression in rural areas:a systematic review (2015) · cites this paper as [40]
Cites
Internet-administered cognitive behavior therapy for health problems: a systematic review
Cuijpers, P., van Straten, A., & Andersson, G. (2008) · Journal of Behavioral Medicine · doi:10.1007/s10865-007-9144-1 · Cited by 555 · see citing works
Kay‐Lambkin, F. J., Baker, A. L., Lewin, T. J., & Carr, V. J. (2009) · Addiction · doi:10.1111/j.1360-0443.2008.02444.x · Cited by 269 · see citing works
Self-citationBewick, B. M., Trusler, K., Barkham, M., Hill, A. J., Cahill, J., & Mulhern, B. (2008) · Preventive Medicine · doi:10.1016/j.ypmed.2008.01.005 · Cited by 233 · see citing works
Computerised cognitive-behavioural therapy for depression: systematic review
Kaltenthaler, E., Parry, G., Beverley, C., & Ferriter, M. (2008) · British Journal of Psychiatry · doi:10.1192/bjp.bp.106.025981 · Cited by 206 · see citing works
Adaptive Designs for Randomized Trials in Public Health
Brown, C. H., Ten Have, T. R., Jo, B., Dagne, G., Wyman, P. A., Muthén, B., & Gibbons, R. D. (2009) · Annual Review of Public Health · doi:10.1146/annurev.publhealth.031308.100223 · Cited by 184 · see citing works
Baker, A. L., Kavanagh, D. J., Kay‐Lambkin, F. J., Hunt, S. A., Lewin, T. J., Carr, V. J., & Connolly, J. (2010) · Addiction · doi:10.1111/j.1360-0443.2009.02757.x · Cited by 146 · cited 1× · see citing works
“19 Thus, practitioners working with people who have a mental health problem and comorbid harmful drug use should feel confident in encouraging their clients to consider multiple simultaneous targets for treatment within a CBT/MI framework.”
BackgroundSelf-citation
Flagged first, then by citations
Cited by
Sorted by citations
Kaner, E. F., Beyer, F. R., Garnett, C., Crane, D., Brown, J., Muirhead, C., Redmore, J., O'Donnell, A., Newham, J. J., de Vocht, F., et al. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011479.pub2 · Cited by 308 · see citing works
Riper, H., Andersson, G., Hunter, S. B., Wit, J., Berking, M., & Cuijpers, P. (2014) · Addiction · doi:10.1111/add.12441 · Cited by 276 · see citing works
Musiat, P., & Tarrier, N. (2014) · Psychological Medicine · doi:10.1017/s0033291714000245 · Cited by 188 · see citing works
Internet and computer based interventions for cannabis use: a meta-analysis
Tait, R. J., Spijkerman, R., & Riper, H. (2013) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2013.05.012 · Cited by 144 · see citing works
Marsch, L. A., Guarino, H., Acosta, M., Aponte-Melendez, Y., Cleland, C., Grabinski, M., Brady, R., & Edwards, J. (2014) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2013.08.012 · Cited by 139 · see citing works
Improving the Efficiency of Psychotherapy for Depression: Computer-Assisted Versus Standard CBT
Thase, M. E., Wright, J. H., Eells, T. D., Barrett, M. S., Wisniewski, S. R., Balasubramani, G. K., McCrone, P., & Brown, G. K. (2018) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2017.17010089 · Cited by 131 · see citing works
Vallury, K. D., Jones, M., & Oosterbroek, C. (2015) · Journal of Medical Internet Research · doi:10.2196/jmir.4145 · Cited by 105 · see citing works
“One extra study was identified by hand searching at this stage, resulting in 11 studies being finally included in this review [38-48].”
InfluentialBoumparis, N., Loheide-Niesmann, L., Blankers, M., Ebert, D. D., Korf, D., Schaub, M. P., Spijkerman, R., Tait, R. J., & Riper, H. (2019) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2019.03.016 · Cited by 110 · see citing works
A qualitative exploration of Internet-based treatment for comorbid depression and alcohol misuse
Darvell, M. J., Kavanagh, D. J., & Connolly, J. M. (2015) · Internet Interventions · doi:10.1016/j.invent.2015.03.003 · Cited by 69 · see citing works
Batterham, P. J., Calear, A. L., Farrer, L., McCallum, S. M., & Cheng, V. W. S. (2018) · Internet Interventions · doi:10.1016/j.invent.2017.08.002 · Cited by 48 · see citing works
Olmos, A., Tirado-Muñoz, J., Farré, M., & Torrens, M. (2018) · Addictive Behaviors · doi:10.1016/j.addbeh.2017.11.045 · Cited by 47 · see citing works
Lord, S., Moore, S. K., Ramsey, A., Dinauer, S., & Johnson, K. (2016) · JMIR Mental Health · doi:10.2196/mental.4927 · Cited by 47 · see citing works
Campos, D., Mira, A., Bretón-López, J., Castilla, D., Botella, C., Baños, R. M., & Quero, S. (2018) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s153041 · Cited by 30 · see citing works
Kay-Lambkin, F. J., Baker, A. L., Kelly, B. J., & Lewin, T. J. (2012) · Journal of Dual Diagnosis · doi:10.1080/15504263.2012.723315 · Cited by 31 · see citing works
Self-citationSimblett, S. K., Yates, M., Wagner, A. P., Watson, P., Gracey, F., Ring, H., & Bateman, A. (2017) · JMIR Mental Health · doi:10.2196/mental.6022 · Cited by 26 · see citing works
Treatments for Co-Occurring Depression and Substance Use in Young People: A Systematic Review
Deady, M., Teesson, M., & Kay-Lambkin, F. (2014) · Current Drug Abuse Reviews · doi:10.2174/1874473707666141015220608 · Cited by 25 · see citing works
Self-citationOutcomes and challenges of motivational interviewing in dual diagnosis treatment—A systematic review
Bastos Maia, M., Martins, P. M., & Figueiredo-Braga, M. (2025) · Journal of Dual Diagnosis · doi:10.1080/15504263.2024.2434218 · Cited by 3 · see citing works
- Authors
- Kay‐Lambkin, F. J., Baker, A. L., Kelly, B., & Lewin, T. J.
- Affiliations
- UNSW Sydney (AU)
- University of Newcastle Australia (AU)
- Corresponding author
- Kay‐Lambkin, Frances J
- Venue
- Medical Journal of Australia
- Publisher
- AMPCo
- Published
- 2011-08
- Volume
- 195
- Issue
- S3
- Pages
- S44-50
- ISSN
- 0025-729X (ISSN-L)
- 1326-5377
- OpenAlex
- W41496956
- Cited by
- 128
- References
- 6
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 2 · 2023: 2 · 2022: 9 · 2021: 10 · 2020: 13 · 2019: 8 · 2018: 4 · 2017: 13 · 2016: 12 · 2015: 14 · 2014: 15 · 2013: 8 · 2012: 10
- FWCI
- 14.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- The Medical Journal of Australia (publishedVersion)
- PubMed (publishedVersion)
- NOVA (University of Newcastle Australia) (submittedVersion)
- Funders
- National Health and Medical Research Council
- National Medical Research Council
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- motivational interviewing, client-centered therapy, supportive counseling, depression, alcohol consumption, cannabis use, primacy
- MeSH terms
- Adolescent, Adult, Alcoholism, Analysis of Variance, Australia, Marijuana Abuse, Counseling, Depression, Female, Humans, Interview, Psychological, Male, Middle Aged, Motivation, Therapy, Computer-Assisted, Comorbidity, Cognitive Behavioral Therapy, Linear Models, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
