COMPUTERIZED COGNITIVE BEHAVIOUR THERAPY: A SYSTEMATIC REVIEW

2004 ◽  
Vol 32 (1) ◽  
pp. 31-55 ◽  
Author(s):  
Eva Kaltenthaler ◽  
Glenys Parry ◽  
Catherine Beverley
Keyword(s):  
Systematic Review ◽  
Anxiety Disorders ◽  
Cognitive Behaviour Therapy ◽  
Mental Health Problems ◽  
Behaviour Therapy ◽  
Treatment As Usual ◽  
Cognitive Behaviour ◽  
Common Mental Health Problems ◽  
Potential Benefits

Depression, anxiety disorders and phobias are common mental health problems associated with considerable occupational and interpersonal impairment. Although there is substantial evidence to support the use of cognitive behaviour therapy (CBT) in the treatment of these disorders, access is limited. Computerized cognitive behaviour therapy (CCBT) is one of a variety of aids to self-management that offer patients the potential benefits of CBT with less therapist involvement than therapist led CBT (TCBT). In this systematic review of the efficacy of CCBT, 16 studies were identified. Of these 11 were RCTS and the remaining 5 were pilot or cohort studies. The quality of studies ranged from poor to moderate (although the criteria used precluded the highest rating). In the studies comparing CCBT with TCBT, five studies showed CCBT have equivalent outcomes to TCBT. One study of depressed inpatients found TCBT to be significantly more effective than CCBT. Four studies found CCBT to be more effective than treatment as usual (TAU). Two studies found CCBT to be no more effective than TAU. Two studies compared CCBT with bibliotherapy. Of these, one study found CCBT to be as effective as bibliotherapy and one found bibliotherapy to be significantly more effective than CCBT on some outcome measures. Although the results of this review are not conclusive, CCBT is potentially useful in the treatment of anxiety disorders, depression and phobias. From the results of this review, we make three recommendations to improve the quality of research in this field, and suggest four areas requiring further research.

Cost-effectiveness of brief cognitive behaviour therapy versus treatment as usual in recurrent deliberate self-harm: a decision-making approach

2003 ◽  
Vol 33 (6) ◽  
pp. 977-986 ◽  
Author(s):  
S. BYFORD ◽  
M. KNAPP ◽  
J. GREENSHIELDS ◽  
O. C. UKOUMUNNE ◽  
V. JONES ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cost Effectiveness ◽  
Cognitive Behaviour Therapy ◽  
Service Providers ◽  
Behaviour Therapy ◽  
Treatment As Usual ◽  
Deliberate Self Harm ◽  
Cognitive Behaviour ◽  
Self Harm

Background. Deliberate self-harm can be costly, in terms of treatment and subsequent suicide. Any intervention that reduces episodes of self-harm might therefore have a major impact on the costs incurred by service providers and the productivity losses due to illness or premature death.Method. Four hundred and eighty patients with a history of recurrent deliberate self-harm were randomized to manual-assisted cognitive behaviour therapy (MACT) or treatment as usual. Economic data were collected from patients at baseline, 6 and 12 months, and these data were complete for 397 patients. Incremental cost-effectiveness was explored using the primary outcome measure, proportion of patients having a repeat episode of deliberate self-harm, and quality of life. The uncertainty surrounding costs and effects was represented using cost-effectiveness acceptability curves.Results. Differences in total cost per patient were statistically significant at 6 months in favour of MACT (−£897, 95% CI −1747 to −48, P=0·04), but these differences did not remain significant at 12 months (−£838, 95% CI −2142 to 466, P=0·21). Nevertheless, exploration of the uncertainty surrounding these estimates suggests there is >90% probability that MACT is a more cost-effective strategy for reducing the recurrence of deliberate self-harm in this population over 1 year than treatment as usual. The results for quality of life were not conclusive.Conclusion. Cost-effectiveness acceptability curves demonstrate that, based on the evidence currently available, to reject MACT on traditional grounds of statistical significance and to continue funding current practice has <10% chance of being the correct decision in terms of cost-effectiveness.

scholarly journals Understanding Black and Minority Ethnic service user's experience of racism as part of the assessment, formulation and treatment of mental health problems in cognitive behaviour therapy

2019 ◽  
Vol 12 ◽  
Author(s):  
Andrew Beck
Keyword(s):  
Mental Health ◽  
Cognitive Behaviour Therapy ◽  
Mental Health Problems ◽  
Cumulative Risk ◽  
Health Problems ◽  
Service Users ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Engagement Process ◽  
Minority Ethnic

AbstractExperiences of racism can be a cumulative risk factor for developing mental health problems. Cognitive Behaviour Therapists working with Black and Minority Ethnic (BME) service users should be confident in their ability to establish the necessary rapport to ask about these experiences and be able to incorporate this information into longitudinal formulations and as part of maintenance cycles. This paper sets out guidelines as to how to do this as part of a wider engagement process.

Efficacy of Cognitive Behaviour Therapy in Generalized Anxiety Disorders

2004 ◽  
Vol 74 (1) ◽  
pp. 36-42 ◽  
Author(s):  
M. Linden ◽  
D. Zubraegel ◽  
T. Baer ◽  
U. Franke ◽  
P. Schlattmann
Keyword(s):  
Anxiety Disorders ◽  
Cognitive Behaviour Therapy ◽  
Generalized Anxiety ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Generalized Anxiety Disorders

scholarly journals Effectiveness of Transdiagnostic Cognitive Behaviour Therapy for Anxiety and Depression in Adults: A Systematic Review and Meta-analysis

2016 ◽  
Vol 44 (6) ◽  
pp. 673-690 ◽  
Author(s):  
Philip Andersen ◽  
Paul Toner ◽  
Martin Bland ◽  
Dean McMillan
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Cognitive Behaviour Therapy ◽  
Meta Analysis ◽  
Grey Literature ◽  
Anxiety And Depression ◽  
Behaviour Therapy ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour ◽  
Effectiveness Data

Background: Transdiagnostic Cognitive Behaviour Therapy (CBT) seeks to identify core cognitive-behavioural processes hypothesized to be important across a range of disorders and to develop a treatment that targets these. This contrasts with standard CBT approaches that are disorder-specific. Proponents of transdiagnostic CBT suggest that it may offer advantages over disorder-specific CBT, but little is known about the effectiveness of this approach. Aims: The review aimed to summarize trial-based clinical and cost-effectiveness data on transdiagnostic CBT for anxiety and depression. Method: A systematic review of electronic databases, including peer-reviewed and grey literature sources, was conducted (n = 1167 unique citations). Results: Eight trials were eligible for inclusion in the review. There was evidence of an effect for transdiagnostic CBT when compared to a control condition. There were no differences between transdiagnostic CBT and active treatments in two studies. We found no evidence of cost-effectiveness data. Conclusions: Quality assessment of the primary studies indicated a number of methodological concerns that may serve to inflate the observed effects of transdiagnostic approaches. Although there are positive signs of the value of transdiagnostic CBT, there is as yet insufficient evidence to recommend its use in place of disorder-specific CBT.

scholarly journals @Home eTherapy Service for People with Common Mental Health Problems: an Evaluation

2017 ◽  
Vol 46 (1) ◽  
pp. 115-120 ◽  
Author(s):  
Judith Gellatly ◽  
Leanne Chisnall ◽  
Nic Seccombe ◽  
Kathryn Ragan ◽  
Nicola Lidbetter ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Treatment Options ◽  
Third Sector ◽  
Health Problems ◽  
Initial Assessment ◽  
Successful Implementation ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Common Mental Health Problems

Background: Ensuring rapid access to psychological interventions is a priority of mental health services. The involvement of peer workers to support the delivery of more accessible treatment options such as computerized cognitive behaviour therapy (CCBT) is recognized. Aims: To evaluate the implementation of a third sector remote CCBT @Home eTherapy service for people experiencing common mental health problems supported by individuals with lived experience. Method: Supported CCBT packages with telephone support were delivered over a 30-month period. Self-complete measures identifying levels of depression, anxiety and functioning were administered at each treatment appointment. Results: Over 2000 people were referred to the @Home eTherapy service; two-thirds attended an initial assessment and 53.4% of referrals assigned to CCBT completed treatment. Statistically significant improvements in anxiety, depression and functioning were found, with 61.6% of treated clients meeting recovery criteria. Conclusions: The service meets Improving Access to Psychological Therapies (IAPT) key performance targets, and is comparable to other IAPT services using CCBT. Evidence for the successful implementation of such a service by a third sector organization is provided.

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