Health
Internet CBT Review and Analysis of Depression-ScienceDaily
Internet-based cognitive-behavioral therapy (CBT) for depression is often as effective as traditional CBT. This is evident from international studies involving scientists from the University of Gothenburg. However, some online treatments contain elements that can be harmful.
Internet CBT (iCBT) as a way to provide treatment is on the rise. Nevertheless, it has been unclear which parts of the treatment are most useful for depression, which are less effective and potentially harmful to the patient.
In international research, researchers from Gothenburg University participated in systematic literature reviews and meta-analysis. This study is based on 76 randomized controlled trials (RCTs) conducted in Sweden and elsewhere. In total, RCTs included 17,521 patients, 71% of whom were women.
This study is currently published in Lancet Psychiatry with the support of Kyoto University in Japan. One of the co-authors is Cecilia Björkelund, a senior professor of family medicine at the Sahlgrenska Academy at Gothenburg University.
“In mild or moderate depression, iCBT is as effective as traditional CBT. For many, it’s a great way to access treatment without going to the therapist. Elderly-I We found something completely unexpected, “she says.
Like traditional CBT, the online version requires corrections to the patient’s thoughts, feelings, and behaviors that impede and upset the patient’s life. During treatment, which often lasts about 10 weeks, they are given tasks and exercises to perform on their own.
The factor that proved to be the most important for prognosis was the depth of depression at the start of treatment. Better results were obtained with mild depression. Therapist support and text message reminders increased the proportion of patients who completed treatment.
“When using iCBT in health care, programs need to be regulated as well as drugs, but that’s not the case today. With this study, we’ve taken a real step. First, what’s the best? Investigate whether it works. Second, it provides knowledge on how to design a program and adapt its configuration to the patient’s problem, “says Björkelund.
However, iCBT requires continuous therapeutic contact. One of the reasons is the importance of the therapist seeing improvement within 3-4 weeks and ensuring that trends do not go in the wrong direction. Björkelund emphasizes the great potential risk of depression. For severe depression, treatment via the internet is inadequate.
This study shows the risks of using iCBT in programs that include relaxation therapy. This is not beneficial, it can have adverse effects, exacerbate depressive symptoms, and cause “relaxation-induced anxiety.”
“Not recommended for people with depression. Relaxation programs should not be used as part of the treatment for depression in health care,” says Björkelund.
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