A recent review published in the Journal of Psychiatric Practice highlights the effectiveness of computer-assisted cognitive-behavior therapy (CCBT) and mobile mental health applications in alleviating symptoms of anxiety and depression. The study, conducted by a team led by Matthew Mishkind, PhD, from the University of Colorado, and Jesse Wright, MD, PhD, from the University of Louisville, emphasizes the need for ongoing development and increased acceptance of these technologies among both patients and clinicians.
The researchers found that the evidence supporting the effectiveness and efficiency of CCBT justifies its broader implementation in clinical settings. Additionally, certain mental health apps have demonstrated effectiveness in reducing anxiety and depression symptoms, particularly with short-term use.
CCBT is defined as a digital tool that facilitates a series of user interactions aimed at delivering core cognitive-behavioral therapy methods for psychiatric disorders. Most CCBT programs are developed by experts in the field and are intended to be used under the guidance of clinicians, prioritizing patient confidentiality and safety.
One of the main advantages of CCBT is its ability to significantly decrease the time and effort required from clinicians, making treatment more cost-effective and accessible for users. However, the review notes that dropout rates can be higher compared to traditional therapy, and reimbursement from U.S. insurers for these services remains limited. Understanding patient demographics and expectations is crucial to managing these dropout rates.
The review cites multiple systematic studies and meta-analyses that report medium to large effect sizes for clinician-supported CCBT, while unguided CCBT shows less consistent results. The study also lists programs that have been validated through at least two randomized controlled trials for treating anxiety and depression.
In contrast, mobile mental health apps typically provide only select activities associated with CBT rather than a complete treatment program. Well-designed apps can enhance in-person therapy by offering real-time updates to providers, engaging patients between sessions, and helping them practice new skills outside of therapy. However, many mobile apps lack a solid scientific basis for behavior change, with some containing inaccurate information and frequently sharing sensitive user data. Although many apps are free to download, over half require in-app purchases for full functionality.
Conclusion
Dr. Mishkind, Dr. Wright, and their colleagues note that while CCBT and mental health apps are increasingly integrated into comprehensive treatment plans, many clinicians have yet to fully explore or utilize these options in their practice. They assert that the substantial evidence supporting the effectiveness of CCBT warrants its wider dissemination in clinical environments.
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