Internet cognitive behavioural therapy (iCBT) vs face to face CBT

Research (Fairburn and Patel 2014, Andersson and Cuijpers 2010) has shown that one of the most effective and cheapest ways to scale psychological treatments is computerised self-delivered or Internet cognitive behavioural therapy (iCBT) which facilitates treatments. However the most argued issue with it is engagement.

So, is it possible to keep people in therapy with iCBT? Ballegooijen et al. 2014 did an study for depression in adults 18+ years who had been either diagnosed with depression or scored above cut-off on a validated symptom scale. They wanted to see the engagement to guided iCBT as compared to face to face CBT. They used guided iCBT rather than unguided as they thought that the guiding factor could influence in the study - however they later realised it didn't make a great impact.

To conduct the study, they looked at previous diverse CBT and iCBT studies from which they extracted the number of sessions and completeness of the treatment. In the results, CBT ranged from 12 to 28 sessions and iCBT interventions consisted of 5 to 9 sessions. Both CBT and iCBT participants completed in average 84% and 81% respectively of the treatment, so no big differences, but the number of people completing the treatment was significantly higher for CBT (85%) than for iCBT (65%). The problem is that in most iCBT trials the reasons to discontinue the treatment are not reported by participants, so there's no analysis in that area. Though there was an study that suggests it's due to recovery.

Because of the use of many previous heterogeneous studies this is in fact a very limited study but it really proves that treatment with iCBT can be done and the focus should be on finding how to maximise engagement. After all, it holds great advantages such as being cheaper than face to face CBT and being really easily scalable. Our very own Dr Andres Fonseca goes into a detailed analysis of the paper on Mental Elf. You can read it following this link.

If you had to do a CBT treatment, what would you prefer, face to face or iCBT?