Computerised Cognitive Behavioral Therapy (CCBT) delivers cognitive behavioral techniques to a computer-user to increase successful coping strategies and improve mental wellbeing. The National Institute for Clinical Excellence (2006) describes CCBT as a “generic term for delivering CBT via an interactive computer interface delivered by a personal computer, internet or interactive voice response system”.
Official data from the World Health Organisation shows us that annually in the UK 7.7% of the population suffer from depression and 10% from anxiety. In the United States 9.5% of the population annually suffer from depression with 18.1% of the population suffering from anxiety. However, both depression and anxiety can be successfully treated in many cases, and with Cognitive Behavioral Therapy proving to be as effective as medication (Watkins & Williams, 1998) and a popular choice for sufferers any provision of CBT on a wider basis is desirable. Hence, computerised CBT programmes may offer a unique opportunity to dramatically improve the lives of millions of people.
There are cognitive behavioral therapy sessions in which the user interacts with computer software (either on a PC, or sometimes via a voice-activated phone service), instead of face to face with a therapist. It cannot replace face-to-face therapy, but it can provide an option for patients, especially in light of the fact that there are not always therapists available, or the cost can be prohibitive. Computerized CBT is clinically proven and drug-free. For people who are feeling depressed and withdrawn, the prospect of having to speak to someone about their innermost problems can be off-putting. In this respect, CCBT (especially if delivered online) can be a good option.
Randomized controlled trials have proven its effectiveness, and in February 2006 the UK’s National Institute for Health and Clinical Excellence (NICE) recommended that CCBT be made available for use within the NHS across England and Wales, for patients presenting with mild/moderate depression, rather than immediately opting for antidepressant medication.
A new UK government initiative for tackling mental health issues has recently been launched by the Care Services Improvement Partnership. This confirms Primary Care Trust (PCT) responsibilities in delivering the NICE Technology Appraisal on CCBT. National Director for Mental Health, Professor Louis Appleby CBE has confirmed that by 31 March 2007 PCTs should have ST Solutions’ “FearFighter” and Ultrasis’ “Beating the Blues” CCBT products in place and the NICE Guidelines should be met. Some areas have developed, or are trialing, other CCBT products notably the Serenity Programme developed in-house by the NHS and currently being trialed in North Wales (UK).
The more recent NICE guideline (2009) has recognised that there are likely to be a number of computerised CBT products that are useful to patients. They have therefore removed the endorsement of any specific product.
These days there are a number of sites offering computerised CBT. Many of them offer interactive communication with therapists. To get live feedback has shown to improve the result of online CBT.
At Auckland University in New Zealand, a team led by Dr. Sally Merry have been developing a computerised CBT fantasy ‘serious’ game to help tackle depression amongst adolescences. The game is currently undergoing testing and the results are thought to be released in 2011. The game has a number of features to help combat depression, where the user takes on a role of a character who travels through a fantasy world, combating ‘literal’ negative thoughts and learning techniques to manage their depression.