Telemedicine has expanded during the pandemic. Online doctors’ appointments across all medical areas are now much more common. A recent Swedish study looked at online psychological therapy, specifically internet cognitive behavioral therapy (iCBT), to understand which parts of cognitive behavioral therapy treatment are most effective and which are less so or perhaps even harmful when delivered online.
CBT is one of the most successful and widely applied therapies used to treat depression. The goal of CBT is to help patients develop more positive mental outlooks and effective coping skills to identify their emotions, recognize them in the present moment, and manage them in real time. A course of CBT often lasts about ten weeks and involves homework assignments or tasks meant to help further patients on the road to mental wellness.
A team from the University of Gothenburg in Sweden conducted a meta-analysis of 76 randomized control trials involving more than 17,500 patients. Using data pulled from these studies, they were able to conduct a broader analysis and draw more definitive conclusions about the effectiveness of iCBT than was previously possible.
iCBT was found to be just as good as in-person CBT when it came to reducing symptoms of mild to moderate depression. “For many, it’s a superb way of getting access to therapy without having to go to a therapist,” researcher, Cecelia Bjorkelund, said in a statement. “We also saw that it was especially good for the elderly — a finding we didn’t entirely expect.”
The relaxation-based techniques offered as part of certain online CBT programs could be harmful to some people. They can lead to “relaxation anxiety.”
The opportunity for continuous therapeutic contact, particularly over the first month or so of treatment, is another aspect of iCBT that makes it so successful, the researchers found. This critical window allows therapists to observe patients and ensure that their symptoms are beginning to improve, not worsen.
The relaxation-based techniques offered as part of some online CBT programs could be harmful to people dealing with more serious forms of depression, however. These techniques may actually worsen depression symptoms or, alternatively, cause what has been termed “relaxation anxiety.” Bjorkeland noted that iCBT is also inappropriate for cases of severe depression, which require more involved care.
“For a [seriously] depressed person, it isn’t advisable,” Bjorkelund explained, adding that it is the unregulated nature of the current iCBT industry that worries her and other professionals. “If you’re going to use iCBT in health care, the programs have to be regulated just as well as drugs are, but that’s not the case today,” she added.
If you or a loved one are suffering from mild to moderate depression, iCBT could help. Talk to your doctor or other trusted healthcare professional to obtain a referral for a licensed psychologist or psychotherapist. If you or a loved one are experiencing severe depression, or have thoughts of hurting yourself or others, seek immediate, person-to-person help. The Suicide Prevention Lifeline is available 24-hours a day at 800-273-8255.
This study is published in The Lancet Psychiatry.