Cognitive behaviour therapy (CBT) for depression by computer vs. therapist: Patient experiences and therapeutic processes

Abstract

This case series compares patient experiences and therapeutic processes between two modalities of cognitive behaviour therapy (CBT) for depression: computerized CBT (cCBT) and therapist-delivered CBT (tCBT). In a mixed-methods repeated-measures case series, six participants were offered cCBT and tCBT in sequence, with the order of delivery randomized across participants. Questionnaires about patient experiences were administered after each session and a semi-structured interview was completed with each participant at the end of each therapy modality. Therapy expectations, patient experiences and session impact ratings in this study generally favoured tCBT. Participants typically experienced cCBT sessions as less meaningful, less positive and less helpful compared to tCBT sessions in terms of developing understanding, facilitating problem-solving and building a therapeutic relationship.

Participant experiences of Eye Movement Desensitisation and Reprocessing vs. Cognitive Behavioural Therapy for grief: similarities and differences

“…This outcome has been identified in other qualitative research and has been referred to as the ‘tool kit’ provided by CBT (Gega et al, 2013). In contrast, participants in the EMDR condition did not describe the acquisition of tools that could be used after therapy; previous research has described this as a limitation of EMDR (Maxwell, 2003).…”

Intellectual disability and computers in therapy: Views of service users and clinical psychologists

“…People without ID indicated that the benefits and value of computerised therapy programmes were in increasing their insight into their mental health problems, improving their knowledge and understanding of CBT, teaching them therapy skills and techniques (Bendelin et al, 2011;Gega, Smith, & Reynolds, 2013) and helping them feel empowered (Knowles et al, 2014).…”

“…This comment is important because it pre-empts an important limitation of computerised therapy: the generic standardised materials that do not address the person's specific needs and circumstances (Gega et al, 2013;Hind et al, 2010) A clinician touched upon the possibility of involving a third party, such as carers or teachers, when using computers in therapy. This is important not only because carers enable people with ID to access therapy services, but also because carers can help the communication between the therapist and the person with ID (Department of Health, 2009;Hurley et al, 1998;Royal College of Psychiatrists, 2004) and enhance therapy effects (Rose, Loftus, Flint, & Carey, 2005).…”

Mixed methods in psychotherapy research: A review of method(ology) integration in psychotherapy science

“…Thus, the researchers were able to more thoroughly explore the experiences of a small sample ( N = 6) of participants in two different types of cognitive behavioral treatment (CBT). These researchers aimed to “explore factors which can influence patients’ progress and experiences with therapy” (Gega et al., , p. 228) rather than purely comparing treatment modality effectiveness. The researchers’ efforts in this study, that is the integration of qualitative and quantitative data, also resulted in findings that diverged from those in other similar studies about online and in‐person CBT.…”