Editing Cognitive behavioral therapy (section)

==={{anchor|Computerized}} Computerized or Internet-delivered (CCBT)===

Computerized cognitive behavioral therapy (CCBT) has been described by [[National Institute for Health and Clinical Excellence|NICE]] as a "generic term for delivering CBT via an interactive computer interface delivered by a personal computer, internet, or interactive voice response system",<ref name="NiceTA97">{{cite web|url = http://www.nice.org.uk/guidance/TA97|title = Depression and anxiety&nbsp;– computerised cognitive behavioural therapy (CCBT)|publisher = National Institute for Health and Care Excellence|date = 12 January 2012|access-date = 4 February 2012}}</ref> instead of face-to-face with a human therapist. It is also known as internet-delivered cognitive behavioral therapy or ICBT.<ref>{{cite journal | vauthors = Nordgren LB, Hedman E, Etienne J, Bodin J, Kadowaki A, Eriksson S, Lindkvist E, Andersson G, Carlbring P | display-authors = 6 | title = Effectiveness and cost-effectiveness of individually tailored Internet-delivered cognitive behavior therapy for anxiety disorders in a primary care population: a randomized controlled trial | journal = Behaviour Research and Therapy | volume = 59 | pages = 1–11 | date = August 2014 | pmid = 24933451 | doi = 10.1016/j.brat.2014.05.007 | doi-access = free }}</ref> CCBT has potential to improve access to evidence-based therapies, and to overcome the prohibitive costs and lack of availability sometimes associated with retaining a human therapist.<ref>{{cite journal | vauthors = Marks IM, Mataix-Cols D, Kenwright M, Cameron R, Hirsch S, Gega L | title = Pragmatic evaluation of computer-aided self-help for anxiety and depression | journal = The British Journal of Psychiatry | volume = 183 | pages = 57–65 | date = July 2003 | pmid = 12835245 | doi = 10.1192/bjp.183.1.57 | doi-access = free }}</ref><ref>{{Cite journal |title=What is digital health technology and what can it do for me? |url=https://evidence.nihr.ac.uk/collection/what-is-digital-health-technology/ |website=NIHR Evidence|year=2022 |doi=10.3310/nihrevidence_53447 |s2cid=252584020 }}</ref> In this context, it is important not to confuse CBT with 'computer-based training', which nowadays is more commonly referred to as [[e-Learning]].

Although improvements in both  research quality and treatment adherence is required before advocating for the global dissemination of CCBT,<ref>{{cite journal | vauthors = Heeren A | title = Commentary: The Impact of Digital Technology on Psychological Treatments and Their Dissemination | journal = Frontiers in Psychology | volume = 9 | page = 1571 | date = August 2018 | pmid = 30210401 | doi = 10.3389/fpsyg.2018.01571 | pmc = 6122262 | doi-access = free }}</ref> it has been found in meta-studies to be cost-effective and often cheaper than usual care,<ref name="journals.cambridge.org">{{cite journal | vauthors = Musiat P, Tarrier N | title = Collateral outcomes in e-mental health: a systematic review of the evidence for added benefits of computerized cognitive behavior therapy interventions for mental health | journal = Psychological Medicine | volume = 44 | issue = 15 | pages = 3137–3150 | date = November 2014 | pmid = 25065947 | doi = 10.1017/S0033291714000245 | s2cid = 25303848 }}</ref><ref>MoodGYM was superior to informational websites in terms of psychological outcomes or service use</ref> including for anxiety<ref>{{cite journal | vauthors = Adelman CB, Panza KE, Bartley CA, Bontempo A, Bloch MH | title = A meta-analysis of computerized cognitive-behavioral therapy for the treatment of DSM-5 anxiety disorders | journal = The Journal of Clinical Psychiatry | volume = 75 | issue = 7 | pages = e695–e704 | date = July 2014 | pmid = 25093485 | doi = 10.4088/JCP.13r08894 | s2cid = 40954269 }}</ref> and PTSD.<ref name="NIHR Evidence_2023">{{Cite journal |date=27 January 2023 |title=Online CBT for post-traumatic stress disorder is as effective as face-to-face therapy |url=https://evidence.nihr.ac.uk/alert/online-cbt-for-ptsd-is-as-effective-as-face-to-face-therapy/ |journal=NIHR Evidence|doi=10.3310/nihrevidence_56507 |s2cid=257844874 }}</ref><ref name="Bisson_2022">{{cite journal | vauthors = Bisson JI, Ariti C, Cullen K, Kitchiner N, Lewis C, Roberts NP, Simon N, Smallman K, Addison K, Bell V, Brookes-Howell L, Cosgrove S, Ehlers A, Fitzsimmons D, Foscarini-Craggs P, Harris SR, Kelson M, Lovell K, McKenna M, McNamara R, Nollett C, Pickles T, Williams-Thomas R | display-authors = 6 | title = Guided, internet based, cognitive behavioural therapy for post-traumatic stress disorder: pragmatic, multicentre, randomised controlled non-inferiority trial (RAPID) | journal = BMJ | volume = 377 | pages = e069405 | date = June 2022 | pmid = 35710124 | doi = 10.1136/bmj-2021-069405 | pmc = 9202033 | s2cid = 249679685 }}</ref> Studies have shown that individuals with social anxiety and depression experienced improvement with online CBT-based methods.<ref>{{cite journal | vauthors = Andrews G, Cuijpers P, Craske MG, McEvoy P, Titov N | title = Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: a meta-analysis | journal = PLOS ONE | volume = 5 | issue = 10 | pages = e13196 | date = October 2010 | pmid = 20967242 | pmc = 2954140 | doi = 10.1371/journal.pone.0013196 | bibcode = 2010PLoSO...513196A | doi-access = free }}</ref> A study assessing an online version of CBT for people with mild-to-moderate PTSD found that the online approach was as effective as, and cheaper than, the same therapy given face-to-face.<ref name="NIHR Evidence_2023" /><ref name="Bisson_2022" /> A review of current CCBT research in the treatment of OCD in children found this interface to hold great potential for future treatment of OCD in youths and adolescent populations.<ref name="Freeman2014" /> Additionally, most [[Internet Interventions for Posttraumatic Stress|internet interventions for post-traumatic stress disorder]] use CCBT. CCBT is also predisposed to treating mood disorders amongst non-heterosexual populations, who may avoid face-to-face therapy from fear of stigma. However presently CCBT programs seldom cater to these populations.<ref>{{cite journal | vauthors = Rozbroj T, Lyons A, Pitts M, Mitchell A, Christensen H | title = Assessing the applicability of e-therapies for depression, anxiety, and other mood disorders among lesbians and gay men: analysis of 24 web- and mobile phone-based self-help interventions | journal = Journal of Medical Internet Research | volume = 16 | issue = 7 | pages = e166 | date = July 2014 | pmid = 24996000 | pmc = 4115263 | doi = 10.2196/jmir.3529 | doi-access = free }}</ref>

In February 2006 NICE recommended that CCBT be made available for use within the [[National Health Service|NHS]] across England and Wales for patients presenting with mild-to-moderate depression, rather than immediately opting for antidepressant medication,<ref name="NiceTA97" /> and CCBT is made available by some health systems.<ref>{{cite web|url=http://www.devonpartnership.nhs.uk/uploads/tx_mocarticles/CCBT_Leaflet.pdf |archive-url=https://web.archive.org/web/20090504084624/http://www.devonpartnership.nhs.uk/uploads/tx_mocarticles/CCBT_Leaflet.pdf |archive-date=2009-05-04 |url-status=live|title=Devon Partnership NHS Trust: Home|publisher=NHS UK}}</ref> The 2009 NICE guideline recognized that there are likely to be a number of computerized CBT products that are useful to patients, but removed endorsement of any specific product.<ref>{{cite web |url = http://guidance.nice.org.uk/CG91/NICEGuidance/pdf/English|title = CG91 Depression with a chronic physical health problem|date = 28 October 2009|publisher = National Institute for Health and Care Excellence}}{{page needed|date = April 2013}}</ref>