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Online CBT is no more effective than usual GP care for depression

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11–20 of 41 posts

Re: Online CBT is no more effective than usual GP care for depression

#11
to echo df3's point: this study showed that online CBT wasn't that helpful but didn't couldn't tell if it was a compliance issue or a modality issue.

This is a classic problem in drug trials as well: you get data on how the drug works in a controlled setting (when the patients are monitored) but in the real world: do people take their meds reliably?

It may be that many people suffering depression benefit from the (not specifically trained -- this is the point) GP talking to them as a forcing function. The diet companies know this well.

Re: Online CBT is no more effective than usual GP care for depression

#12
post #5

The study did not seem to separate the results of those who completed online CBT from the majority who did not. An interesting excerpt: "Take-up of computerised CBT was low, despite regular calls to encourage participants to use the programmes. The median number of sessions completed was two out of eight for Beating the Blues and one out of six for MoodGYM. Only 18% of people who started Beating the Blues completed a…

> despite regular calls to encourage participants to use the programmes

People aren't going to use it if it sucks or isn't giving them value. I looked into Beating the Blues a while ago - it's not exactly a great experience. Being reminded just isn't enough.

> Can an app do a substantially better job than books?

I think so.

Books are passive content that you consume in your own time. And, it certainly is helpful. But an app can do so much more towards offering a much richer, more engaging experience. But - and this is crucial - you have to get it right. And I think it is MUCH easier to get a book right, than an app. A book is just the content - an app is a manifestation of that content; if the book could talk, what would it say? ask? how would it do it and how often?

We'll see. My side project is to scratch some CBT & behavioral itches I have had with an app. I could be entirely wrong, but I wont know till I finish and see if it is of use for me.

Re: Online CBT is no more effective than usual GP care for depression

#13
post #7
post #6

Couldn't the headline read: "Online CBT as effective as usual GP care for depression"?

The online stuff was in addition to GP care, not in lieu of it.

>>The online stuff was in addition to GP care, not in lieu of it.

And it made no difference.

From the article: >> There was no significant difference between usual GP care, Beating the Blues plus usual care, or MoodGYM plus usual care at four, 12 or 24 months.

So I would say there was no indication that the online CBT was of any benefit whatsoever.

Re: Online CBT is no more effective than usual GP care for depression

#14
post #5

The study did not seem to separate the results of those who completed online CBT from the majority who did not. An interesting excerpt: "Take-up of computerised CBT was low, despite regular calls to encourage participants to use the programmes. The median number of sessions completed was two out of eight for Beating the Blues and one out of six for MoodGYM. Only 18% of people who started Beating the Blues completed a…

> despite regular calls to encourage participants to use the programmes People aren't going to use it if it sucks or isn't giving them value. I looked into Beating the Blues a while ago - it's not exactly a great experience. Being reminded just isn't enough. > Can an app do a substantially better job than books? I think so. Books are passive content that you consume in your own time. And, it certainly is helpful. But…

Is beating the blues free? Is it any good? I mean, you seem to say it's not too good, but it has to be of any use... No?

Re: Online CBT is no more effective than usual GP care for depression

#15
post #7

Earlier quoted context omitted.

The online stuff was in addition to GP care, not in lieu of it.

>>The online stuff was in addition to GP care, not in lieu of it. And it made no difference. From the article: >> There was no significant difference between usual GP care, Beating the Blues plus usual care, or MoodGYM plus usual care at four, 12 or 24 months. So I would say there was no indication that the online CBT was of any benefit whatsoever.

Or that both hit the ceiling on CBT effectiveness.

Re: Online CBT is no more effective than usual GP care for depression

#17

Earlier quoted context omitted.

>>The online stuff was in addition to GP care, not in lieu of it. And it made no difference. From the article: >> There was no significant difference between usual GP care, Beating the Blues plus usual care, or MoodGYM plus usual care at four, 12 or 24 months. So I would say there was no indication that the online CBT was of any benefit whatsoever.

Or that both hit the ceiling on CBT effectiveness.

There was no indication of that either.

Re: Online CBT is no more effective than usual GP care for depression

#18
I can recommend:

1. Mindful meditation [free] -> Daily practice (30+ minutes)

John Kabat-Zinn [0] masters the link between science and meditation and has published very valuable books (including guided/audio meditation exercises) [1]. There are a couple of scientific studies which prove effectiveness [2] [3].

2. LSD [$5-10/dose + $25/multi-use test kit] -> One-time experience (every 6 months max.)

Benefits (mid- and long-term) are similar to those of meditation. It however requires one to literally read/understand/know everything about the substance before applying it (minimum literature: "The psychedelic explorer's guide" by Fadiman). Also, order a test kit and test before you ingest. Certain "edge cases"/people should not try it. In addition, you may be able to access your spiritual dimension, which increases quality of life even further (it is less immediate with meditation).

You may combine micro-dosing LSD with meditation for accessing the meditative state easier (it's quite a challenge for depressed people).

[0] https://en.wikipedia.org/wiki/Jon_Kabat-Zinn

[1] https://thepiratebay.org/torrent/4180277/Mindful_Way_Through...

[2] http://news.harvard.edu/gazette/story/2011/01/eight-weeks-to...

[3] http://www.vox.com/2015/8/27/9214697/meditation-brain-neuros...

Re: Online CBT is no more effective than usual GP care for depression

#20
"is no more effective than usual"

Hm, interesting phrasing.

Is this another way of saying "was found to be just as effective as the more expensive standard treatment"?

> There was no significant difference between usual GP care, Beating the Blues plus usual care, or MoodGYM plus usual care at four, 12 or 24 months.

No significant difference, so it's every bit as good.

> CBT delivered online or via a computer was thought to offer a potential low-cost alternative.

And it costs less.

So yes, they found it is less expensive and works just as well as the standard treatment, but choose to phrase it in a way to indicate the study had failed by saying "is no more effective" which misleadingly implies it might be less effective, rather than the more accurate "is just as effective", which is more clear and accurate given that there was "no significant difference".

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