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

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21–30 of 41 posts

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

#21

"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 thou…

I think you're misreading the results.

> 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 if "usual GP care" is the baseline, online CBT doesn't add to that baseline.

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

#22

"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 thou…

[deleted]

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

#23

"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 thou…

The title is confusing. The article describes that the addition of CBT to the usual care did not improve the outcomes. I would suspect that for these types of illnessss it would be unethical not to prescribe regular care.

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

#24
post #18

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

#26

As I recall, some influential people in NICE and/or the NHS really wanted this to work because it's vastly cheaper and more available than in-person CBT. This result is consistent with a longstanding but controversial hypothesis that the overall quality of the therapist-client relationship is far more important than the nuts and bolts of whatever theory the therapist follows [1]. [1] https://en.wikipedia.org/wiki/Dod…

I recall something that supports this hypothesis.

there is good evidence that merely _reading_ the book "feeling good" by David burns (father of CBT) is as effective as medication.

this indicates the relationship matters, because we're talking about people who didn't _act_ on the book, but merely _read_ it.

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

#28
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…

I think a large part of that is due to the fact that CBT therapy can feel patronising to a lot of people.

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

#29
post #9
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…

> But I still wonder if online CBT was effective for the small portion of participants who did complete it? MoodGym and Beating the Blues have some evidence behind them. NICE was recommending Beating the blues because they have some evidence of efficacy for it. Maybe there's a simple fix. Something like Flo to keep people engaged with it, or some kind of gamifaction. http://www.health.org.uk/flo Or maybe Recovery Col…

> NICE was recommending Beating the blues because they have some evidence of efficacy for it.

You know how 'traditional chinese medicine' came about? Mao needed to invent something to give to the peasants that wasn't expensive as real health care.

http://www.slate.com/articles/health_and_science/medical_exa...

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

#30
post #9

Earlier quoted context omitted.

> But I still wonder if online CBT was effective for the small portion of participants who did complete it? MoodGym and Beating the Blues have some evidence behind them. NICE was recommending Beating the blues because they have some evidence of efficacy for it. Maybe there's a simple fix. Something like Flo to keep people engaged with it, or some kind of gamifaction. http://www.health.org.uk/flo Or maybe Recovery Col…

> NICE was recommending Beating the blues because they have some evidence of efficacy for it. You know how 'traditional chinese medicine' came about? Mao needed to invent something to give to the peasants that wasn't expensive as real health care. http://www.slate.com/articles/health_and_science/medical_exa...

You can read the evidence that NICE has.
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