For those of us who don't know: CBT - Cognitive Behavioral Therapy GP - General practitioner (normal doctor?)
Yeah, "general practitioner" in the UK = "primary care physician" or "family doctor" in other countries, more-or-less.
Online CBT is no more effective than usual GP care for depression
31–40 of 41 posts
Re: Online CBT is no more effective than usual GP care for depression
#32Earlier 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...
Really off topic, and I'm probably being pedantic, but I don't see the conclusion that you've given from what's presented in the article, re: blaming Mao for the modern ideology that perpetuates chinese medicine. I mean, it's true that a dialectical approach would probably lead to the adoption of most ideologically useful form of medicine, but a distinct separation of 'chinese medicine' and 'western medicine' seems directly antithetical to what Mao was saying... the fact that Mao wanted to address rural/traditional medicine and integrate into a medical tradition doesn't imply that Mao is the reason for orientalism and mysticism with regard to that medicine, especially since those things obviously far predate Mao.
Re: Online CBT is no more effective than usual GP care for depression
#33Earlier 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...
This is obviously refuted by the fact that Chinese ex-pats associated with the KMT in Taiwan (i.e. the very people who fled Mao) have been practicing "traditional Chinese Medicine" to varying degrees since their pre-Mao childhoods. To believe that Slate article is to believe that somehow Chinese herb shops appeared in Taiwan in response to propaganda from either Mao or the US Government and that these peoples' childhood memories were subsequently "revised". That makes absolutely no sense.
Edit: Perhaps what you mean is that the Western notion of Chinese medicine as a viable alternative to Western medicine was invented by Mao? That might have some shred of truth. But it's a very narrowly defined truth, and a very semantic one.
Re: Online CBT is no more effective than usual GP care for depression
#34If the GP care was ineffective, of course the CBT modeled after that care was equally ineffective. To expect any different is just silly.
I would be interested to see a study of obvious alternatives - perhaps an online interactive exercise program, something that provided a positive social interaction, or how the use of a sleep tracker could affect depression.
Re: Online CBT is no more effective than usual GP care for depression
#35The 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…
Completion dates are low much like for reasons that completion dates for MOOCs are low.
I have a scheduled time and place for meeting a doctor. Not going will inconvenience many people, so there's a lot of social pressure to go. I've already put it in my calendar, so mentally I've accepted that I'll be doing this for a couple hours. When I go, the next meeting will be scheduled, locking me into a virtuous cycle of commitment.
An online thing I can do on my own time? Ha! We've gotten pretty good at ignoring reminder emails, no set time was put into place, and there's no set rhythm.
The "right" way to test the effectiveness of the program is to still get people scheduled to go to a doctor's office, but instead of talking to a doctor, you use a computer (and schedule the next visit).
For people like me, the main advantage of college wasn't access to the professor's, it's the set timeframe, place, and penalties for not showing up. Same sort of thing applies here I think
Re: Online CBT is no more effective than usual GP care for depression
#36Earlier quoted context omitted.
> 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...
This is obviously refuted by the fact that Chinese ex-pats associated with the KMT in Taiwan (i.e. the very people who fled Mao) have been practicing "traditional Chinese Medicine" to varying degrees since their pre-Mao childhoods. To believe that Slate article is to believe that somehow Chinese herb shops appeared in Taiwan in response to propaganda from either Mao or the US Government and that these peoples' childh…
Revision of distant childhood memories is very common. We all trust our memories too much, especially in a legal context. Childhood memories are just as, if not more, malleable.
It's more useful to think of memories as Michael Bay's version of "Pearl harbor".
Re: Online CBT is no more effective than usual GP care for depression
#37Earlier quoted context omitted.
This is obviously refuted by the fact that Chinese ex-pats associated with the KMT in Taiwan (i.e. the very people who fled Mao) have been practicing "traditional Chinese Medicine" to varying degrees since their pre-Mao childhoods. To believe that Slate article is to believe that somehow Chinese herb shops appeared in Taiwan in response to propaganda from either Mao or the US Government and that these peoples' childh…
Revision of distant childhood memories is very common. We all trust our memories too much, especially in a legal context. Childhood memories are just as, if not more, malleable. It's more useful to think of memories as Michael Bay's version of "Pearl harbor".
Yes. But it's one thing to question whether the chicken soup your mother made used canned or homemade stock. It's quite another to question whether she ever actually made chicken soup when you were sick, and then repeat that for the millions of other people who remember having chicken soup.
Re: Online CBT is no more effective than usual GP care for depression
#38As 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.
A link for that would be appreciated.
Re: Online CBT is no more effective than usual GP care for depression
#39The 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…
Hey, any chance you'd be open to telling me a bit about what you're working on? I'm on a bit of a... journey to get beyond the 'shitty contract webdev work', and the direction I'm looking to go is technology applied to psychology (therapy and/or lifestyle, in particular). My first thought was also some CBT-related app.
Re: Online CBT is no more effective than usual GP care for depression
#40Earlier quoted context omitted.
> 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…
Hey, any chance you'd be open to telling me a bit about what you're working on? I'm on a bit of a... journey to get beyond the 'shitty contract webdev work', and the direction I'm looking to go is technology applied to psychology (therapy and/or lifestyle, in particular). My first thought was also some CBT-related app.
Sure. Well, It's an app to help you be a better person of your own design. CBT is one of the libraries to choose from, but there are others for leadership, relationships, health and so forth.
Hrm, I would not identify it as an appification of CBT - You can use it to help implement CBT or other behavioral/cognitive changes, but the actual understanding would need to be done previously, to get the most benefit. Although I suppose even without any previous knowledge or awareness, some value could be derived.