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This post is by Monica Velici of Sparta Health

Smartphones, tablets, and computers are increasingly expanding the availability of health services. This means we can access help anonymously at a time and place that suits us.

Only about one-third of individuals with mental health difficulties get help. While there are multiple reasons for this, practical factors such as availability of health professionals, travel restrictions, time and financial constraints may limit access to mental health care. Individuals may also be hesitant to seek help, either because of worries about the stigma connected to mental illness or because of a preference to self-manage difficulties. While technology is not always a replacement for face-to-face treatment for mental health difficulties, it can offer increased choice and flexibility. It may also motivate individuals to take that first step in seeking help.

There is strong evidence that psychological therapy, particularly cognitive behavioural therapy, can be effectively delivered online to treat a range of mental health difficulties. Significant research has proved that cognitive behavioural therapy can be effective for treating a variety of mental health difficulties, such as anxiety, depression, and mood disorders. Additionally, individuals may not need to find a nearby therapist to reap the benefits. According to a recent meta-analysis published in  EClinicalMedicine journal, looking at 17 studies, cognitive behavioural therapy delivered online, was more effective compared to face-to-face therapy at reducing the severity of depression symptoms, with one study reporting reduced financial burden to patients (1).

This is not the first study to highlight the benefits of online treatment versus in-patient cognitive behavioural therapy. Research published in the Canadian Medical Association Journal argued that online cognitive behavioural therapy, combined with clinical care, was successful in treating depression, anxiety, and emotional distress in patients suffering with chronic illness (2).

Additionally, some research trials found that online therapy is as effective in reducing symptoms as therapy delivered face-to-face by a clinician. Evidence is particularly strong that anxiety, depression, and stress can be treated online. Research suggests that online therapy, for example email and video conferencing, can result in client satisfaction with both the therapy and the quality of their relationship with the therapist that is similar to levels of satisfaction with face-to-face therapy.

Who isn’t it suitable for?

Electronically delivered mental health services are not for everyone. Some people prefer the in-person dialogue with a health professional and some types of therapy rely on that rather than the use of structured treatment materials.

Some individuals do not feel confident about using computers or other technology, so trying to navigate an electronic service may increase their anxiety levels. Online treatment is generally less suited to more severe forms of mental illness, such as psychosis. But there are emerging developments in using technology in severe mental illness treatment, such as the use of iPads to use website resources within face-to-face therapy sessions with clients with psychosis.

Online treatment tends also to be less effective with largely physical problems rather than those related more to emotions, thoughts, and behaviours, but again there are exceptions to this. Many physical health conditions, such as cancer, have a psychological impact, which internet-based therapy can be effective in helping people cope with.

Digital mental health services are generally less suitable for people experiencing an immediate crisis. But, in some cases, an online service may be the only way a person is willing and able to reach out for help. People dealing with multiple mental health problems can often benefit more from a more personalised face-to-face approach – though web-based programs that tailor treatment to the individual’s reported symptoms are available.

About Monica Velici

Monica joined Sparta Health in February 2020 as part of the rehabilitation service support team. She has a degree in Psychology, an MSc in Clinical Neurodevelopmental Sciences, and a keen interest in dementia and mental health. Monica aims to become a fully accredited therapist.

References

  1. Luo et al., A comparison of electronically-delivered and face to face cognitive behavioural therapies in depressive disorders: A systematic review and meta-analysis, EClinicalMedicine (2020), doi:10.1016/j.eclinm.2020.100442
  2. Gratzer D, Khalid-khan F. Internet-delivered cognitive behavioural therapy in the treatment of psychiatric illness. CMAJ. 2016;188(4):263-272. doi:10.1503/cmaj.150007
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