A new study from the University of Regina finds that people suffering from anxiety and depression can benefit from receiving therapist-assisted treatment over the Internet, even when communication with an actual therapist is considered optional.
A serious public health concern, mental illness is said to affect one in five Canadians at some time in their lives. Aside from the personal costs of anxiety and depression, the social costs are high, with research last year from the Conference Board of Canada showing that depression is associated with a $32.3 billion a year loss in gross domestic product while the effects of anxiety cost an added $17.3 billion a year.
Typical treatment options for both anxiety and depression involve both pharmacological and psychological/therapeutic resources, with cognitive behavioural therapy now the most widely used approach to address mental health issues. And while CBT, which aims to change a patient’s negative or unhealthy thought patterns through guided exercises and practice, has a proven track record, access to effective face-to-face treatment is a hindrance for some.
Hence the value in Internet-delivered cognitive behavioural therapy (ICBT), which gives patients access to treatment materials and exercises through a week-by-week program, often complemented by brief but regular contact with an actual therapist to help support their progress. Moreover, studies have shown that ICBT actually works — people who make use of such programs see improvements in their mood and symptoms.
“Reviews of the ICBT literature are encouraging, especially for improvements in depression and anxiety,” say the authors, researchers in the Department of Psychology at the University of Regina. “While these results are promising, finite resources is a limiting factor in meeting demand for mental health services.”
To that end, there are options available which require less investment of the therapist’s time, one being self-guided ICBT and another being ICBT with optional therapist support. For the current study, researchers looked at the latter option, enrolling 180 patients in an ICBT program, roughly half of whom followed a standard program with weekly interaction with a therapist while the other half followed a program with optional weekly support.
The results showed that the optional group had a lower program completion rate compared to the standard group (56.6 per cent versus 82.4 per cent), yet for those who did complete the optional program, ICBT treatment proved just as effective.
“Despite lower levels of therapist support, those receiving optional weekly therapist support showed large symptom improvements comparable to those receiving standard weekly therapist support on measures of depression,” say the researchers.
The study found that those in the optional support program tended to send fewer and briefer messages to their therapist, yet in a post-treatment follow up, a survey found that satisfaction with treatment was similarly high for participants in both program streams.
“From a systems perspective, optional support could reduce time, and therefore costs, to deliver ICBT,” say the researchers. “Feedback from therapists suggests that substantial time is spent writing to patients who are enrolled in ICBT, but who do not respond to therapist support.”
The new study was published in the Journal of Anxiety Disorders.