Assessing the success of internet-based cognitive behavioral therapy

Physician, researcher and scientist Dr. Jorge Palacios explains how this style of care works and how it can help combat today's mental healthcare crisis.
By Bill Siwicki
11:55 AM

Dr. Jorge Palacios, senior digital health scientist at SilverCloud Health

Photo: SilverCloud Health

Cognitive behavioral therapy, known more commonly in psychological circles as CBT, can lead to great success in changing problematic thinking and behavior in patients.

"Cognitive behavioral therapy is a form of psychological treatment that has been demonstrated to be effective for a range of problems including depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders, and severe mental illness," according to the American Psychological Association.

"Numerous research studies suggest that CBT leads to significant improvement in functioning and quality of life," the association continued. "In many studies, CBT has been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications."

Dr. Jorge Palacios, senior digital health scientist at SilverCloud Health, part of Amwell, leads research for SilverCloud and has authored many peer-reviewed research papers that underscore the clinical validity of internet-based CBT.

Recent research is validating internet-based CBT as a quality care approach, Palacios noted. We sat down with him to discuss exactly what internet-based CBT is and its potential importance in combating the mental health crisis today.

Q. In a nutshell, what is CBT? Further, please explain internet-based CBT.

A. CBT is a therapeutic approach that centers around the connection between one's thoughts, emotions and behaviors. CBT aims to alleviate symptoms of anxiety and depression by disrupting negative thoughts and feelings while empowering patients to navigate their current challenges.

Internet-based CBT applies the same principles, but through a digital delivery via smartphone, tablet or computer. Internet-based CBT has been clinically proven to be an effective treatment option for people with mild to moderate symptoms of anxiety and depression.

Q. You have authored many peer-reviewed research papers that underscore the clinical validity of internet-based CBT. Please describe how your research has proven clinical validity.

A. Internet-based CBT has been shown to be an effective tool for managing mental health issues, and is backed by dozens of trials and peer-reviewed research, including a study featured in the Journal of Anxiety Disorders that highlights how computer therapy for anxiety and depression disorders is an effective and acceptable practice of healthcare.

In the U.K., the vast amount of research has led internet-based CBT interventions to be officially recommended by the National Institute for Health and Care Excellence as a treatment alternative for depression and anxiety.

One of our randomized controlled trials, published in Nature's npj Digital Medicine, found that our internet-based CBT programs were both effective and potentially cost-effective in treating depression and anxiety.

Specifically, the study examined SilverCloud Health internet-based CBT programs and found that more than half of participants with a diagnosis of anxiety and/or depression recovered after three months of treatment, with many continuing to improve over the course of 12 months, highlighting the long-term benefits of internet-based CBT.

The research emphasizes how digital cognitive behavioral therapy as part of the wider spectrum of psychological care can deliver strong clinical improvements and promote recovery.

As a medical doctor, researcher and scientist by training, I am passionate about increasing access to effective digital and behavioral health solutions for all that are based on high-quality evidence. I understand that in the medical field, doctors are taught to make evidence-based solutions, and therefore we must hold the tools and technologies we put in front of them to the same standards.

Ongoing clinical research is therefore critical in the digital health space to continue empowering practitioners to make the best decisions for their patients.

Q. You suggest the importance of using internet-based CBT to combat the mental health crisis. How can it help?

A. The pandemic has only exacerbated the ongoing mental health crisis in the U.S. and across the world. And even as restrictions loosen in some places, many people continue to face isolation, depression, anxiety, grief, job loss and insecurity.

According to the Kaiser Family Foundation, 31.5% of U.S. adults reported symptoms of anxiety or depressive disorder just as recently as the time frame between March 2, 2022, and March 14, 2022.

While the pandemic has affected people of all ages, young people have been especially hard hit. This fact is highlighted by a recent CDC study that found that "more than a third of high school students reported they experienced poor mental health during the COVID-19 pandemic, and 44% reported they persistently felt sad or hopeless during the past year."

As the prevalence of mental health issues grows, we are seeing a shortage of mental health providers to handle the influx of patients. This in turn has led to a highly capacity-strained industry that I predict will only continue to worsen in the years ahead if we don't figure out a solution.

During a time where healthcare providers face unprecedented demand, internet-based CBT provides accessible, effective, clinically proven support for people with mild to moderate symptoms. This in turn alleviates wait times, frees up capacity and addresses other potential barriers to care such as stigma and transportation issues.

Internet-based CBT offers a user-friendly, on-demand solution that protects patient privacy and allows the user to get immediate help from the comfort and convenience of his or her home.

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.

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