A new atudy finds that an online computerized cognitive behavioral therapy (CCBT) program both alone and in combination with Internet Support Groups (ISG) is more effective than doctors for anxiety and depression.

The randomized trial, led by Bruce L. Rollman, M.D., M.P.H., professor of medicine and director of the Center for Behavioral Health and Smart Technology at the University of Pittsburgh, enrolled 704 depressed and anxious patients from 26 UPMC-affiliated primary care offices across western Pennsylvania. Patients 18 to 75 years old were referred into the trial by their UPMC primary care physician between August 2012 and September 2014. Eligible and consenting patients were then randomized to one of three groups: care manager-guided access to the eight-session Beating the Blues CCBT program; care manager-guided access to both the CCBT program and a password-protected ISG patients could access 24/7 via smartphone or desktop computer; or usual behavioral health care from their primary care physician.

Over the six-month intervention, 83 percent of patients randomized to CCBT started the program, and they completed an average of 5.3 sessions. Seventy-seven percent of patients assigned to the ISG logged into the site at least once, and 46 percent provided one or more posts or comments. Six months later, those patients randomized to CCBT reported significant improvements in their mood and anxiety symptoms and the more CCBT sessions patients completed, the greater the improvement in mood and anxiety symptoms.  

Although patients randomized to both CCBT and ISG had similar overall improvements in mood and anxiety symptoms compared to patients randomized to only CCBT, secondary analysis revealed those who engaged more with the ISG tended to experience greater improvements in symptoms.

Several CCBT programs have proven as effective as face-to-face cognitive behavioral therapy at treating mood and anxiety disorders and are used by many patients outside the U.S., but CCBT remains largely unknown and underutilized within the U.S., Dr. Rollman said. ISG that enable individuals with similar conditions to access and exchange self-help information and emotional support have proliferated in recent years, but benefits have yet to be established in randomized trials.

Still, his is good news for doctors, who can treat patients with conditions a little easier to define.