title: Computer-assisted cognitive therapy for depression: maintaining efficacy while reducing therapist time.
abstract: OBJECTIVE
  The aim of this investigation was to compare the efficacy of computer-assisted cognitive therapy against standard cognitive therapy and a control group without treatment for outpatients with nonpsychotic major depressive disorder.
  
  
  METHODS
  Medication-free participants (N=45) with major depressive disorder were randomly assigned to cognitive therapy (N=15), computer-assisted cognitive therapy (N=15), or a wait list (N=15). Both active treatments consisted of nine sessions over 8 weeks. Therapist time was reduced after the first visit for computer-assisted cognitive therapy, with 25-minute sessions rather than 50-minute sessions. Assessments were completed pretreatment, after 4 and 8 weeks of therapy, and 3 and 6 months posttreatment.
  
  
  RESULTS
  Computer-assisted cognitive therapy and standard cognitive therapy were superior to the wait list control group for treatment of depression and did not differ from each other on the primary outcome variables. Very large between-group effect sizes were observed. Improvement in depression for both computer-assisted cognitive therapy and standard cognitive therapy was maintained at the 3- and 6-month follow-up evaluations. Computer-assisted cognitive therapy had more robust effects, relative to being wait-listed, than standard cognitive therapy in reducing measures of cognitive distortion and in improving knowledge about cognitive therapy.
  
  
  CONCLUSIONS
  A multimedia, computer-assisted form of cognitive therapy with reduced therapist contact was as efficacious as standard cognitive therapy. Computer-assisted therapy could decrease costs and improve access to cognitive therapy for depression.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY 40232, USA. jwright@iglou.com
authors.forename: Jesse H
authors.initials: JH
authors.lastname: Wright
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Wright
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Albano
authors.forename: Monica R
authors.initials: MR
authors.lastname: Basco
authors.forename: L Jane
authors.initials: LJ
authors.lastname: Goldsmith
authors.forename: Troy
authors.initials: T
authors.lastname: Raffield
authors.forename: Michael W
authors.initials: MW
authors.lastname: Otto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000191:economics / Q000379:methods*; D003865:Major Depressive Disorder / Q000191:economics / Q000523:psychology / Q000628:therapy*; D005260:Female; D017048:Health Care Costs; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D010817:Physician-Patient Relations; D011569:Psychiatric Status Rating Scales; D013813:Therapy, Computer-Assisted; D013997:Time Factors; D016896:Treatment Outcome