Computer-aided psychotherapy for anxiety disorders: a meta-analytic review.
Computer-aided psychotherapy (CP) is said to (1) be as effective as face-to-face psychotherapy, while requiring less therapist time, for anxiety disorder sufferers, (2) speed access to care, and (3) save traveling time. CP may be delivered on stand-alone or Internet-linked computers, palmtop computers, phone-interactive voice response, DVDs, and cell phones. The authors performed a meta-analysis of 23 randomised controlled studies (RCTs) that compared CP with non-CP in anxiety disorders: phobias, n = 10; panic disorder/agoraphobia, n = 9; PTSD, n = 3; obsessive-compulsive disorder, n = 1. Overall mean effect size of CP compared with non-CP was 1.08 (95% confidence interval: 0.84-1.32). CP and face-to-face psychotherapy did not differ significantly from each other (13 comparisons, d = -0.06). Much caution is needed when interpreting the findings indicating that outcome was unrelated to type of disorder, type of comparison group, mode of CP delivery (Internet, stand-alone PC, palmtop), and recency of the CP system and that effect size decreased when more therapist time was replaced by the computer. Because CP as a whole was as effective as face-to-face psychotherapy, certain forms of CP deserve to be integrated into routine practice.
Cuijpers
Pim
P
Department of Clinical Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, Amsterdam, The Netherlands. P.Cuijpers@psy.vu.nl
Marks
Isaac M
IM
van Straten
Annemieke
A
Cavanagh
Kate
K
Gega
Lina
L
Andersson
Gerhard
G
D001008:Anxiety Disorders / Q000628:therapy*; D006801:Humans; D011613:Psychotherapy / Q000295:instrumentation*; D013813:Therapy, Computer-Assisted / Q000379:methods*