In findings that could revolutionise the way psychologists treat their patients, researchers at the University of New South Wales (UNSW) and St Vincent’s Hospital have shown online treatments are just as effective as face-to-face therapies for a wide range of common mental disorders.
Anxiety, social phobias and depression are all conditions that respond well to clinician-supported internet-based treatments, the researchers found, with program participants recording recovery rates comparable to those in face-to-face therapy.
Moreover, the online sessions were significantly more cost-effective than traditional treatments, and required as little as a quarter of the amount of clinician time.
Separate randomised controlled trials have now been conducted targeting depression (the Sadness program), generalised anxiety disorder (Worry program) and social phobias (Shyness program). The studies were undertaken by Professor Gavin Andrews and Dr Nick Titov, from UNSW’s School of Psychiatry and The Virtual Clinic at Sydney’s St Vincent’s Hospital.
A paper outlining the results of the latest generalised anxiety disorder (GAD) trial appears next month in the Australian and New Zealand Journal of Psychiatry.
The researchers say the initial pilot investigations were so successful participants are now being sought for new, larger trials of the Worry and Shyness programs. The clinic expects to have treated more than 1,200 people in online trials by the end of the year.
Dr Titov said the results achieved by all three programs - which involved simple online lessons, regular emails and online discussion forums - surprised everyone involved.
“After completing the various programs, more than 70 per cent of participants diagnosed with generalised anxiety disorder no longer met that diagnostic criteria. In the Shyness program 85 per cent of participants recorded good improvement in their scores on measures of social phobia, and more than a third of depressed patients no longer met the criteria to be diagnosed as clinically depressed,” Dr Titov said.
While the internet programs may never completely replace face-to-face therapies, they have the potential to significantly enhance the capacity of existing services, Dr Titov said.
In the latest GAD trial, a clinical psychologist spent just two hours by email with each patient over 10 weeks of the program, about a quarter of the time a clinician would spend in traditional face-to-face treatments.
Dr Titov said the online programs represented a new cost-effective way of reaching people who are otherwise unable to access treatments.
“Only 35 per cent of people with anxiety or depression seek treatment over a 12 month period, and only one in 10 sees a psychologist,” he said. “Internet-based programs may play an important role in increasing those numbers.”
The researchers said it was still unclear why the internet programs were so effective.
“We think it’s partly because our programs are highly structured and involve people working systematically through a series of lessons and homework assignments, guided by clinical comment,” he said.
“It’s really about empowering people to be their own therapist, or supporting people to develop the confidence to get more specialised face-to-face treatment after they finish,” Dr Titov said.
Anyone interested in participating in the clinic’s next Worry and Shyness programs should go to the Virtual Clinic website.