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Computer-Aided Psychotherapy for Anxiety Disorders: A Meta-Analytic Review

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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.

Keywords: Computer-aided psychotherapy; Internet therapy; anxiety disorders; meta-analysis

Document Type: Research Article


Affiliations: 1: Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands 2: Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands,Institute of Psychiatry, King's College London, London 3: School of Psychology, University of Newcastle and Northumberland, Newcastle-upon-Tyne, UK 4: School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK 5: Department of Behavioural Sciences and Learning, Linkoping University, Linkoping,Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden

Publication date: June 1, 2009

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