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Research Assessment #4

Date​: 09 October 2020

Subject​: Internet Cognitive Behavioral Therapy for Depression

MLA: ​Citation: Webb, Christian A, et al. “Internet-Based Cognitive-Behavioral Therapy for

Depression: Current Progress and Future Directions.” Harvard review of psychiatry vol.

25,3 (2017): 114-122. DOI:10.1097/HRP.0000000000000139

Annotations: ​Here

Assessment​:

The article, “Internet-Based Cognitive-Behavioral Therapy for Depression: Current Progress and

Future Directions” discusses Internet Cognitive Behavioral Therapy (iCBT), a growing

and advancing psychotherapeutic source available through the internet. Unlike in

traditional therapy, users do not visit a therapist face-to-face and instead run their own

course online. This new technological advancement addresses the issue of accessibility

for lower-income individuals and those with geographical disadvantages. While research

proves iCBT decrease depressive symptoms, the main problem is that since evaluations

are self-diagnosed, many users drop out of the course. Emails, phone calls, and check-ups

have, therefore, been integrated into the programs to hold the patients more accountable.

As iCBT develops, psychologists will need to create more personalized features to

enhance the effectiveness of the therapy.

Through this article, I have gained a general understanding of how Internet Cognitive Behavioral

Therapy works and what effects it has on users. As more research surfaces, it seems to

have a positive trend towards becoming more effective for patients compared to iCBT
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prototypes as new technology and personalization are available. It is exciting to find out

that these programs provide a more accessible option with similar or the same benefits as

going to a therapist's office. However, I was surprised by the data that supports this

conclusion. With suicidal patients, for example, therapists are trained to detect specific

symptoms or sayings that indicate they may attempt. The computer I thought would lack

this attention to detail because they are not able to analyze their behaviors and quotes in

person. The article contradicts my theory, though, as these programs use passive data,

which includes speech patterns, social media activity, and the use of other apps, to

examine if the patient is in a depressive episode. I know that this tool could save lives,

but is it technically ethical? If users are not aware of the data these iCBT programs are

using to detect their mental health, and when they find out, could this cause paranoia or

other effects? If I used this in my app, I would need to disclose the usage in a way that

would not drive away customers.

iCBT, in both its techniques and effects, offers more similarities to classic CBT than differences.

iCBT seeks to teach their patients why they are thinking and behaving a certain way, then

assigns homework to apply it to their situation. The format follows what I have studied

previously about face-to-face therapy. The principle that maladaptive thoughts can be

adjusted to produce better behavior is cohesive in both compositions. The fundamental

difference between the two is how the client and therapist interact, assuming the iCBT

even does so. While it does have its limitations, as stated previously, it is essential to

recognize the positive possibilities. In modern times, internet access is available to nearly

all incomes and geographies. However, therapy does not have the same reach, as it can be
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too expensive or far away. Another issue is the stigma of attending therapy, which often

drives people away from seeking the help they need. iCBT is designed to overcome all of

these obstacles to increase accessibility. I think that these programs can help address the

stated issues globally and help more people prioritize their mental health. Anxiety and

depression levels have been at an all-time high, especially with children and teens. By the

young generation's connection with social media, iCBT, as well as advertising mental

health on these platforms, will reach these users better than on websites or

mouth-to-mouth. The increased use of mobile phones will also provide CBT teachings

and homework through a more manageable design that people can access quicker. I

believe iCBT is the modern solution to the lack of mental health treatment and will grow

to become a source for everyone across the world.

The research I conducted is relevant to me because I hope to create a Cognitive Behavioral

Therapy app as my original work. I planned to include informational courses over CBT,

interactive homework options, a way to communicate with a therapist, and motivational

elements to drive patients to continue their journey. The article, though, has shown me

components of iCBT that could improve my design if I were to incorporate them. For

example, data shows that when therapists reach out to users via email, call, or text, they

are more likely to stick with the program. I want to use this research to create my own

system that keeps patients obligated to finish. More importantly, the article introduced me

to the current drawbacks and complications found in iCBT programs. The first issue is

the drop rate. Without the guidance of an actual therapist, patients do not feel as

motivated to complete the program in its entirety. After brainstorming ideas on how to
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decrease this, I thought that a game or reward system would work. If completing

homework or lessons would earn users points towards something, then maybe they would

want to continue working through the app, and subsequently receiving the help they need.

I think that this would differentiate my app because it is both healthful and entertaining. It

could also be useful when dealing with children, as the game component will help them

learn better and by interacting with the program. The second issue I hope to address is by

increasing the number of people who find iCBT appealing. Demographics reveal that

specific types of people are more likely to succeed than others. For users that find it most

effective are women, people with higher educations, people with higher depressive

severity, and single people. I want to improve effectiveness for those who do not fit these

categories by examining what attracts or helps them. Through this research, I want to add

in these elements to improve the success rate of my app.

The article leaves me with a few questions: Are iCBT programs able to adapt to new or

worsening systems? If the programs continue to grow in popularity, how will they be able

to provide personalized and check-ins with therapists to all users? The questions I have

are more related to the system than the psychology of iCBT because I know little about

programming right now. I hope to conduct more research to increase my knowledge to

help me create an app that can benefit all walks of life. I also want to find a therapist plan

so that I can better understand the steps patients take towards recovery, and therefore I

can incorporate them into my system.