Abstract

Objective: Technology can provide affordable, accessible mental health care and some research suggests internet-delivered Cognitive Behavior Therapy (iCBT) can be an effective treatment for various problems and can be an affordable, accessible alternative to traditional treatments. Advantages of iCBT over face-to-face therapy include lower cost, no travel time, easy access, no waitlists, and trackable progress. To our knowledge there have been no studies of iCBT programs used during the course of routine care. This study evaluated the usage and effectiveness of one iCBT program, SilverCloud (SC), in a university counseling center. Methods: Participants (N = 5568) were students at a large, private western university. Participants were either self-referred to the program, chose to enroll at intake as a standalone intervention, or were referred by their treating clinician as an adjunct to regular treatment. Data was analyzed using regression models with robust standard errors that allowed us to take into account the fact that there may be an effect of participants seeing the same therapist. Results: Results indicated that all three groups had comparable outcomes. However, usage was generally low (less than 10% of the program) and SC usage accounted for less than 1% of the variance in outcome. Conclusions: These results suggest that internet-delivered therapy may be a viable alternative to in-person therapy.

摘要

目的：技术可以提供负担得起的，可及的精神保健服务，一些研究表明，互联网提供的认知行为疗法（iCBT）可以有效地解决各种问题，并且可以替代传统疗法，且负担得起，可及。与面对面治疗相比，iCBT的优势包括成本更低，无需出行时间，使用方便，无需等待清单以及可追踪的进度。据我们所知，尚未进行常规护理过程中使用的iCBT计划的研究。这项研究评估了大学咨询中心中一项iCBT计划SilverCloud（SC）的使用和有效性。方法：参与者（N = 5568）是一所大型私立西方大学的学生。参与者要么自我介绍该计划，要么选择入院时作为独立干预措施，或者由其治疗临床医生推荐作为常规治疗的辅助手段。使用具有可靠标准误差的回归模型对数据进行了分析，这使我们能够考虑到这样的事实，即参与者看到同一位治疗师可能会产生影响。结果：结果表明，三组均具有可比的结果。但是，使用率通常较低（不到程序的10％），而SC使用率则不到结果差异的1％。结论：这些结果表明，互联网提供的疗法可能是替代亲自疗法的可行选择。