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Review of computerised cognitive behavioural therapies

Products and outcomes for people with mental health needs

by Joanna Hofman, Alexandra Pollitt, Miriam Broeks, Katherine Stewart, Christian Van Stolk

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Research Questions

  1. What are the tools, platforms and applications that provide assessment and support for mental health needs that are currently offered on the market?
  2. How are these tools characterised in terms of the channels they use to transmit the information, their characteristics of support and functionalities?
  3. What is the available evidence on the effectiveness of these tools to tackle mental health and employment outcomes?

Common mental health problems, such as depression, anxiety, and other disorders, affect many people and incur increasing costs to individuals, employers, and government. Several challenges have been identified in the provision of public services for people with common mental health problems.

A previous study by RAND Europe suggested that providing access to online mental health assessment and support and building on computerised cognitive behavioural therapy (cCBT) interventions could help reach out to the general population and, in particular, those less likely to seek help elsewhere. This study explores online platforms and mobile applications that offer cognitive behavioural therapy (CBT) for people with mental health needs.

Overall, this review shows that a variety of cCBT products exist which differ both in terms of the conditions products aim to address and the ways in which platforms are designed. The tools offer support through a varying number of modules (or lessons) clustered around specific issues that need to be addressed. The number of modules offered by the tools differs slightly by condition: platforms for anxiety disorders and insomnia are on average lengthier, with a median number of modules of 9 and 8 respectively, compared to those for depression in which the median is 6.5. The majority of tools use a linear structure and offer at least some additional guidance, although the intensity of this extra support is typically low.

Key Findings

Mental health outcomes

  • The review found that the cCBT tools appear to have a positive effect on mental health outcomes, although this varies depending on the characteristics of participants and the outcomes being measured. Improvements were found for depression, anxiety disorders and insomnia.

Work-related outcomes

  • Only a few studies examined work-related effects of the cCBT tools. Those that did showed a positive significant improvement in both work-related outcomes and mental health improvements.

Future of cCBT tools

  • While there is no 'silver bullet' for future designs of cCBT, one can expect that mobile applications will increase in number and that most cCBT platforms will provide at least a basic level of additional support. cCBT interventions lend themselves well to — and offer space for — experimentation in their design and delivery mechanisms. However, there are no evident patterns that would suggest that certain types of tools (or which elements of their design) determined the level of their effectiveness.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Approach and methodology

  • Chapter Three

    Findings

  • Chapter Four

    Conclusions and implications for future cCBT

Research conducted by

The study was prepared for Ingeus UK Ltd. and conducted by RAND Europe.

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