Computer therapy can be accomplished by the use of email, video chat, or a messaging window in order to treat patients at a distance and reduce clinician time. For some patients, attending therapy sessions is fraught with emotional hardship, and using a computer elicits greater revelations than face-to-face therapy. Although critics argue computer therapy has major drawbacks, studies have shown its use in cognitive behavioral therapy (CBT) for depression produces results on par with standard cognitive therapy.
CBT is designed to change destructive and negative patterns of thinking. Computer therapy is adequate to this task, proponents argue, especially for people whose access to conventional therapy is limited. Costs are typically lower and clinic time is reduced. Programs can be taken over the Internet or used independently with the guidance of the therapist.
If scheduling difficulties preclude a patient from seeking counseling, computer therapy may be a better way to do so. Emails can be sent any time, and a messaging window can be used in real time for discussion purposes. The therapist can answer the emails when it is convenient, thus reducing clinic time spent on in-person meetings. If the patient has communications he wishes the therapist to see, they can be forwarded directly.
Patients who have issues with face-to-face therapy can participate in some programs by voice rather than in person. Some people have an easier time talking online than in person. For them, computer therapy may be less anxiety-provoking. To establish a trusting relationship, an initial in-person meeting can be scheduled. Subsequent visits can take place as the patient becomes more comfortable.
Critics of computer therapy have pointed out that without the in-person aspect, important non-verbal clues that point to a person’s true state of mind will be missed. They argue this can precipitate dangerous, even fatal results. In addition, they say there are ample opportunities for deception on the part of a patient who may not reveal a serious problem, such as an eating disorder, that computer therapy cannot help. Logistical questions are also raised regarding whether a therapist licensed to practice in one area can legally treat someone who lives outside that jurisdiction.
A study showed that computer therapy assisted in CBT treatment of mild to moderate depression. The program in the study was designed with a multimedia approach and used in conjunction with anti-depressant medications. Therapists were able to reduce clinic time by half, and the effectiveness of the treatment did not wane. Despite these results, this therapeutic approach would not be useful in treating serious illnesses, such as bipolar disorder or schizophrenia.