Virtual CBT Curbs Depression, But Not All Components Are Effective

July 05, 2023 - A new study found that although adults with depression benefitted from virtual cognitive behavioral therapy (CBT), this result was independent of specific program components such as activity scheduling, functional analysis, and thought challenging.

Depression is a common condition that the Centers for Disease Control and Prevention (CDC) indicates regularly affects 4.7 percent of adults.

Tools intended to treat this condition can vary, however, CBT is a common treatment method. This is often delivered virtually or through the Internet.

To gather insight into the inner workings of Internet-delivered CBT, researchers conducted a randomized optimization trial that included hundreds of patients with depression. The motive behind this research was to determine the effect that individual components of CBT treatment have on depression. The components that researchers evaluated for the study were activity scheduling, functional analysis, thought challenging, relaxation, concreteness training, absorption, and self-compassion training.

This analysis would also allow researchers to identify the white noise and make treatment more effective and efficient, the study noted.

Researchers recruited 767 patients for the study, who were randomized between July 7, 2015, and March 29, 2017. Patients also engaged in follow-up care for six months after treatment.

As participants engaged with Internet-delivered CBT, they were randomly assigned to seven experimental treatment combinations within the CBT care delivery platform. These treatment combinations included or omitted any of the seven components the researchers were evaluating. In the process of measuring outcomes, the primary measure was depression symptoms. Secondary measurements included anxiety levels along with functioning in the work, home, and social settings.

Of the 767 original recruits of the study, 66 percent completed the six-month post-treatment follow-up period. The main finding was that participants experienced lower depression levels when participating in CBT therapy. But researchers also found that the use or omission of six of the seven treatment components did not impact depression levels. Absorption training was the only factor that affected symptoms at the six-month follow-up mark.

Based on this result, researchers surmised that the positive effects that derive from virtual CBT are likely due to spontaneous remissions. They also likely correlate with factors that are generally always found in CBT components, such as making active plans, along with nonspecific therapy factors, like positive expectancy. 

Prior research has also indicated positive results associated with virtual CBT therapy.

In June, researchers from the University of Pittsburgh and the University of New Mexico found that virtual CBT led to lower severity levels of common dialysis symptoms among chronic kidney disease (CKD) patients.

CKD is a common condition in the US, and dialysis is one of the main treatments. Dialysis, however, is often linked to side effects such as fatigue, pain, and depression.

To compensate for these downsides, researchers created a CBT resource providing patients with 12 weekly virtual sessions. This tool allowed patients to define goals and obtain customized care. 

Following a study that involved 160 patients, researchers found that the resource led to an increase in energy levels and an improvement in pain severity.