Skip to main content
    • Aa
    • Aa

The acceptability to patients of computerized cognitive behaviour therapy for depression: a systematic review

  • E. Kaltenthaler (a1), P. Sutcliffe (a1), G. Parry (a1), C. Beverley (a2), A. Rees (a1) and M. Ferriter (a3)...

Cognitive behaviour therapy (CBT) is widely used to treat depression. However, CBT is not always available to patients because of a shortage of therapists and long waiting times. Computerized CBT (CCBT) is one of several alternatives currently available to treat patients with depression. Evidence of its clinical effectiveness has led to programs being used increasingly within the UK and elsewhere. However, little information is available regarding the acceptability of CCBT to patients.


A systematic review of sources of information on acceptability to patients of CCBT for depression.


Sources of information on acceptability included: recruitment rates, patient drop-outs and patient-completed questionnaires. We identified 16 studies of CCBT for the treatment of depression that provided at least some information on these sources. Limited information was provided on patient take-up rates and recruitment methods. Drop-out rates were comparable to other forms of treatment. Take-up rates, when reported, were much lower. Six of the 16 studies included specific questions on patient acceptability or satisfaction although information was only provided for those who had completed treatment. Several studies have reported positive expectancies and high satisfaction in routine care CCBT services for those completing treatment.


Trials of CCBT should include more detailed information on patient recruitment methods, drop-out rates and reasons for dropping out. It is important that well-designed surveys and qualitative studies are included alongside trials to determine levels and determinants of patient acceptability.

Corresponding author
*Address for correspondence: Dr E. Kaltenthaler, School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK. (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

G Andersson , J Bergström , F Holländare , P Carlbring , V Kaldo , L Ekselius (2005). Internet-based self-help for depression: randomised controlled trial. British Journal of Psychiatry 187, 456461.

H Christensen , K Griffiths , C Groves , A Korten (2006 b). Free range users and one hit wonders: community users of an Internet-based cognitive behaviour therapy program. Australian and New Zealand Journal of Psychiatry 40, 5962.

H Christensen , KM Griffiths , AE Korten , K Brittliffe , C Groves (2004 b). A comparison of changes in anxiety and depression symptoms of spontaneous users and trial participants of a cognitive behaviour therapy website. Journal of Medical Internet Research 6, e46.

G Clarke , D Eubanks , E Reid , C Kelleher , E O'Connor , LL DeBar , F Lynch , S Nunley , C Gullion (2005). Overcoming Depression on the Internet (ODIN) (2): a randomized trial of a self-help depression skills program with reminders. Journal of Medical Internet Research 7, e16.

G Eysenbach (2005). The law of attrition. Journal of Medical Internet Research 7, e11.

A Ghosh , IM Marks , AC Carr (1988). Therapist contact and outcome of self-exposure treatment for phobias. British Journal of Psychiatry 152, 234238.

KM Griffiths , H Christensen (2006) Review of randomised controlled trials of Internet interventions for mental disorders and related conditions. Clinical Psychologist 10, 1629.

E Kaltenthaler , P Shackley , K Stevens , C Beverley , G Parry , J Chilcott (2002). A systematic review and economic evaluation of computerised cognitive behaviour therapy for depression and anxiety. Health Technology Assessment 6, 189.

MB Keller , JP McCullough , DN Klein , B Arnow , DL Dunner , AJ Gelenberg , JC Markowitz , CB Nemeroff , JM Russell , ME Thase , MH Trivedi , J Zajecka (2000). A comparison of nefazodone, the cognitive-behavioral analysis system of psychotherapy and their combination for the treatment of chronic depression. New England Journal of Medicine 342, 14621470.

IM Marks , D Mataix-Cols , M Kenwright , R Cameron , S Hirsch , L Gega (2003). Pragmatic evaluation of computer-aided self-help for anxiety and depression. British Journal of Psychiatry 183, 5765.

RJ Maxwell (1992). Dimensions of quality revisited: from thought to action. Quality in Health Care 1, 171177.

K Murray , Pombo-Carril M Guadelupe , N Bara-Carril , M Grover , Y Reid , C Langham , H Birchall , C Williams , J Treasure , U Schmidt (2003). Factors determining uptake of a CD-ROM-based CBT self-help treatment for bulimia: patient characteristics and subjective appraisals of self-help treatment. European Eating Disorders Review 11, 243260.

MG Newman , A Consoli , C Barr Taylor (1997 a). Computers in assessment and cognitive behavioral treatment of clinical disorders: anxiety as a case in point. Behavior Therapy 28, 211235.

MG Newman , J Kenardy , S Herman , C Barr Taylor (1997 b). Comparison of palmtop-computer-assisted brief cognitive-behavioral treatment to cognitive-behavioral treatment for panic disorder. Journal of Consulting and Clinical Psychology 65, 178183.

DJ Osgood-Hynes , JH Greist , IM Marks , L Baer , SW Heneman , KW Wenzel , PA Manzo , JR Parkin , CJ Spierings , SL Dottl , HM Vitse (1998). Self-administered psychotherapy for depression using a telephone-accessed computer system plus booklets: an open US-UK study. Journal of Clinical Psychiatry 59, 358365.

DM Sharp , KG Power , V Swanson (2004). A comparison of the efficacy and acceptability of group versus individual cognitive behaviour therapy in the treatment of panic disorder and agoraphobia in primary care. Clinical Psychology and Psychotherapy 11, 7382.

S Van den Berg , DA Shapiro , D Bickerstaffe , K Cavanagh (2004). Computerized cognitive-behaviour therapy for anxiety and depression: a practical solution to the shortage of trained therapists. Journal of Psychiatric and Mental Health Nursing, 11, 508513.

MF Zabinski , DE Wilfley , KJ Clafas , AJ Winzelberg , C Barr Taylor (2004). An interactive psychoeducational intervention for women at risk of developing an eating disorder. Journal of Consulting and Clinical Psychology 72, 914919.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 15
Total number of PDF views: 142 *
Loading metrics...

Abstract views

Total abstract views: 504 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 24th May 2017. This data will be updated every 24 hours.