From the first trials of internet-based psychological therapies in the early 2000s, results have been compelling. Interest in e-therapies continues to grow among mental health professionals working in both primary and secondary care, funders, planners, and service users.
The end of psychiatry as we know it?
E-therapies offer very cost-effective solutions for the many people who experience mild to moderate high-prevalence mental health problems like depression and anxiety, and who have problems accessing a psychological therapist in-person.
E-therapy researcher Gavin Andrews, Professor of Psychiatry at the University of New South Wales, even joked about “the end of psychiatry as we know it,” and claimed e-therapies can be twice as effective as seeing a psychiatrist or psychologist in person.
Te Pou’s interest in e-therapy
Te Pou has had a long-term interest in promoting talking therapies and e-therapy provides an increasingly popular option for those seeking help for mental health problems.
Within stepped care models of service delivery, e-therapies can provide a low-intensity form of treatment with or without clinical support, particularly in primary care, where a general practitioner can easily refer a person to an e-therapy programme or a helpful website, and then provide follow-up. If the low-intensity approach is not helpful, then a more intensive intervention may be needed.
Beating the Blues
One e-therapy which has a number of randomised clinical trials behind it and has been recommended by NICE for use in the National Health Service in the UK for many years is Beating the Blues, and it’s recently been made available free to the user within primary care in New Zealand.
Like most e-therapies, Beating the Blues is based on cognitive behavioural therapy but there are few available that are integrated into primary care as this one is, with links back to the person’s health provider. Should the person’s condition worsen and they start using any suicidal language while doing the programme, the health practitioner is alerted and can provide support.
The programme was trialled some years ago in Northland, with positive results, and there is anecdotal evidence that it’s being well received elsewhere.
New Zealand e-therapy for young people - SPARX
In New Zealand, we’ve been developing our own forms of e-therapy.
In 2008, under Associate Professor Sally Merry’s leadership, Auckland University developed a computer-based programme for young people which allows them to choose and design avatars to guide them through seven games, and restore balance in imaginary worlds.
SPARX was evaluated with a large randomised controlled trial completed in 2009. The results were very promising, and were published in the BMJ last year. Since then further research has been undertaken, and an online tool for health professionals to support the use of SPARX in clinical practice is being developed with funding from the Health Research Council.
The Journal for New Zealanders with mild to moderate depression
The Journal is another online programme for New Zealanders with mild to moderate depression or anxiety, based on problem solving therapy.
It can be freely accessed through the website of the National Depression Initiative. Fronted by Sir John Kirwan and psychiatrists Lyndy Matthews and Simon Hatcher, who also helped develop the programme itself, The Journal has been visited by thousands of New Zealanders since its launch in 2008, again with very positive results.
Over 80 per cent of users who have completed three or more of the six sessions have reported improvements in their mood whether or not they have completed the programme.