Depressed? Try Therapy Without the Therapist

New York Times, By Tina Rosenberg, June 19

Elle is a mess. She’s actually talented, attractive and good at her job, but she feels like a fraud — convinced that today’s the day she’ll flunk a test, lose a job, mess up a relationship. Her colleague Moody also sabotages himself. He’s a hardworking, nice person, but loses friends because he’s grumpy, oversensitive and gets angry for no reason.

If you suffer from depression or anxiety as Elle and Moody do, spending time with them could help. They are characters in a free online program of cognitive behavioral therapy called MoodGYM, which leads users through quizzes and exercises — therapy without the therapist.

Cognitive behavioral therapy is a commonly used treatment for depression, anxiety and other conditions. With it, the therapist doesn’t ask you about your mother — or look at the past at all.

Instead, a cognitive behavioral therapist aims to give patients the skills to manage their moods by helping them identify unhelpful thoughts like “I’m worthless,” “I’ll always fail” or “people will always let me down.” Patients learn to analyze them and replace them with constructive thoughts that are more accurate or precise. For example, a patient could replace “I fail at everything” with “I succeed at things when I’m motivated and I try hard.” That new thought in turn changes feelings and behaviors.

The success of cognitive behavioral therapy is well known; many people consider it the most effective therapy for depression. What is not widely known, at least in the United States, is that you don’t need a therapist to do it. Scores of studies have found that online C.B.T. works as well as conventional face-to-face cognitive behavioral therapy – as long a there is occasional human support or coaching. “For common mental disorders like anxiety and depression, there is no evidence Internet-based treatment is less effective than face-to-face therapy,” said Pim Cuijpers, professor of clinical psychology at the Vrije Universiteit Amsterdam and a leading researcher on computer C.B.T.


Online therapy is effective against an astonishing variety of disorders. A Swedish survey of studies found that online C.B.T. has been tested for 25 different ones. It was most effective for depression, anxiety disorders, severe health anxiety, irritable bowel syndrome, female sexual dysfunction, eating disorders, cannabis use and pathological gambling. “Comparison to conventional C.B.T. showed that [online] C.B.T. produces equivalent effects,” the researchers concluded.

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