Is CBT the Only Effective Online Treatment?

We know how negative feelings and thoughts can trap someone in a vicious cycle and wreak havoc with the person’s health. This may lead to a significant increase in anxiety, depression and suicidal thoughts, with instances of domestic violence and substance abuse being also reported.

In order to cope with these overwhelming issues, people are turning to online mental health treatment more than ever before. For those who are unable to leave their homes, or choose not to for any reason whatsoever, counselling via telehealth has provided the much-needed relief.

Out of all available treatment techniques, CBT has been the predominant one online. Cognitive behavioural therapy aims to change negative thought patterns and establishing good habits to improve your mental wellbeing. This, combined with the fact studies had shown it to be extremely effective even when conducted in a virtual setting, has led to its ever-growing popularity.

What is CBT?

Cognitive behavioural therapy, also referred to as CBT, is a type of talking therapy, which has been found to be very effective in not only decreasing the symptoms of anxiety and depression, but equally good for treating panic disorder, specific phobia and post-traumatic stress disorder as well.

CBT is also considered to be a short-term therapy, where online sessions last usually between eight to fifteen weeks, leading to roughly a 50% improvement in the patient’s mental health condition. Since the treatment is time-limited, a person will know when the course ends and have a clear idea of what the outcome will be.

The cost of each session may vary, but it is in the range of £40-£100 per session, if one opts for a private session. Otherwise, a person can directly access a free course (under some conditions) for therapy treatment from the NHS psychological therapy service (IAPT) without a prescription from a GP, or ask their GP for a referral if they so desire. Sessions usually last for an hour and take place once a week.

How does CBT actually work online?

Online CBT works exactly the same way as an in-person consultation with a specialist except that the conversation is in writing instead of spoken. Studies have shown that many persons find this method easy, secure and less intimidating than a face to face interaction in a regular clinic where one mind it less daunting to express their true feelings.

This dominant method of treatment works by assisting a person to challenge and identify their behaviour, emotions and dysfunctional thoughts. A qualified therapist will guide you from start to finish through the sections, worksheets, messaging (whenever needed) and live video sessions, no matter the part of the world you are in and in working hours that fit your time zone.

More specifically, CBT adopts an approach that is goal-oriented and requires an extremely active involvement by the individual to succeed, as it focuses on their present thoughts and behaviours. By changing their way of thinking, CBT can decrease distress and make the person function in a manner that will benefit them and even those around them.

Advantages of CBT

CBT has been found to be effective in:

• Treatment of mental health disorders and especially in cases where medications alone have not worked.
• Compared to other talking therapies, CBT can be completed in a shorter period.
• Since the course is highly structured it can be provided in different formats such as groups, self-help journals and computer programmes.
• The knowledge gained from CBT can be incorporated in day to day life to help cope with any issues which may arise long after the treatment has been completed.

The downside of CBT

• CBT has its downsides too. Some of them are:
• CBT requires absolute dedication to the process. A therapist can only advise you, but the commitment has to come from within.
• Due to the structured nature of CBT it may not be suitable for persons with complex health issues or those with learning difficulties.
• CBT involves confronting one’s own anxieties and emotions which can initially lead to emotional distress.
• CBT only focuses on the capacity of individuals to change their feelings and thoughts. It does not address the wider issues relating to their health and well-being or the possibility of an unhappy childhood.

Alternative approaches to CBT

All talking therapies are a form of psychological treatment for emotion related issues and involve working with a trained therapist. Since different therapies may suit different people, one talking therapy may provide better help than the other.

• Counselling: This talking therapy involves speaking in confidence with a counsellor. The NHS may offer you this service to treat types of depression arising from a bereavement or those having fertility issues. Counselling can finish in one session or over a course of sessions lasting for weeks or months.
• Behavioural Activation: Behavioural activation is another talking therapy that is offered to one or more individuals over phone calls by a therapist. The aim is to motivate a person to make small but positive changes to improve one’s life.
• Interpersonal Therapy: ITP focuses on treating people suffering from depression issues arising within the family and relations. The idea is to improve the poor relationship that can cause mild depression that has not responded to other talking therapies, including CBT.
• EMDR: The eye movement desensitisation and reprocessing therapy is for those who have post-traumatic stress disorder or PTSD. People who have PTSD may experience flashbacks of traumatic events from their past. EMDR helps to remove these negative images from the brain and requires active support of families and friends as the recovery process can be quite distressing.
• MBCT: Known as mindfulness-based cognitive therapy helps a person to focus on their thoughts and feelings the moment they occur. MBCT uses mindfulness techniques like breathing exercises with cognitive therapy to manage your thoughts to make you feel better.
• Psychodynamic Psychotherapy: This type of therapy traces back your childhood experiences that you are unaware of but are affecting your behaviour today. This approach is widely popular and considered the best alternative to CBT, if your objective is to dive deeper.

Best apps and other tools for online mental health

Finding the best mental health app, or tool, in a rapidly rising technology world can be intimidating with so many options to choose from. The silver lining, however, is that these remote options are quickly giving a bang for the buck to their traditional rivals. Some of the best tools are:

• Online information
• Online communities
• Social media
• Blogs/Podcasts
• Chatbots

Here is a list of some of the best mental health apps you can download today itself:

• BetterHelp (Best overall)
• Headspace (Sleep and Meditation)
• Thrive (mood relaxation techniques)
• My Possible Self (mood tracker, journals and motivation messages)
• Calm Harm (manage self-harm)
• Recovery Record (eating disorders)
• Quit That (addictions)
• Moodfit (comprehensive set of tools)

As mentioned, CBT is a talk-based therapy technique and isn’t usually combined with medical prescriptions. NHS psychologist do have the ability to combine therapy with meds, but if you prefer to use an app of your own choosing, then Get Cerebral is the best option for combining both. You can read Get Cerebral reviews and see how it compares to leading online therapy sites such as Betterhelp for example.

Online therapy is here to stay

With telehealth usage scaling great heights, resolving concerns related to security and privacy will be a critical issue. Despite this, several studies at Georgetown University in the US have shown that both providers and patients have viewed telehealth favourably.

Proper, effective and inexpensive therapy options can provide succour to people to live a better life by filling in the gaps for those who would otherwise get priced out. The shift to telehealth, in the US especially, has brought about a massive change. While it has lowered one bar to care it has raised new therapeutic challenges and it will be interesting to keep following these trends as they develop.