Despite its effectiveness, cognitive behavioural therapy (CBT) is difficult to access in Ireland, due to a lack of trained practitioners. However one potential way of getting around this is by delivering it via the internet, Irish experts have said.

CBT is often referred to as a ‘talking therapy'. It aims to help people to better understand how their thoughts and feelings influence their behaviours. It is used to treat a range of mental health problems, including depression, anxiety and obsessive compulsive disorder (OCD).

According to Conal Twomey and Michael Byrne, who both work in the field of mental health with the HSE West, and Gary O Reilly, director of the doctorate in clinical psychology programme in UCD, there is ‘strong evidence' that CBT is an effective therapy.

"However, it is difficult to access, partially because there are not enough trained practitioners in primary (GP) and secondary (hospital) care. The inaccessibility of CBT may be especially pertinent in Ireland due to our underdeveloped mental health services," they noted.

Because of this, new ways of delivering CBT are required and one such method is known as computerised CBT (cCBT), which refers to the delivery of the therapy via the internet.

cCBT can be delivered in ‘real-time' via instant messaging, however many types are made up of pre-determined programmes, which consist of information sessions and homework assignments.

"A cCBT programme can be completed on a purely self-help basis or it can be offered with assistance from appropriate staff members, such as psychologists and counselors," the experts explained.

While the composition of these programmes varies, most include one or more of the following:
-Education
-Quizzes
-Mood diaries
-Activity planning
-Goal setting
-Homework tasks.

While the number of sessions can vary, research indicates that five to 10 sessions are often what is required. These sessions are usually completed on a weekly basis, but they can also be completed at a person's own pace.

When it comes to the two most commonly seen mental health problems in primary care - depression and anxiety - three major studies on cCBT have shown it to be effective.

"Moreover, these analyses indicated that the average depressed or anxious person who avails of cCBT will fare better clinically than around three-quarters of those who do not receive treatment," they experts explained.

Some of the pros of availing of cCBT include:
-It is easily accessible and convenient - you have 24-hour access in your own home
-It ensures privacy and reduces stigma
-Low or no cost to the service user.

Cons can include:
-High drop-out rates, particularly with self-help cCBT
-Not suitable for various groups, such as people not familiar with computers
-Potential loss of the benefits from a therapeutic relationship.

The experts also pointed out that the quality of individual cCBT programmes is likely to vary ‘because of the unregulated nature of the internet and the proliferation of therapy websites in recent years'.

One freely accessible programme that is available to people in Ireland is the Australian programme, MoodGym. It is actually being offered to some mental health service users in Roscommon as part of a pilot project by the HSE West.

The experts concluded that cCBT offers ‘an effective treatment for common mental health problems in primary care'.

They made their comments in Forum, the Journal of the Irish College of General Practitioners.

For more information on depression, see our Depression Clinic here