Computerized Cognitive-Behavioral Therapy in a Stepped Care Model of Treatment

A growing body of literature suggests that computerized cognitive-behavioral therapies (CCBT) are effective in community settings in terms of symptom reduction, favorable client satisfaction, attrition comparable to standard cognitive-behavioral therapy, reduced clinician time, high cost-effectiveness, and ease of integration into community clinics. Clinicians report lack of knowledge about computerized programs as the main reason that they have not used CCBT in their practice. To mitigate this disconnect between empirical evidence and dissemination, this article first reviews empirical studies focusing on the efficacy of CCBT for specific psychological disorders, followed by a review of research on the effectiveness of CCBT in community settings. Next, issues related to dissemination and barriers to CCBT adoption by clinicians are discussed. Finally, the implications of CCBT for research and practice and the possible role of CCBT in a stepped care model of treatment is discussed in terms of cost-effectiveness, standards of care, and implications for public policy.