¿Es la terapia cognitivo conductual asistida por ordenador una solución viable para los problemas de Difusión de la Terapia Cognitiva?

La terapia cognitiva-conductual (CBT) es la forma más ampliamente estudiado de la psicoterapia para el trastorno depresivo mayor. (1,2) Los metaanálisis de ensayos controlados han establecido que, a través de 12-16 semanas de tratamiento, la eficacia de la TCC es comparable a la medicación antidepresiva, (3-5) con un menor riesgo de recaída después del tratamiento se detiene. (6,7) CBT también puede mejorar significativamente los resultados del tratamiento cuando se usa en combinación con la farmacoterapia, (8,9),  a pesar de estas justificaciones convincentes, existen barreras importantes que limitan el uso de la TCC en la práctica contemporánea.

Uno de los obstáculos es que no hay suficientes terapeutas entrenados, particularmente en centros de salud mental rurales y públicos. (12) Otro pertenece al costo de la terapia. Una tercera barrera es el resultado de las molestias y el tiempo involucrado en la programación y asistir a un gran número de sesiones durante un período de tres a cuatro meses. 

Si, la terapia conductual cognitiva asistida por ordenador es efectiva (CCBT) podría ayudar a hacer frente a todas estas limitaciones. (14) A pesar de que la primera forma de CCBT se introdujo hace más de 20 años, (15,16) la investigación y desarrollo se ha disparado en el última década, sobre todo porque a los programas multimedia más sofisticados se puede acceder ahora a través de Internet, tales como los de www.amindterapia.com, los primeros programas de psicoterapia asististida por ordenador disponibles en Español,  los metaanálisis de una literatura de investigación floreciente han documentado la eficacia de estos diversos modelos de CCBT. (20-24)

References

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3. Cuijpers P, Berking M, Andersson G, Quigley L, Kleiboer A, Dobson KS. A meta-analysis of cognitive-behavioural therapy for adult depression, alone and in comparison with other treatments. Can J Psychiatry. 2013;58(7):376-385

4. Cuijpers P, van Straten A, van Oppen P, Andersson G. Are psychological and pharmacologic interventions equally effective in the treatment of adult depressive disorders? A meta-analysis of comparative studies. J Clin Psychiatry. 2008;69(11):1675-1685.

5. Weitz ES, Hollon SD, Twisk J, et al. Baseline Depression Severity as Moderator of Depression Outcomes Between Cognitive Behavioral Therapy vs Pharmacotherapy: An Individual Patient Data Meta-analysis. JAMA Psychiatry. 2015;72(11):1102-1109.

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17. Beating the Blues™ US – Helping you to manage your emotional well-being. http://beatingthebluesus.com/ Accessed November 27, 2016.

18. MoodGYM training program. https://moodgym.anu.edu.au/welcome Accessed November 27, 2016.

19. Empower interactive. Good Days Ahead. http://www.empower-interactive.com/solutions/good-days-ahead/ Accessed November 27, 2016.

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24. Rozental A, Magnusson K, Boettcher J, Andersson G, Carlbring P. For better or worse: an individual patient data meta-analysis of deterioration among participants receiving internet-based cognitive behavior therapy. J Consult Clin Psychol. 2016. [Epub ahead of print 10.1037/ccp0000158].

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