Therapy online as good as face to face

Internet-delivered therapy is gaining ground – it has been proven helpful against arachnophobia, tinnitus and depression. At the forefront of this research field is Gerhard Andersson, professor of clinical psychology and recent winner of two awards for his efforts. He sees a number of areas where web-based therapy can benefit patients as well as the healthcare system.

Outside Gerhard Andersson’s office window it’s raining. Inside it’s raining awards – on him. In October he won the Swedish Psychological Association’s award for 2014, which he had been a contender for since 2009. But winning the Nordic Medical Award in December was a real surprise:

”Oh, I thought. Is our research on internet-based treatment so strong?”

Prof Andersson is recognised as one of the pioneers in the development of internet-based treatment for mental illness. His study (published 2000) of headache sufferers who receive such treatment, was one of the first in the world on this subject. By email, the patients learned about relaxation and stress management – and the results were good. Since then, advancements in both the technology and the form of treatment have made it possible to help people with such widely varied problems as obsessive-compulsive disorder, phobias, depression and tinnitus.

”Several studies show that this type of therapy works just as well as meeting a psychologist face to face. It’s no longer about internet-based treatment or not – the internet is already part of our lives,” says Prof Andersson.

For some patients, online therapy might even work better – for instance people who suffer from social anxiety disorder, but who have been offered treatment in the form of group therapy.

”People with social anxiety can find it extremely difficult to sit in a group, which means they might not be present mentally during the session, or might not turn up at all,” says Prof Andersson.

The patients who take part in the internet-based treatment are perceived as motivated, which can partly explain the strong results. Other benefits are that the patients can decide themselves when to proceed with treatment. They don’t need to sneak away from work, and can carry out the treatment from their sofa at home. Also, patients can easily re-read any information they don’t understand the first time round, which can be difficult when sitting face to face with a psychologist.

Prof Andersson is not able to say exactly why internet-based therapy works so well:
”We know that it works. How it works is the next question we researchers are asking.”

Web-based therapy has proven to be a successful form of treatment for many different conditions. But it doesn’t suit every individual. In addition to motivation, patients must have some basic knowledge of how computers work.

”But I know of a 70-year-old who didn’t even own a computer, but who signed up for treatment. She bought a computer in order to take part, and managed fine.”

In addition to easing a wide range of symptoms, Prof Andersson can see that internet-based treatment fills a gap in the healthcare system. For the thousands of people who can’t get care because their condition is not considered serious enough, it can be a good option. Another possible application is for sufferers of chronic mental illness.

”Many people suffer from recurrent depressions. If it’s not a deep depression, the patient could have contact with a psychologist over the internet.”

Still, the award-winning frontman for internet-based therapy urges caution. He mentions antidepressants, which when first launched were a powerful tool for helping people.

”Nowadays they are sometimes prescribed too readily. Internet-based therapy mustn’t suffer the same fate. The treatment mustn’t be sloppily implemented in the healthcare system, and it’s essential to continue to fine-tune the treatment by way of research.”



Text: Therese Ekstrand Amaya
Photo: Vibeke Mathiesen