Last month I attended the 7th World Congress for CBT in Lima, Peru. Conferences are a great way to get up to speed on the latest developments in a field, and this conference was no exception. Overall, the presentations made me very optimistic about the future of online therapy. There is a lot of exciting and encouraging research being conducted.

As part of a symposium on internet-based treatment, I presented some of the latest results from AI-Therapy’s Overcome Social Anxiety program:

Dr Fjola Helgadottir presenting AI-Therapy overcoming social anxiety at the CBT World Congress 2013

Investigation into real world treatment data

My presentation was somewhat unusual for an academic conference in that it was based on real world data. Typically, talks are based on carefully controlled trials. There is an important reason for this – one goal of a trial is to make the results reproducible by other researchers. This is a key aspect of scientific research. However, there is an important question that is often ignored: will the results translate into the real world? The real world is chaotic, users are not screened, users are not monitored, there is less control over the equipment used, etc. In the past it has been found that treatments that work well in a laboratory environment cease to have the same impact when they are released to the general population. One goal of my talk was to present data from a commercially available treatment program, and contrast this with the latest results from academic systems.

 

Visitors to the AI-Therapy website

Before continuing, I should mention that all AI-Therapy users are anonymous, and their results are kept strictly confidential. The only data I presented are aggregated, showing average scores across groups of users.

As can be seen in the slide above, we have had almost 20,000 unique visitors to the website since our launch about a year ago. The top 5 countries for visitors are:

  1. USA
  2. UK
  3. Iceland
  4. Australia
  5. Canada

These results are roughly what I would expect. The US is our largest market, but a significant margin. The reason Iceland has made the top 3 is due to some media coverage we have received there.

 

Effective social anxiety treatment

In order to assess the efficacy of the Overcome Social Anxiety program, I determined its pre-post effect size. When using the program, users fill out a series of questionnaires before starting, and the same questionnaires after completion. The effect size is a standardized measures of the reduction in symptoms over this period (see this page for information about effect sizes, and effect size calculators).

The effect size for the first 19 people who completed all sections of the program was 1.7. An effect size of 0.2 is considered small, an effect size of 0.5 is considered medium, and effect size of 0.8 is considered large. Therefore, an effect size of 1.7 is very large. (It is important to note that this value has been calculated based on people who completed the whole program, and does not include people who started the program, but did not reach the end. We intend to write up a more detailed analysis, and release it as a white paper on this site. Please watch this space.) The primary conclusion is that online treatment programs for social anxiety can be an effective treatment strategy for real world patients.

I am already looking forward to the 8th CBT World Congress, which will be held in Melbourne Australia in 2016. I look forward to seeing the advances that will be made in the online therapy field over the next  three years!

Fjola

Fjola  Helgadottir, PhD, MClinPsych, is a clinical psychologist, a senior research clinician at the University of Oxford, and is a co-creator of AI-Therapy.com, an online CBT treatment program for overcoming social anxiety

 

A recent study says “yes”!

Online therapy is an active and growing area of research in clinical psychology. In fact, there was a symposium devoted to the subject at the recent World Congress of CBT in Lima, Peru (which I was honoured to be a part of – to be covered in a future blog). Perhaps the most important question that researchers are trying to answer is: “Does online work as well as face to face therapy?”

This is a difficult question to answer since there are so many hidden variables. In fact, there is no universal answer, since it depends on the particular online system being examined, and the skill level of the therapists involved in the study. A better questions is “Can online therapy work as well as face to face therapy?” In other words, are there any online systems that can match the results of live therapists for a specific problem? According to a recent publication, the answer is “yes”!

A team of researchers from the University of Zurich published the following paper:

  • Birgit Wagner, Andrea B. Horn, Andreas Maercker. Internet-based versus face-to-face cognitive-behavioral intervention for depression: A randomized controlled non-inferiority trial. Journal of Affective Disorders. July 23, 2013. (see this link for more information)

Can online therapy be as good as face to face therapy

The authors conducted a study involving 62 people with moderate depression. Half of the patients were treated using traditional CBT in-person techniques, and the other half were treated online. The authors found that at a three month follow up, the patients who were treated online had fewer symptoms of depression than the control group. In other words, the online treatment program actually performed better than the face to face therapy.

 

Advantages of online therapy

I have discussed some of the advantages of online therapy on this blog and in my publications. These include:

  • Clients can progress at their own pace
  • Clients have a complete record of their treatment, which they can revisit at any time
  • “Therapist drift” is a known phenomenon, where therapists move away from the best practices of a particular treatment over time. With online treatments, it is easier to enforce a consistent treatment, with the correct “dose” of clinical content delivered during each session.

Of course, online therapies have challenges of their own. In particular, it is more difficult to adapt the treatment towards the individual symptoms and needs of the users without therapist involvement. In fact, it is this problem of individual personalization that AI-Therapy’s social anxiety program attempts to address.

More studies are needed to fully investigate the strengths and weaknesses of online therapy. However, the study above adds to a growing body of evidence that online therapy has tremendous potential, and will play an important role in the future of mental health treatment.

 

Fjola

Fjola  Helgadottir, PhD, MClinPsych, is a clinical psychologist, a senior research clinician at the University of Oxford, and is a co-creator of AI-Therapy.com, an online CBT treatment program for overcoming social anxiety

 

We are very excited to have arrived in Lima, Peru for the conference. The scientific program is extremely rich, so my biggest problem is selecting which talks to attend. For every hour, there seems to be about 3 interesting talk to select from!

Here we are, the co-founders of AI-Therapy, Overcome social anxiety Dr Fjola Helgadottir and A./Prof Ross Menzies:

AI-Therapy at the World Congress of CBT in Lima Peru
AI-Therapy at the World Congress of CBT in Lima Peru

I have two talks coming up. For anyone who happens to be here, please come along and say hi. Here are the details:

  • Thursday 25th of July at 9-10:20. We will speak about the latest developments in AI-Therapy, in the symposium “Latest developments in online treatments”. There will be some of the world’s leading experts on Internet treatments of evidence based treatments on the panel. Venue: Maria Angola, Room: Las Campanas
  • Tuesday 23rd of July at 3:30-4:50. We will speak about how the Icelandic financial crisis simulated the origin of Obsessive Compulsive Problems. The discussion will be about general belief in magical thinking, such as the paranormal, horoscopes etc, and how these thinking patterns may influence people’s coping strategies. Venue: Estelar, Room: Arequipa

The next World Congress of CBT will be Melbourne, Australia in 2016, and Ross is a convenor. It is amazing how much work goes into planning these conferences. Even though it is still 3 years away, Ross has been busy planning the 2016 conference for a while now.

First up is the opening ceremony with Aaron Beck, the father of CBT!

 

Fjola

Fjola  Helgadottir, PhD, MClinPsych, is a clinical psychologist, a senior research clinician at the University of Oxford, and is a co-creator of AI-Therapy.com, an online CBT treatment program for overcoming social anxiety

I recently came across the webpage of a talented designer who has a few comics on social anxiety. Here is an example:

Social anxiety comic

(Click on the comic to see the original post.)

This comic is very insightful, and beautifully illustrates two points:

  • People without social anxiety often fall victim to the cognitive fallacy “something that is easy and natural for me should also be easy and natural for everyone else – all they need to do is try”. These are usually well-meaning individuals, but they couldn’t be more wrong.
  • Overcoming social anxiety is difficult. Like learning a language, it requires learning and practicing a new set of skills. This takes time and dedicated effort. In fact, overcoming social anxiety is much more difficult than acquiring most new skills, such as an instrument or a language. This is because it involves critically evaluating and challenging core thinking and behavior patterns, which operate at both emotional and cognitive levels.

Please let me know if you’ve seen any other social anxiety-inspired art.

In other news, I’m off to Lima, Peru in a few days for the The World Congress of Behavioral and Cognitive Therapies. I will be presenting data from several projects, including the latest AI-Therapy results. Stay tuned!

Fjola

Fjola  Helgadottir, PhD, MClinPsych, is a clinical psychologist, a senior research clinician at the University of Oxford, and is a co-creator of AI-Therapy.com, an online CBT treatment program for overcoming social anxiety

You may have noticed we have been a little slow on the blog updates lately. The reason is that we have been very busy working on our new product, and are pleased to announce:

 

Statistics for Psychologists

This is a little different than our core area (online self-help), so let me explain why we’ve created it. There are lots of statistics programs out there. However, some of them are hard for non-statisticians to use, some are expensive, and most require you to install software on your computer. We wanted something accessible, easy to use, and not loaded with options we don’t need. Given our extensive background in statistics and software, we decided to create our own solution.

These are our target audiences:

  1. Academia: The online calculators provide academic researchers with tools to help them distinguish between effective and non-effective therapies. Naturally our focus is psychology, but the tools themselves will be equally useful to researchers in any field.
  2. Clinicians:  Too often clinicians never give stats a second thought after they finish their degree. However, chances are that you are surrounded by interesting data in your clinic. We encourage you to run some therapy data through the program, as you may be surprised by what you find!
  3. Students: Learning stats isn’t easy. What we’ve created is something between an online tutorial and an interactive calculator. One way to learn the concepts is by interacting with the tools and visualizations. Try to get a feel for how changes to the input impact the results.
  4. Everyone else: Statistics is much more important in our day to day lives than most people give it credit for. In particular, it helps us make sense of the world around us. Take the plunge, and see what it’s all about!

Please get in touch and let us know if you have any feedback or feature requests. Also, help us spread the word if you know of anyone who might find this useful.

 

Sample graph from AI-Therapy's Statistics for Psychologists

Website Design

As you may have already noticed, we’ve given the AI-Therapy website a facelift. There are a number of improvements, including easier navigation, more content, and higher quality video.  Please take a look, and let us know what you think!

 

ai-therapy

 

Logo

We also have a new logo, which was designed by the same person who helped us with the new website (Rob Hogg of Skinny Whippet):

 

AI-Therapy-logo-transparent111

 

Conference Travel

We’re pretty excited to be going to the World Congress of Behavioral and Cognitive Therapies (WCBCT 2013) in Lima, Peru in July this year. This conference is held every three years, in various countries around the world. It provides an opportunity for researchers and clinicians to meet and discuss the “state of the art” in CBT.

I will be giving two talks at the conference:

  1. I was honoured to be invited to speak in a symposium with world’s leaders in online CBT (the other speakers are Gerhard Andersson and Per Carlbring from Sweden, Pim Cuijpers from Netherlands, and Nick Titov from Australia). The title of the symposium is The latest developments in internet-based treatments of common mental disorders. I will be speaking about some of my work at the University of Oxford, as well as the latest developments with AI-Therapy.
  2. My second talk is based on work I conducted with Ross Menzies of the University of Sydney and Mark Jones of the University of Queensland. The title is Superstitious behaviour in Iceland during and after the global financial crisis simulates the aetiology of obsessive-compulsive disorder.

 

We’re pretty busy these days, but there are exciting times ahead!

 

 

fdh

 

Fjola  Helgadottir, PhD, MClinPsych, is a clinical psychologist, a senior research clinician at the University of Oxford, and is a co-creator of AI-Therapy.com, an online CBT treatment program for overcoming social anxiety

 

Dear AI-Therapy blog readers,

I would like to thank you for helping us getting the word out there. Some highlights from our first few months:

  • We have now had 18,146 page views
  • Some of our early customers have successfully reached the end of the program
  • We are continuing to see outstanding results for those who complete all 7 modules of AI-Therapy

One of the reasons the blog hasn’t had many posts in that last few weeks is that I’ve been busy travelling. I attended the Australian Association for Cognitive and Behaviour Therapy (AACBT) conference in Queensland, and was very impressed with the quality of the scientific program. Furthermore, the keynote speeches were fantastic. Personal highlights were Ross Menzies (AI-Therapy co-founder), Leane Hides (president of AACBT) and Matt Sanders (Triple P Parenting program). It is great to see the how Australian commitment to CBT is continuing at full force.

While I was in Australia I got together with Ross Menzies, and had a very productive few days. We created a video that explains a bit more about AI-Therapy, including its history and how it works. A 3 minute video can be viewed here, for best quality you can make it full screen and put the quality to HD 1080p.

Ross and I also did some planning for the future of AI-Therapy, and I’m happy to say that there are some exciting plans in the works. In particular, we’ve started laying the groundwork for new treatment programs, including obsessive compulsive disorder (OCD) and generalised anxiety disorder (GAD).

AI-Therapy has recently been featured in the Icelandic media: “AI-Therapy is not trying to cut out psychologists, rather reach a wider audience“. For non-Icelandic readers, Google Chrome’s translation tool does a pretty good job of getting the main message across.

Autumn wishes from Oxford,

Oxford Autumn Nov 2012
Autumn colours at the Warneford Hospital bus stop.

 

fdh

 

Fjola  Helgadottir, PhD, MClinPsych, is a clinical psychologist, a senior research clinician at the University of Oxford, and is a co-creator of AI-Therapy.com, an online CBT treatment program for overcoming social anxiety