Computer-guided cognitive–behavioural therapy for anxiety states

There is a wide and ubiquitous gap between the demand for and the supply of cognitive–behavioural therapy (CBT) for anxiety states. Radical means of closing this gap are required, and computerizing the routine aspects of the delivery of CBT is one option. A few randomized controlled trials and effectiveness studies have been conducted, indicating that this approach has much promise, with therapy delivered via the Internet, CDs, palmtops and virtual reality. Outcomes appear to be comparable to those with face-to-face therapy, and patients report high levels of satisfaction. For many patients computer-guided CBT may be the only specialist treatment available to them. Many aspects require further research attention, such as cost-effectiveness, the suitability of this approach for particular groups, and the implications for the therapeutic relationship.