Free, online, computerized CBT (cognitive-behavioral therapy) for depression
(July 2006)

Free? Then can it be worth much? Ah, that might depend on how hard you work. This is working with a computer, not a human (but read on; this is not the first time this has been tried. Several other such programs have clearly worked. This one has had over 100,000 users so far).

Mind you, this may not work as well as seeing a real live therapist who knows the CBT approach well. But lots of people can't get real live CBT, because they:

So, if there was a way to get cognitive therapy for free, that would be pretty nifty. Well, there is.

This idea originated, in a way, not with the internet but with another technology: telephone-based "interactive voice response" (IVR). Trying to make CBT more widely available, a team of researchers created an IVR system of therapy. I never got to try it, but apparently it worked as well as a live therapist.  Then, an intermediate form of computer-assisted therapy was tested at Harvard, in which a computer program was used to deliver some of the basic explanations and planning of CBT.  Therapist time was reduced accordingly. This worked as well as standard, "live" therapy.Wright  Now, there is a program in which all of your interaction is with your computer, none with a human.

Here are several ways in which this free program could harm you:

There is no evidence that this computer approach is better than a live therapist.  So since we know that good live CBT really works; and since we don't have a head-to-head comparison of computer versus live therapist yet; for now, you should only use this approach if for some reason it's clear: you need additional antidepressant help, and you are not going to be able to see a good, live therapist.

Mood Gym, from Australia
This is the program you need to check out.  (There are others, such as an online CBT for panic disorder, but it's not free or freely available). No cost, no loss of privacy, just working through a series of lessons online, with routine homework (just as you would get from a live CBT therapist).

But does it work? Well, so far we know it works as well as some other online things you could do; and it works better than being on a wait list.Christensen And it clearly works better if you really throw yourself into it -- finishing the whole program, for example.

My opinion: if you really can't get CBT some other way; and if you need to add an additional antidepressant element into your treatment, this is not very likely to hurt you (except per the warnings above); it might help you (will probably help at least some). I think it's at least worth looking into.

Here you go, to the Mood Gym.  I hope you stick it out to see what can happen.