Therapy via Internet yields good results

"The purpose of Internet-based treatment is not to replace traditional therapy, face to face, for those who need it. But for many people it is an equally good, even better, alternative, since they can choose their own time and place," he says.

"There is no single depression treatment that fits everybody. But the more treatments we have, the better the chance of finding the right treatment for the next person seeking help."

The primary advantage is that more people can get access to treatment that thus far has involved a long waiting list. And for patients who risk relapsing this is an especially welcome improvement, as the shortage of trained CBT therapists limits the possibility of continued treatment.

"If there are lingering symptoms following a treatment for depression, there is a great risk of relapse. But among the individuals with previous depressions who participated in our Internet-based relapse prevention, only 10 percent experienced a new period of depression, compared with 38 percent in the control group."

Even in Internet treatment, patients have the support of a personal therapist, but this involves about 2-2.5 hours of the therapist's work time, which can be compared with 45 minutes per week for 10-15 weeks in traditional CBT.

"The county councils that introduced Internet treatment estimate that they will be able to treat four times as many patients as when they work face to face."

"What's more, society can probably save huge amounts of money if we can prevent relapses, since 10 percent of all sickness compensation in Sweden goes to individuals who are on leave owing to depression."

What makes CBT especially suitable for Internet-based treatment is that is based on a number of principles that therapists teach their patients to use in their own everyday lives.

"What's important is not the therapist as an individual but rather the specific methods that are the core of CBT, and these can be taught in many different ways -- including via the Internet," says Fredrik Holländare, who has worked at a psychiatric outpatient unit in Hallsberg since 2002.