A piece found on nature.com highlighted the existing and emerging technologies that allow clients to receive CBT through virtual means. Some include virtual reality and smartphone Apps. Some pros I can see are helping those with agoraphobia avoid anxiety with social situations. However, this may also isolate the same clients whose goals are to overcome their anxiety.

“The most common application is digital delivery of cognitive behavioural therapy (CBT) for depression and anxiety disorders, but the area is diversifying rapidly. Pear Therapeutics in Boston partnered with Sandoz, a division of Swiss pharmaceutical company Novartis, to develop an app called reSET that delivers CBT for substance-abuse disorder. Pear also has plans to develop a product for schizophrenia, and is collaborating with the University of Virginia in Charlottesville to develop a treatment for insomnia and depression, called Somryst. The leading player in this area is currently London- and San Francisco-based digital-health company Big Health. Its Sleepio system is an online self-care programme based on CBT for insomnia, which has been shown to improve both insomnia symptoms and mental well-being.”

A concerning phenomenon with our increased screen time is decreased social interactions. My experience working with clients in an outpatient behavioural health program with CBT can support the use of these technologies, but in my opinion, does not replace them. Having physical social interaction in a support group is invaluable. You need to see others and their expressions, hear the voices, be in the same room – to experience collective effervescence.

Collective Effervescence – a community or society may at times come together and simultaneously communicate the same thought and participate in the same action. Such an event then causes collective effervescence which excites individuals and serves to unify the group.

Participating in these programs has the benefits:

  • Following a schedule (routines)
  • Holding clients accountable
  • Participate by speaking out and expressing their thoughts & feelings, the vital concepts of CBT itself.

Well, what about in a virtual context? A skype conference call comes to mind. While this may have many benefits for clients who live in rural or restrictive environments (because not clients are able-bodied and able to physically come to these programs), there are many barriers that should be addressed for quality care such as quality of video/audio/lighting, delays in communication, knowledge and physical access to technologies. Even with these factors addressed, I imagine being behind a computer would lead me to be more passive and feel less included than physically being in a room with other people who are experiencing the same hardships as me. If possible, these technologies should supplement conventional methods, to provide additional tools to clients and to hold them accountable outside of therapy, in their home/work/environment.