Psychological Medicine

Review Article

The acceptability to patients of computerized cognitive behaviour therapy for depression: a systematic review

E. Kaltenthalera1 c1, P. Sutcliffea1, G. Parrya1, C. Beverleya2, A. Reesa1 and M. Ferritera3

a1 School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK

a2 Adult Social Care Directorate, Cumbria County Council, Rickergate, Carlisle, UK

a3 Department of Research and Development, Nottinghamshire Healthcare NHS Trust, Rampton Hospital, Woodbeck, Notts, UK


Background Cognitive behaviour therapy (CBT) is widely used to treat depression. However, CBT is not always available to patients because of a shortage of therapists and long waiting times. Computerized CBT (CCBT) is one of several alternatives currently available to treat patients with depression. Evidence of its clinical effectiveness has led to programs being used increasingly within the UK and elsewhere. However, little information is available regarding the acceptability of CCBT to patients.

Method A systematic review of sources of information on acceptability to patients of CCBT for depression.

Results Sources of information on acceptability included: recruitment rates, patient drop-outs and patient-completed questionnaires. We identified 16 studies of CCBT for the treatment of depression that provided at least some information on these sources. Limited information was provided on patient take-up rates and recruitment methods. Drop-out rates were comparable to other forms of treatment. Take-up rates, when reported, were much lower. Six of the 16 studies included specific questions on patient acceptability or satisfaction although information was only provided for those who had completed treatment. Several studies have reported positive expectancies and high satisfaction in routine care CCBT services for those completing treatment.

Conclusions Trials of CCBT should include more detailed information on patient recruitment methods, drop-out rates and reasons for dropping out. It is important that well-designed surveys and qualitative studies are included alongside trials to determine levels and determinants of patient acceptability.

(Received March 01 2007)

(Revised November 26 2007)

(Accepted November 26 2007)

(Online publication January 21 2008)


c1 Address for correspondence: Dr E. Kaltenthaler, School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK. (Email: