The controversy and derision associated with computerized forms of psychotherapy are almost as old as George Orwell's (1949) classic book 1984, and the two are often compared. The 1980s have come and gone, making Orwell's projections of dystopia seem a bit naive yet still somehow relevant. The same might be said of many early conceptualizations of computerized psychotherapy. To the relief of many clinicians whose livelihoods depend on the practice of psychotherapy, the state of the art with respect to psychotherapy is computer-aided and not computer-replaced treatment.
Known as “therapy-support programs, ” or more popularly, “therapy extenders, ” most computer-aided psychotherapy programs are still in the developmental stage. Some have been launched and reported in the scientific literature, but few have yet been thoroughly evaluated. Preliminary indications are that outcomes with computer-based interventions maybe comparable to in-person therapy (Jacobs et al., 2001). This chapter discusses many of these new applications. Most computerized therapy programs on the open marketplace are stand-alone applications running on individual personal computers. Some of the programs available in the marketplace are discussed in chapter 13, as part of our detailing of the Online Clinical Practice Management model.
Most of this technology developed as stand-alone applications probably will be available within the next 5 to 10 years through the Internet. In fact, distributors will most likely rely at least partially on the Internet for sales, as this is the best worldwide distribution channel. The global distribution of computer-aided psychotherapy programs raises a number of multicultural and multilingual challenges, however. Web consumers may not always be in the best position to determine how to interact with materials developed for specific cultural or linguistic groups. Nonetheless, practitioners are also likely to depend increasingly on the Internet for various functions related to the delivery of services to mental health patients, including the upgrading of programs, knowledge supplementation, record storage, sophisticated data analysis, and direct delivery of services.
Ken Weingardt is a clinical psychologist investigating how the field of instructional design and technology can be used to transform empirically validated treatment