Depression is a common mental health problem. An effective talking treatment for depression is cognitive behaviour therapy (CBT). Computerised CBT (cCBT) is a more recently developed form of CBT that is delivered with help from a computer rather than a face-to-face therapist. Previous research indicates that the effectiveness of cCBT can be increased when it is supported with guidance delivered by telephone. We conducted a fair test of a freely available cCBT program [MoodGYM (National Institute for Mental Health Research, Australian National University, Canberra, ACT, Australia)] delivered in two different ways. In the first way, cCBT was delivered with minimal support, as offered in the UK NHS at the moment. In the second, the same cCBT program was delivered, but in conjunction with weekly telephone calls providing guidance delivered according to a manual (telephone-facilitated cCBT).

A total of 369 people with depression were allocated either (1) cCBT with minimal support or (2) telephone-facilitated cCBT. People recruited to the trial completed questionnaires about symptoms of depression, and general and mental well-being, at 4 and 12 months after the study started.

The telephone facilitation of the cCBT program resulted in additional reductions in depression severity in the short term, but we were no longer able to detect this effect at 12 months. The provision of telephone facilitation therefore increases the effectiveness of cCBT. We found that this enhancement of care was achieved at an acceptable cost and is likely to be good value for money for the NHS. When people with depression are offered cCBT, they should also be offered telephone support to increase the chances of deriving benefit.