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Californians with chronic pain or depression are frequently seen in safety-net clinics. Cognitive behavioral therapy has been shown to be effective with both conditions, but a shortage of behavioral health providers is a significant barrier to timely treatment in these settings.

Digital programs that provide computerized cognitive behavioral therapy (CCBT) may hold promise for these patients. Such programs can be used on computers and handheld devices. To find out what the barriers are and how they might be overcome, the California Health Care Foundation funded two pilot tests, one focused on depression and one on chronic pain.

• Beating the Blues is a series of eight 50-minute CCBT sessions that use video vignettes designed for adults with mild-to-moderate depression. It was administered through the California Institute for Behavioral Health Solutions at community clinics in San Joaquin and Modoc Counties.

• ReThink Pain is a program designed for chronic pain patients in the safety net who are seeking a non-medication alternative to treatment. It was administered by the San Francisco Health Plan at 10 of their clinics in San Francisco.

Both pilots encountered significant challenges, which are described in the issue brief. After the programs were completed, staff members offered detailed recommendations to help safety-net organizations succeed in the use of CCBT with their depression and chronic pain patients.

The complete issue brief is available as a Document Download.