These online self-help programs have been tested in randomized controlled trials, the gold-standard in scientific research.
The Internet abounds with websites that promise solutions for what ails you, whether you want to sleep better, lose weight, quit smoking, or beat a chronic health condition. Plenty of them look legit—but can an online program really improve problems like these, right from the comfort of your home computer?
Some can, say University of Michigan researchers, but it can be hard to distinguish the science-backed sites with the unproven ones. So they did just that—compiling a Top-40 list of online programs that have all been studied, and shown to work, in randomized controlled trials.
The list of 44 sites, published this week in the Journal of Medical Internet Research, includes programs that can help people reduce their use of alcohol, tobacco, and marijuana; improve their diet and exercise habits; and manage issues like insomnia, depression, anxiety, phobias, chronic pain, cardiovascular disease risk, and childhood health problems.
“I describe these sites like programs because they’re not like little apps or quick bits of information,” says lead author Mary Rogers, Ph.D., a researcher in the department of internal medicine. “You can’t just go online and read a few paragraphs and suddenly feel better.”
Many of these website use intensive, multi-step courses developed by psychologists or physicians, she says; they require users to monitor their own progress and complete assignments on a regular basis. Some take weeks or months to complete, and some (but not all) charge a fee or require users to register.
But for many people, says Rogers, they’re worth the time and effort. “These sites made the list because, in the research, people who used them improved more than people who didn’t,” she says.
The online Biggest Loser Club, for example, helped people lose nearly five pounds and reduce their waist circumference by an inch, while people who didn’t use the program gained a pound and added .1 inch to their waist. The website painACTION improved symptoms in one out of four patients with long-term back pain, and one out of three patients with migraines, compared to a control group. And for every four people who used the online program Deprexis, one recovered from depression.
Some of these programs were created by government-funded research—“taxpayer dollars,” says Rogers—so it’s only fair that they’re available to the general public and not just to clinical trial participants, she says.
“As researchers, we publish our findings in medical journals but we don’t often take the extra steps to let the public know which interventions work and which don’t,” says Rogers. Her team looked at the results of 1,733 studies, but found that only 21 percent of online self-help programs used in those studies continued to operate after their trials were over. (Lack of continued funding is probably a big reason, she says.)
The full list of science-backed websites—most in English but some in other languages, as well—is available as a PDF on the journal’s website. Rogers says she hopes to develop a searchable database of these programs (and add to it as more studies are published) so people can easily find ones designed to help with specific problems.
Rogers stresses that this list is just a starting point, and that just because a site isn’t on the list doesn’t mean it can’t be helpful. “It just means it hasn’t been studied, so we really don’t know yet,” she says. She also points out that her team only examined single-person self-help programs—not ones that utilized group therapy or peer-to-peer mentoring.
And similarly, just because a program is on the list doesn’t mean it will help every person who tries it. “They’re not a guarantee, but if you’re looking for help for one of these problems, they’re a good starting point,” says Rogers.