Computer-administered therapies are most beneficial when integrated into a stepped care treatment program. In stepped care, self-help that is not occurring or is occurring without expected benefits can be rapidly augmented by coaching to encourage program use to troubleshoot problems with cognitive-behavior therapy (CBT) techniques. The state of affairs in obsessive-compulsive disorder (OCD) led to the development of BT STEPSTM, a nine-step computer-administered, self-help, interactive voice response (IVR) CBT program. Insurers are reluctant to embrace computer-based therapies, stating that they will not pay for nonhuman therapy even when human therapy is rationed and often less effective. It is early in the course of design, development, study, and dissemination of computer therapies. Elements of effective human therapy that seem worthy of emulation in computer-assisted therapy include clarity, interactivity, flexibility, empathy, brevity, assessment and monitoring, and reinforcement of attempts at and accomplishment of therapeutic change.