Internet-Delivered Cognitive Behavior Therapy for Anxiety Disorders Is Here to Stay
Abstract
Anxiety disorders are common and disabling. Cognitive behavior therapy is the treatment of choice but is often difficult to obtain. Automated, internet-delivered, cognitive behavior therapy (iCBT) courses may be an answer. There are three recent systematic reviews of randomized controlled trials that show that the benefits are substantial (d = 1.0) and similar to face to face CBT. There are two large effectiveness trials that demonstrate strong effects when iCBT is used in primary care; 60 % of patients who complete the courses no longer meet diagnostic criteria. The courses are suitable for most people with a primary anxiety disorder. Research studies usually exclude people whose anxiety is secondary to schizophrenia, bipolar disorder, or substance abuse or who are actively suicidal. Little additional input from clinicians is required. Patients find the courses very convenient. Clinically, the principal advantage is the fidelity of the treatment. What you prescribe is what the patient sees.
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The sample size was calculated to detect a large effect size (d = 1) with a power of 0.80 and an alpha of 0.05, accounting for 30% Internet dropout rates, yielding a minimum of 57 participants.
“Power calculations and Internet dropout rates (30 %) [51, 52] were taken into consideration to estimate the necessary sample size to detect a large effect size (d = 1) with a power of 0.80 and an alpha of 0.05, based on a similar study [32] and recent systematic reviews [36]. The RCT will recruit a minimum of 57 participants”
From An Internet-based treatment for flying phobia (NO-FEAR Airlines): Study protocol for a randomized controlled trial (2016) · cites this paper as [36]
Self-applied interventions improve the possibility of reaching people in need, improving access to evidence-based treatments.
“These self-applied interventions improve the possibility of reaching people in need, improving the access to evidence-based treatments [33, 36]”
From An Internet-based treatment for flying phobia (NO-FEAR Airlines): Study protocol for a randomized controlled trial (2016) · cites this paper as [36]
Internet-delivered cognitive-behavioral therapy has advantages including confidentiality, cost savings, flexibility, and the possibility of reaching patients who would otherwise never receive psychological assistance.
“Some of the main advantages of these kinds of interventions are confidentiality, cost savings, flexibility because patients can access the treatment at any time and from anywhere, and the possibility of reaching patients who would otherwise never receive psychological assistance [24, 25].”
From An internet-based intervention for adjustment disorder (TAO): Study protocol for a randomized controlled trial (2018) · cites this paper as [24]
Computerised or digital CBT programmes have been shown to be effective in treating anxiety and depression in primary care settings in some studies but not all.
“Computerised or digital CBT programmes have been shown to be effective in treating anxiety and depression in primary care settings in some21–24 but not all studies.25 26”
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- Authors
- Andrews, G., Newby, J. M., & Williams, A. D.
- Affiliations
- UNSW Sydney (AU)
- Corresponding author
- Andrews, Gavin
- Venue
- Current Psychiatry Reports
- Published
- 2014-11-21
- Volume
- 17
- Issue
- 1
- Pages
- 533-533
- ISSN
- 1523-3812 (ISSN-L)
- 1535-1645
- OpenAlex
- W2041710115
- Cited by
- 48
- References
- 31
- Citations by year
- 2025: 2 · 2024: 3 · 2023: 8 · 2022: 3 · 2021: 5 · 2020: 3 · 2019: 8 · 2018: 8 · 2017: 4 · 2016: 2 · 2015: 2
- FWCI
- 0.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Current Psychiatry Reports (publishedVersion)
- PubMed (publishedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- internet-based cognitive behavioral therapy, anxiety disorders, intervention fidelity, primary care, access to mental health care
- MeSH terms
- Anxiety Disorders, Humans, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Telemedicine, Internet
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