Guided internet-based cognitive behavioral therapy for adolescent anxiety: predictors of treatment response
Open accessAbstract
BACKGROUND: Guided internet-based cognitive behavioral therapy (ICBT) has been found efficacious in reducing symptoms of anxiety in adolescents with anxiety disorders, but not all respond equally well. OBJECTIVE: In this study, we explored candidate predictors of ICBT treatment response within the frame of a randomized controlled trial. METHODS: Sixty-five adolescents (13-17 years) with anxiety disorders according to DSM-IV received 14 weeks of therapist-guided ICBT. Outcome was evaluated as improvement (continuous change score) from pre-treatment to 12-month follow-up according to self-reported anxiety symptoms and clinician-rated diagnostic severity. Clinical predictors included baseline self- and parent-reported anxiety symptom levels, baseline clinician-rated severity of primary diagnosis, summed baseline clinician-rated severity of all anxiety diagnoses, baseline self-rated depressive symptoms, age of onset, and primary diagnosis of social phobia. Demographic predictors included age, gender and computer comfortability. Therapy process-related predictors included number of completed modules and therapist phone calls, summed duration of therapist phone calls, degree of parent support, and therapeutic alliance. Multi-level models were used to test the prediction effects over time. RESULTS: Higher levels of self- and clinician-rated baseline anxiety and self-rated depressive symptoms, female gender, and higher levels of computer comfortability were associated with increased treatment response. None of the proposed therapy process-related predictors significantly predicted treatment response. CONCLUSION: The present findings indicate that ICBT may be an acceptable choice of treatment for youths, even those with relative high levels of anxiety and depressive symptoms.
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Extrapolating research findings from face-to-face therapies to their digital equivalents may not be appropriately comparable because differences in how content is delivered are likely to affect both engagement and associated treatment responses.
“However, extrapolating research findings from face-to-face therapies to their digital equivalents may not be appropriately comparable because differences in how content is delivered (e.g., via developing human relationships) is likely to affect both engagement and associated treatment responses (20).”
From Effect of Engagement With Digital Interventions on Mental Health Outcomes: A Systematic Review and Meta-Analysis (2021) · cites this paper as [20]
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- Authors
- Stjerneklar, S., Hougaard, E., & Thastum, M.
- Affiliations
- Aarhus University (DK)
- Corresponding author
- Stjerneklar, Silke
- Venue
- Internet Interventions
- Publisher
- Elsevier BV
- Published
- 2019-03
- Volume
- 15
- Pages
- 116-125
- ISSN
- 2214-7829 (ISSN-L)
- PMC
- PMC6371410
- OpenAlex
- W2912014510
- Cited by
- 38
- References
- 72
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 2 · 2023: 6 · 2022: 8 · 2021: 6 · 2020: 4 · 2019: 3
- FWCI
- 5.93
- Type
- journal article
- Language
- en
- Update notices
- erratum (2019-09-01)
- Open access
- gold
- doi.org
- Licence
- Locations
- Internet Interventions (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Trygfonden (100886)
- Edith and Godtfred Kirk Christiansens Fund (21-5675)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- internet-based cognitive behavioral therapy, adolescent anxiety, anxiety disorders, predictors of treatment response, depressive symptoms, gender differences, social anxiety disorder, parental support, therapeutic relationship
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