The DOI matches its Crossref record; 53 of the 53 references it cites were found in a registry or an index.
Clinician-Assisted Internet-Based Treatment is Effective for Generalized Anxiety Disorder: Randomized Controlled Trial
Abstract
Objective: The aim of the present study was to determine the efficacy of an Internet-based clinician-assisted computerized cognitive behavioural treatment (CaCCBT) programme for generalized anxiety disorder (the Worry programme). Methods: Forty-eight individuals meeting diagnostic criteria for generalized anxiety disorder (GAD) were randomly assigned to the Worry programme or to a waitlist control group. In the clinician-assisted Worry programme, participants complete six online lessons, weekly homework assignments, receive weekly email contact from a clinical psychologist, and contribute to a moderated online discussion forum with other participants. An intention-to-treat model was used for data analyses. The main outcome measures were Generalized Anxiety Disorder–7 Item Scale (GAD-7) and the Penn State Worry Questionnaire (PSWQ). Results: A total of 75% of treatment group participants completed all six lessons within the 9 week programme and post-treatment data were collected from 21/24 treatment group and 19/21 control group participants. Treatment group participants reported significantly reduced symptoms of worry as measured on the GAD-7 and PSWQ and reduced symptoms of depression as measured on the Patient Health Questionnaire–9 Item Scale (PHQ-9). Mean within- and between-groups effect sizes (Cohen's d) across the two measures of GAD were 1.3 and 1.1, respectively. Participants found the treatment programme acceptable and satisfactory. The clinician spent a total mean of 130 min per person over the programme. Conclusions: The Worry programme, the first randomized controlled trial of CaCCBT for GAD, resulted in clinically significant improvements. These results are consistent with literature indicating that Internet-based programmes, when combined with clinical guidance, can significantly reduce the symptoms of common mental disorders.
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In the citing paper
“Previous ICBT studies on GAD indicate that ICBT can be effective.”
From Internet-delivered acceptance-based behavior therapy for generalized anxiety disorder: A pilot study (2016) · cites this paper as Titov et al., 2009
In the citing paper
“a number of studies have investigated the potential for internet-delivered treatments for GAD and they have reported significant post-treatment and follow-up gains [33,48-51] similar to those found in face-to-face treatment studies [52].”
From Low-intensity internet-delivered treatment for generalized anxiety symptoms in routine care: protocol for a randomized controlled trial (2014) · cites this paper as [51]
In the citing paper
“However, only a handful of studies have investigated the efficacy and effectiveness of low-intensity internet-delivered treatments for GAD [33,48-51].”
From Low-intensity internet-delivered treatment for generalized anxiety symptoms in routine care: protocol for a randomized controlled trial (2014) · cites this paper as [51]
Citations
Cites
The PHQ-9: Validity of a brief depression severity measure
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009606.x · Cited by 44,910
A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1092 · Cited by 31,765
(1998) · The Journal of Clinical Psychiatry · Cited by 19,139
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)
American Psychiatric Association (2000) · doi:10.1176/appi.books.9780890423349 · Cited by 11,069
KESSLER, R. C., ANDREWS, G., COLPE, L. J., HIRIPI, E., MROCZEK, D. K., NORMAND, S.-L. T., WALTERS, E. E., & ZASLAVSKY, A. M. (2002) · Psychological Medicine · doi:10.1017/s0033291702006074 · Cited by 10,327
Self-citationDevelopment and validation of the Penn State Worry Questionnaire
Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990) · Behaviour Research and Therapy · doi:10.1016/0005-7967(90)90135-6 · Cited by 5,099 · cited 13×
“Univariate ANCOVAs on post-treatment GAD-7 and PSWQ scores, controlling for pre-treatment scores (Table 1), showed that the treatment group had significantly lower post-treatment scores than the control group (F1,42 27.38, p B 0.001; F1,42 12.89, p B 0.001), respectively.”
MethodInfluentialLöwe, B., Decker, O., Müller, S., Brähler, E., Schellberg, D., Herzog, W., & Herzberg, P. Y. (2008) · Medical Care · doi:10.1097/mlr.0b013e318160d093 · Cited by 4,527
Moher, D. (2001) · JAMA · doi:10.1001/jama.285.15.1987 · Cited by 2,545
Psychometric properties of the credibility/expectancy questionnaire
Devilly, G. J., & Borkovec, T. D. (2000) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/s0005-7916(00)00012-4 · Cited by 2,295 · cited 7×
“Pre-treatment expectancies and treatment satisfaction Pre-treatment expectancies, as measured on the expectancy factors from the CEQ, were not significantly correlated with any of the outcome measure change scores.”
BackgroundMethodInfluentialInternet-based cognitive behaviour therapy for symptoms of depression and anxiety: A meta-analysis
SPEK, V., CUIJPERS, P., NYKLÍČEK, I., RIPER, H., KEYZER, J., & POP, V. (2007) · Psychological Medicine · doi:10.1017/s0033291706008944 · Cited by 1,586
Hoffman, S. G., & Smits, J. A. J. (2008) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v69n0415 · Cited by 1,420
Sheehan, D. V. (1984) · Medical Entomology and Zoology · Cited by 883
Generalized anxiety disorder: prevalence, burden, and cost to society
Wittchen, H.-U. (2002) · Depression and Anxiety · doi:10.1002/da.10065 · Cited by 733
Internet-based self-help for depression: randomised controlled trial
Andersson, G., Bergström, J., Holländare, F., Carlbring, P., Kaldo, V., & Ekselius, L. (2005) · British Journal of Psychiatry · doi:10.1192/bjp.187.5.456 · Cited by 529
National Survey of Mental Health and Wellbeing: Summary of Results
(2008) · PsycEXTRA Dataset · doi:10.1037/e681292012-001 · Cited by 525
Ladouceur, R., Dugas, M. J., Freeston, M. H., Léger, E., Gagnon, F., & Thibodeau, N. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.6.957 · Cited by 446 · cited 1×
“GAD can be treated effectively with cognitive behavioural therapies (CBT) [10], particularly those that include components addressing the cognitive aspects of worry [11,12].”
BackgroundHuman and economic burden of generalized anxiety disorder
Hoffman, D. L., Dukes, E. M., & Wittchen, H.-U. (2008) · Depression and Anxiety · doi:10.1002/da.20257 · Cited by 438
Vickers, A. J. (2005) · BMC Medical Research Methodology · doi:10.1186/1471-2288-5-35 · Cited by 400
Andersson, G., Carlbring, P., Holmström, A., Sparthan, E., Furmark, T., Nilsson-Ihrfelt, E., Buhrman, M., & Ekselius, L. (2006) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.74.4.677 · Cited by 382
Treatment of panic disorder: live therapy vs. self-help via the Internet
Carlbring, P., Nilsson-Ihrfelt, E., Waara, J., Kollenstam, C., Buhrman, M., Kaldo, V., Söderberg, M., Ekselius, L., & Andersson, G. (2005) · Behaviour Research and Therapy · doi:10.1016/j.brat.2004.10.002 · Cited by 372
Dugas, M. J., Ladouceur, R., Léger, E., Freeston, M. H., Langolis, F., Provencher, M. D., & Boisvert, J.-M. (2003) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.71.4.821 · Cited by 331 · cited 1×
“GAD can be treated effectively with cognitive behavioural therapies (CBT) [10], particularly those that include components addressing the cognitive aspects of worry [11,12].”
BackgroundThe empirical basis of generalized anxiety disorder
Brown, T. A., Barlow, D. H., & Liebowitz, M. R. (1994) · American Journal of Psychiatry · doi:10.1176/ajp.151.9.1272 · Cited by 311
Carlbring, P., Gunnarsdóttir, M., Hedensjö, L., Andersson, G., Ekselius, L., & Furmark, T. (2007) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.105.020107 · Cited by 299
Is internet-based CBT for panic disorder and agoraphobia as effective as face-to-face CBT?
Kiropoulos, L. A., Klein, B., Austin, D. W., Gilson, K., Pier, C., Mitchell, J., & Ciechomski, L. (2008) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2008.01.008 · Cited by 290
Clinician-Assisted Internet-Based Treatment is Effective for Panic: A Randomized Controlled Trial
Wims, E., Titov, N., Andrews, G., & Choi, I. (2010) · Australian & New Zealand Journal of Psychiatry · doi:10.3109/00048671003614171 · Cited by 290
Self-citationCarlbring, P., Bohman, S., Brunt, S., Buhrman, M., Westling, B. E., Ekselius, L., & Andersson, G. (2006) · American Journal of Psychiatry · doi:10.1176/ajp.2006.163.12.2119 · Cited by 262
Mitte, K. (2005) · Psychological Bulletin · doi:10.1037/0033-2909.131.5.785 · Cited by 239
Efficacy of internet therapy for panic disorder
Klein, B., Richards, J. C., & Austin, D. W. (2006) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2005.07.001 · Cited by 236
Clinician-Assisted Internet-Based Treatment is Effective for Depression: Randomized Controlled Trial
Perini, S., Titov, N., & Andrews, G. (2009) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670902873722 · Cited by 231 · cited 1×
“We have demonstrated the clinical efficacy of clinician-assisted (CaCCBT) programmes in randomized controlled trials (RCTs) or open studies in patients with depression [16,17], social phobia [18 25], and in a recent trial in patients with panic disorder [26].”
MethodSelf-citationTitov, N., Andrews, G., Choi, I., Schwencke, G., & Mahoney, A. (2008) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670802512107 · Cited by 221
Self-citationPrevalence and Severity of Mental Health-Related Disability and Relationship to Diagnosis
Sanderson, K. A., & Andrews, G. (2002) · Psychiatric Services · doi:10.1176/appi.ps.53.1.80 · Cited by 202
Self-citationWells, J. E., Browne, M. A. O., Scott, K. M., McGee, M. A., Baxter, J., & Kokaua, J. (2006) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/j.1440-1614.2006.01903.x · Cited by 194
Hands-on Help: computer-aided Psychotherapy
Marks, I. M., Cavanagh, K., & Gega, L. (2007) · doi:10.25405/ncl.34083078 · Cited by 182
Shyness 1: Distance Treatment of Social Phobia Over the Internet
Titov, N., Andrews, G., Schwencke, G., Drobny, J., & Einstein, D. (2008) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670802119762 · Cited by 180
Self-citationHUNT, C., ISSAKIDIS, C., & ANDREWS, G. (2002) · Psychological Medicine · doi:10.1017/s0033291702005512 · Cited by 171
Self-citationMarks, I. M., Cavanagh, K., & Gega, L. (2007) · Psychology Press eBooks · doi:10.4324/9780203962152 · Cited by 167
Shyness 2: Treating Social Phobia Online: Replication and Extension
Titov, N., Andrews, G., & Schwencke, G. (2008) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670802119820 · Cited by 133
Self-citationComputer-Aided Psychological Treatments: Evolving Issues
Marks, I., & Cavanagh, K. (2009) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.032408.153538 · Cited by 133 · cited 1×
“These results are consistent with a growing body of Australianbased [27 29] and international [30 34] research indicating the clinical efficacy and effectiveness of Internet-based clinician-assisted CCBT (CaCCBT) in the effective treatment of anxiety and depression [35,36].”
ResultRandomized Controlled Trial of Web-Based Treatment of Social Phobia Without Clinician Guidance
Titov, N., Andrews, G., Choi, I., Schwencke, G., & Johnston, L. (2009) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670903179160 · Cited by 122
Self-citationStatus of computerized cognitive behavioural therapy for adults
Titov, N. (2007) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670601109873 · Cited by 120 · cited 1×
“CCBT programmes use a computer interface to present structured sessions of CBT either via the Internet or at a clinic, and may therefore reduce barriers to treatment [14,15].”
BackgroundSelf-citationPatterns and correlates of generalized anxiety disorder in community samples.
Kessler, R. C., & Wïttchen, H. (2002) · PubMed · Cited by 115
Titov, N., Andrews, G., Schwencke, G., Solley, K., Johnston, L., & Robinson, E. (2009) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670903179228 · Cited by 112
Self-citationVickers, A. J. (2005) · Psychosomatic Medicine · doi:10.1097/01.psy.0000172624.52957.a8 · Cited by 99
Shyness programme: Longer term benefits, cost-effectiveness, and acceptability
Titov, N., Andrews, G., Johnston, L., Schwencke, G., & Choi, I. (2009) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670802534424 · Cited by 88
Self-citationShandley, K., Austin, D. W., Klein, B., Pier, C., Schattner, P., Pierce, D., & Wade, V. (2008) · Journal of Medical Internet Research · doi:10.2196/jmir.1033 · Cited by 84
Internet Treatment for Social Phobia Reduces Comorbidity
Titov, N., Gibson, M., Andrews, G., & McEvoy, P. (2009) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670903001992 · Cited by 58
Self-citationGelenberg, A. J. (2002) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v63n0101 · Cited by 58
Aydos, L., Titov, N., & Andrews, G. (2009) · Australasian Psychiatry · doi:10.1080/10398560903284943 · Cited by 49
The Climate Sadness program: an open trial of Internet-based treatment for depression
Perini, S., Titov, N., & Andrews, G. (2008) · E-Journal of Applied Psychology · doi:10.7790/ejap.v4i2.135 · Cited by 38 · cited 1×
“We have demonstrated the clinical efficacy of clinician-assisted (CaCCBT) programmes in randomized controlled trials (RCTs) or open studies in patients with depression [16,17], social phobia [18 25], and in a recent trial in patients with panic disorder [26].”
MethodSelf-citationTreating generalized anxiety disorder with cognitive-behavioral therapy.
Lang, A. J. (2004) · PubMed · Cited by 22
Internet-Based Self-Management of Generalised Anxiety Disorder: A Preliminary Study
Draper, M., Rees, C. S., & Nathan, P. R. (2008) · Behaviour Change · doi:10.1375/bech.25.4.229 · Cited by 17
The Climate Panic program: an open trial of Internet-based treatment for panic disorder
Wims, E., Titov, N., & Andrews, G. (2008) · E-Journal of Applied Psychology · doi:10.7790/ejap.v4i2.134 · Cited by 16
Self-citationDepression and Generalized Anxiety Symptoms in Panic Disorder Implications for Comorbidity
Ball, S. G., Buchwald, A. M., Waddell, M. T., & Shekhar, A. (1995) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199505000-00005 · Cited by 11
Research works printed but not linked: 2
- Lang AJ, 2004, J Clin Psychiatry, 65, 14
- Sheehan DV, 1998, J Clin Psychiatry, 59, 22
Cited by
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Persuasive System Design Does Matter: a Systematic Review of Adherence to Web-based Interventions
Kelders, S. M., Kok, R. N., Ossebaard, H. C., & Van Gemert-Pijnen, J. E. (2012) · Journal of Medical Internet Research · doi:10.2196/jmir.2104 · Cited by 1,308
Andrews, G., Cuijpers, P., Craske, M. G., McEvoy, P., & Titov, N. (2010) · PLoS ONE · doi:10.1371/journal.pone.0013196 · Cited by 1,311
Self-citationAdvantages and limitations of Internet-based interventions for common mental disorders
Andersson, G., & Titov, N. (2014) · World Psychiatry · doi:10.1002/wps.20083 · Cited by 1,160
Self-citationAndrews, G., Basu, A., Cuijpers, P., Craske, M. G., McEvoy, P., English, C. L., & Newby, J. M. (2018) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2018.01.001 · Cited by 922
Self-citationInternet-Delivered Psychological Treatments
Andersson, G. (2016) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-021815-093006 · Cited by 595
Metadata
- Authors
- Titov, N., Andrews, G., Robinson, E., Schwencke, G., Johnston, L., Solley, K., & Choi, I.
- Affiliations
- UNSW Sydney (AU)
- St Vincent's Hospital Sydney (AU)
- Corresponding author
- Titov, Nickolai
- Venue
- Australian & New Zealand Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2009-01-01
- Volume
- 43
- Issue
- 10
- Pages
- 905-912
- ISSN
- 0004-8674 (ISSN-L)
- 1440-1614
- OpenAlex
- W2102373238
- Semantic Scholar
- 0c00964dd9a9544f82e95160878f9726632ce6dc
- Cited by
- 147
- References
- 53
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 6 · 2023: 5 · 2022: 11 · 2021: 4 · 2020: 10 · 2019: 6 · 2018: 9 · 2017: 6 · 2016: 7 · 2015: 14 · 2014: 12 · 2013: 13 · 2012: 13
- FWCI
- 14.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Australian & New Zealand Journal of Psychiatry (publishedVersion)
- Funders
- Australian Rotary Health
- University of New South Wales
- 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
- generalized anxiety disorder, online therapy, worry, depression, treatment acceptability
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