Guided Internet-Delivered Cognitive Behavior Therapy for Generalized Anxiety Disorder: A Randomized Controlled Trial

Paxling, Björn; Almlöv, Jonas; Dahlin, Mats; Carlbring, Per; Breitholtz, Elisabeth; Eriksson, Thomas; Andersson, Gerhard

doi:10.1080/16506073.2011.576699

Cited by 147Digital Mental Health InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychological Treatments and Assessments

Guided Internet-Delivered Cognitive Behavior Therapy for Generalized Anxiety Disorder: A Randomized Controlled Trial

Paxling, Björn, Almlöv, Jonas, Dahlin, Mats, Carlbring, Per, Breitholtz, Elisabeth, Eriksson, Thomas, Andersson, Gerhard·2011·Cognitive Behaviour Therapy

DOI 10.1080/16506073.2011.576699

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Abstract

Generalized anxiety disorder (GAD) has been effectively treated with cognitive behavioural therapy (CBT) in face-to face settings. Internet-delivered CBT could be a way to increase the accessibility and affordability of CBT for people suffering from GAD. The aim of this study was to evaluate the efficacy of guided Internet-delivered CBT for GAD in a controlled trial with a wait-list control group. A total of 89 participants were included following online screening and a structured psychiatric telephone interview. Participants were randomized to either an 8-week treatment group (n = 44) or a wait-list control group (n = 45). Treatment consisted of a self-help program based on CBT principles and applied relaxation along with therapist guidance. The main outcome measure was the Penn State Worry Questionnaire. Ratings of clinical improvement and symptoms were included as well as secondary outcome measures dealing with anxiety, depression, and quality of life. Among the treatment group participants, 13.6% did not complete the posttreatment measures. The treatment group showed significant improvement compared with the control group on all outcome measures. Large effect sizes (Cohen's d > 0.8) were found both within the treatment group and between the groups in favor of the treatment on all outcome measures except on a measure of quality of life. Results at 1- and 3-year follow-up indicated that treatment results improved or were maintained. The authors conclude that Internet-delivered CBT with therapist support can reduce symptoms and problems related to GAD.

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Previous internet-delivered cognitive behavior therapy studies on generalized anxiety disorder indicate that internet-delivered cognitive behavior therapy can be effective.
“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 Paxling et al., 2011
Guided iCBT has been found to be effective for numerous specific disorders such as panic disorder, generalized anxiety disorder, social anxiety disorder, posttraumatic stress disorder, specific phobia, major depression, stress, and somatic health problems such as irritable bowel syndrome.
“Guided iCBT has been found to be effective for numerous specific disorders such as panic disorder [4,5], generalized anxiety disorder [6,7], social anxiety disorder [8-10], posttraumatic stress disorder [11], specific phobia [12], major depression [3], stress [13], and somatic health problems such as irritable bowel syndrome [14].”
From Individually Tailored Internet-Based Treatment for Young Adults and Adults With Panic Attacks: Randomized Controlled Trial (2012) · cites this paper as [7]
A number of studies have investigated the potential for internet-delivered treatments for GAD and reported significant post-treatment and follow-up gains similar to those found in face-to-face treatment studies.
“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 [49]
Only a handful of studies have investigated the efficacy and effectiveness of low-intensity internet-delivered treatments for GAD.
“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 [49]
Previous studies of online interventions for GAD that have used a CBT protocol similar to the intervention in the current study have reported post-treatment effect sizes of between 0.79 and 1.67, and follow-up effects of between 0.69 and 1.65, based on sample sizes ranging from 10 to 97.
“Previous studies of online interventions for GAD that have used a CBT protocol similar to the intervention in the current study have reported post-treatment effect sizes of between 0.79 and 1.67, and follow-up effects of between 0.69 and 1.65, based on sample sizes ranging from 10 to 97 [33,48-50].”
From Low-intensity internet-delivered treatment for generalized anxiety symptoms in routine care: protocol for a randomized controlled trial (2014) · cites this paper as [49]

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Andrews, G., Bell, C., Boyce, P., Gale, C., Lampe, L., Marwat, O., Rapee, R., & Wilkins, G. (2018) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867418799453 · Cited by 243 · see citing works
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Transdiagnostic versus disorder-specific and clinician-guided versus self-guided internet-delivered treatment for generalized anxiety disorder and comorbid disorders: A randomized controlled trial
Dear, B. F., Staples, L. G., Terides, M. D., Karin, E., Zou, J., Johnston, L., Gandy, M., Fogliati, V. J., Wootton, B. M., McEvoy, P. M., et al. (2015) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2015.09.003 · Cited by 230 · see citing works
A smartphone-based health care chatbot to promote self-management of chronic pain (SELMA): pilot randomized controlled trial
Hauser-Ulrich, S., Künzli, H., Meier-Peterhans, D., & Kowatsch, T. (2020) · JMIR mHealth and uHealth · doi:10.2196/15806 · Cited by 210 · see citing works
Therapeutic alliance in guided internet-delivered cognitive behavioural treatment of depression, generalized anxiety disorder and social anxiety disorder
Andersson, G., Paxling, B., Wiwe, M., Vernmark, K., Felix, C. B., Lundborg, L., Furmark, T., Cuijpers, P., & Carlbring, P. (2012) · Behaviour Research and Therapy · doi:10.1016/j.brat.2012.05.003 · Cited by 202 · see citing works
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Effect of cognitive-behavioral therapy for anxiety disorders on quality of life: A meta-analysis.
Hofmann, S. G., Wu, J. Q., & Boettcher, H. (2014) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0035491 · Cited by 191 · see citing works
Internet-Based Psychodynamic versus Cognitive Behavioral Guided Self-Help for Generalized Anxiety Disorder: A Randomized Controlled Trial
Andersson, G., Paxling, B., Roch-Norlund, P., Östman, G., Norgren, A., Almlöv, J., Georén, L., Breitholtz, E., Dahlin, M., Cuijpers, P. J., et al. (2012) · Psychotherapy and Psychosomatics · doi:10.1159/000339371 · Cited by 181 · see citing works
Self-citation
Therapist Behaviours in Internet-Delivered Cognitive Behaviour Therapy: Analyses of E-Mail Correspondence in the Treatment of Generalized Anxiety Disorder
Paxling, B., Lundgren, S., Norman, A., Almlöv, J., Carlbring, P., Cuijpers, P., & Andersson, G. (2013) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465812000240 · Cited by 162 · see citing works
Self-citation
Two decades of digital interventions for anxiety disorders: a systematic review and meta-analysis of treatment effectiveness
Pauley, D., Cuijpers, P., Papola, D., Miguel, C., & Karyotaki, E. (2021) · Psychological Medicine · doi:10.1017/s0033291721001999 · Cited by 170 · see citing works
Effectiveness of Guided Internet-Based Cognitive Behavior Therapy in Regular Clinical Settings
Andersson, G., & Hedman, E. (2013) · Verhaltenstherapie · doi:10.1159/000354779 · Cited by 165 · see citing works
Self-citation
Internet-based guided self-help for several anxiety disorders: A randomized controlled trial comparing a tailored with a standardized disorder-specific approach.
Berger, T., Boettcher, J., & Caspar, F. (2014) · Psychotherapy · doi:10.1037/a0032527 · Cited by 158 · see citing works
Transdiagnostic versus diagnosis specific cognitive behavioural therapies for anxiety: A meta-analysis
Pearl, S. B., & Norton, P. J. (2017) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2016.07.004 · Cited by 156 · see citing works
Psychological and pharmacological treatments for generalized anxiety disorder (GAD): a meta-analysis of randomized controlled trials
Carl, E., Witcraft, S. M., Kauffman, B. Y., Gillespie, E. M., Becker, E. S., Cuijpers, P., Van Ameringen, M., Smits, J. A. J., & Powers, M. B. (2020) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2018.1560358 · Cited by 151 · see citing works
Online interventions for depression and anxiety – a systematic review
Saddichha, S., Al-Desouki, M., Lamia, A., Linden, I. A., & Krausz, M. (2014) · Health Psychology and Behavioral Medicine · doi:10.1080/21642850.2014.945934 · Cited by 133 · see citing works
“Moderate effect sizes (0.6–0.8) noted on PSWQ, PDSS-SR, K-10 and NEO FFI-N Completion rates of 81% Intention-to-treat analyses 41–73% of participants were classified as in remission at posttreatment and 50–59% were classified as recovered (Continued ) H ealth P sychology & B ehavioural M edicine 873 874 S. Saddichha e…”
MethodInfluential
Therapist-supported Internet cognitive behavioural therapy for anxiety disorders in adults
Olthuis, J. V., Watt, M. C., Bailey, K., Hayden, J. A., & Stewart, S. H. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011565 · Cited by 150 · see citing works
Effectiveness and cost-effectiveness of individually tailored Internet-delivered cognitive behavior therapy for anxiety disorders in a primary care population: A randomized controlled trial
Nordgren, L. B., Hedman, E., Etienne, J., Bodin, J., Kadowaki, Å., Eriksson, S., Lindkvist, E., Andersson, G., & Carlbring, P. (2014) · Behaviour Research and Therapy · doi:10.1016/j.brat.2014.05.007 · Cited by 145 · see citing works
“…effects of ICBT for anxiety disorders (Carlbring et al., 2011; Carlbring, Nordgren, Furmark, & Andersson, 2009; Hedman, Furmark, et al., 2011; Paxling et al., 2011), and the evidence base for the clinical effectiveness of ICBT is growing, showing promising results (Bell, Colhoun, Carter, &…”
ResultSelf-citation
Therapeutic alliance in guided internet therapy programs for depression and anxiety disorders – A systematic review
Pihlaja, S., Stenberg, J.-H., Joutsenniemi, K., Mehik, H., Ritola, V., & Joffe, G. (2018) · Internet Interventions · doi:10.1016/j.invent.2017.11.005 · Cited by 134 · see citing works
Implementation of Telemental Health Services Before COVID-19: Rapid Umbrella Review of Systematic Reviews
Barnett, P., Goulding, L., Casetta, C., Jordan, H., Sheridan-Rains, L., Steare, T., Williams, J., Wood, L., Gaughran, F., & Johnson, S. (2021) · Journal of Medical Internet Research · doi:10.2196/26492 · Cited by 136 · see citing works
Guided internet-based CBT for common mental disorders
Andersson, G., Carlbring, P., Ljótsson, B., & Hedman, E. (2013) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-013-9237-9 · Cited by 119 · see citing works
Self-citation
Long-term effects of internet-supported cognitive behaviour therapy
Andersson, G., Rozental, A., Shafran, R., & Carlbring, P. (2018) · Expert Review of Neurotherapeutics · doi:10.1080/14737175.2018.1400381 · Cited by 117 · see citing works
Self-citation
The efficacy of internet-delivered treatment for generalized anxiety disorder: A systematic review and meta-analysis
Richards, D., Richardson, T., Timulak, L., & McElvaney, J. (2015) · Internet Interventions · doi:10.1016/j.invent.2015.07.003 · Cited by 111 · see citing works
“Four studies were GAD specific samples and interventions (Andersson et al., 2012; Paxling et al., 2011; Robinson et al., 2010; Titov et al., 2009), the remainder were transdiagnostic.”
BackgroundMethodInfluential
Media-delivered cognitive behavioural therapy and behavioural therapy (self-help) for anxiety disorders in adults
Mayo-Wilson, E., & Montgomery, P. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005330.pub4 · Cited by 112 · see citing works
The Use of New Digital Information and Communication Technologies in Psychological Counseling during the COVID-19 Pandemic
Dores, A. R., Geraldo, A., Carvalho, I. P., & Barbosa, F. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17207663 · Cited by 106 · see citing works
The association between therapeutic alliance and outcome in internet-based psychological interventions: A meta-analysis
Kaiser, J., Hanschmidt, F., & Kersting, A. (2020) · Computers in Human Behavior · doi:10.1016/j.chb.2020.106512 · Cited by 105 · see citing works
Guided internet-delivered cognitive behavior therapy for post-traumatic stress disorder: A randomized controlled trial
Ivarsson, D., Blom, M., Hesser, H., Carlbring, P., Enderby, P., Nordberg, R., & Andersson, G. (2014) · Internet Interventions · doi:10.1016/j.invent.2014.03.002 · Cited by 102 · see citing works
Self-citation
Experiences of non-adherence to Internet-delivered cognitive behavior therapy: a qualitative study
Johansson, O., Michel, T., Andersson, G., & Paxling, B. (2015) · Internet Interventions · doi:10.1016/j.invent.2015.02.006 · Cited by 99 · see citing works
Self-citation
Internet-delivered acceptance-based behaviour therapy for generalized anxiety disorder: A randomized controlled trial
Dahlin, M., Andersson, G., Magnusson, K., Johansson, T., Sjögren, J., Håkansson, A., Pettersson, M., Kadowaki, Å., Cuijpers, P., & Carlbring, P. (2016) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.12.007 · Cited by 86 · see citing works
Self-citation
Effectiveness of transdiagnostic internet cognitive behavioural treatment for mixed anxiety and depression in primary care
Newby, J. M., Mewton, L. R., Williams, A. D., & Andrews, G. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.04.037 · Cited by 91 · see citing works
The Diagnosis and Treatment of Generalized Anxiety Disorder
Bandelow, B., Boerner, R. J., Kasper, S. F., Linden, M., Wïttchen, H., & Möller, H. (2013) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.2013.0300 · Cited by 82 · see citing works
Validation of the Internet-Administered Quality of Life Inventory (QOLI) in Different Psychiatric Conditions
Lindner, P., Andersson, G., Öst, L., & Carlbring, P. (2013) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2013.806584 · Cited by 82 · see citing works
Self-citation
Psychotherapies for Generalized Anxiety Disorder in Adults
Papola, D., Miguel, C., Mazzaglia, M., Franco, P., Tedeschi, F., Romero, S. A., Patel, A., Ostuzzi, G., Gastaldon, C., Karyotaki, E., et al. (2023) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2023.3971 · Cited by 93 · see citing works
A randomized controlled trial of ecological momentary intervention plus brief group therapy for generalized anxiety disorder.
Newman, M. G., Przeworski, A., Consoli, A. J., & Taylor, C. B. (2014) · Psychotherapy · doi:10.1037/a0032519 · Cited by 71 · see citing works
Response and Remission Rates in Internet-Based Cognitive Behavior Therapy: An Individual Patient Data Meta-Analysis
Andersson, G., Carlbring, P., & Rozental, A. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00749 · Cited by 71 · see citing works
“Finally, there are also programs based on physical exercise (20), mindfulness (21), and relaxation (22), even if the latter two are often incorporated into ICBT protocols (23).”
BackgroundSelf-citation
Individually Tailored Internet-Based Treatment for Young Adults and Adults With Panic Attacks: Randomized Controlled Trial
Silfvernagel, K., Carlbring, P., Kabo, J., Edström, S., Eriksson, J., Månson, L., & Andersson, G. (2012) · Journal of Medical Internet Research · doi:10.2196/jmir.1853 · Cited by 69 · see citing works
Self-citation
The effectiveness of Internet‐delivered treatment for generalized anxiety disorder: An updated systematic review and meta‐analysis
Eilert, N., Enrique, A., Wogan, R., Mooney, O., Timulak, L., & Richards, D. (2021) · Depression and Anxiety · doi:10.1002/da.23115 · Cited by 60 · see citing works
“A 31.49 (6.56) Mullin et al. (2015) GAD‐7 9.03 (4.62) PHQ‐9 10.87 (5.4) ‐ ‐ Newby et al. (2013) GAD‐7 10.4 (4.37) PHQ‐9 11.01 (4.35) PSWQ 63.67 (10.22) Paxling et al. (2011) GAD‐IV 10.21 (2.28) MADRS‐”
Influential
Current perspectives on Internet delivered cognitive behavioral therapy for adults with anxiety and related disorders
Mewton, L., Smith, J., Rossouw, P., & Andrews, G. (2014) · Psychology Research and Behavior Management · doi:10.2147/prbm.s40879 · Cited by 57 · see citing works
Internet-Delivered Cognitive Behavioral Therapy for Anxiety Disorders in Open Community Versus Clinical Service Recruitment: Meta-Analysis
Romijn, G., Batelaan, N., Kok, R., Koning, J., van Balkom, A., Titov, N., & Riper, H. (2019) · Journal of Medical Internet Research · doi:10.2196/11706 · Cited by 52 · see citing works
Treating Youth Depression and Anxiety: A Randomised Controlled Trial Examining the Efficacy of Computerised versus Face‐to‐face Cognitive Behaviour Therapy
Sethi, S. (2013) · Australian Psychologist · doi:10.1111/ap.12006 · Cited by 59 · see citing works
Internet-delivered cognitive behavior therapy for anxiety and insomnia in a higher education context
Morris, J., Firkins, A., Millings, A., Möhr, C., Redford, P., & Rowe, A. (2015) · Anxiety Stress & Coping · doi:10.1080/10615806.2015.1058924 · Cited by 60 · see citing works
Internet-based exposure treatment versus one-session exposure treatment of snake phobia: a randomized controlled trial
Andersson, G., Waara, J., Jonsson, U., Malmaeus, F., Carlbring, P., & Öst, L.-G. (2013) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2013.844202 · Cited by 59 · see citing works
Self-citation
Pharmacological and psychological interventions for generalized anxiety disorder in adults: A network meta-analysis
Chen, T.-R., Huang, H., Hsu, J., Ouyang, W.-C., & Lin, K. (2019) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2019.08.014 · Cited by 60 · see citing works
Digital interventions in mental health: Evidence syntheses and economic modelling
Gega, L., Jankovic, D., Saramago, P., Marshall, D., Dawson, S., Brabyn, S., Nikolaidis, G. F., Melton, H., Churchill, R., & Bojke, L. (2022) · Health Technology Assessment · doi:10.3310/rcti6942 · Cited by 48 · see citing works
Internet-Based Cognitive Behavior Therapy for Procrastination: Study Protocol for a Randomized Controlled Trial
Rozental, A., & Carlbring, P. (2013) · JMIR Research Protocols · doi:10.2196/resprot.2801 · Cited by 47 · see citing works
Self-citation
Integrating iCBT for generalized anxiety disorder into routine clinical care: Treatment effects across the adult lifespan.
Hobbs, M., Mahoney, A. E. J., & Andrews, G. (2017) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2017.09.003 · Cited by 39 · see citing works
Guided Internet-Based Cognitive Behavioral Therapy for Adult Depression and Anxiety in Routine Secondary Care: Observational Study
Mathiasen, K., Riper, H., Andersen, T. E., & Roessler, K. K. (2018) · Journal of Medical Internet Research · doi:10.2196/10927 · Cited by 45 · see citing works
Predicting Response to Therapist-Assisted Internet-Delivered Cognitive Behavior Therapy for Depression or Anxiety Within an Open Dissemination Trial
Hadjistavropoulos, H. D., Pugh, N. E., Hesser, H., & Andersson, G. (2016) · Behavior Therapy · doi:10.1016/j.beth.2015.10.006 · Cited by 42 · see citing works
Self-citation
Internet-assisted cognitive behavioral therapy
Andersson, G., & Carlbring, P. (2017) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2017.08.004 · Cited by 45 · see citing works
A BRIEF ECOLOGICAL MOMENTARY INTERVENTION FOR GENERALIZED ANXIETY DISORDER: A RANDOMIZED CONTROLLED TRIAL OF THE<i>WORRY OUTCOME JOURNAL</i>: Research Article: Worry Outcome Journal for GAD
LaFreniere, L. S., & Newman, M. G. (2016) · Depression and Anxiety · doi:10.1002/da.22507 · Cited by 40 · see citing works
Linguistic Analysis of Communication in Therapist-Assisted Internet-Delivered Cognitive Behavior Therapy for Generalized Anxiety Disorder
Dirkse, D., Hadjistavropoulos, H. D., Hesser, H., & Barak, A. (2014) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2014.952773 · Cited by 43 · see citing works
Effectiveness of an internet-delivered intervention for generalized anxiety disorder in routine care: A randomised controlled trial in a student population
Richards, D., Timulák, L., Rashleigh, C., McLoughlin, O., Colla, A., Joyce, C., Doherty, G. J., Sharry, J., Duffy, D. J., & Anderson-Gibbons, M. (2016) · Internet Interventions · doi:10.1016/j.invent.2016.10.003 · Cited by 45 · see citing works
Internet-Based Cognitive Behaviour Therapy for Tinnitus Patients Delivered in a Regular Clinical Setting: Outcome and Analysis of Treatment Dropout
Kaldo, V., Haak, T., Buhrman, M., Alfonsson, S., Larsen, H.-C., & Andersson, G. (2013) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2013.769622 · Cited by 48 · see citing works
Self-citation
Patient Perspectives on Strengths and Challenges of Therapist-Assisted Internet-Delivered Cognitive Behaviour Therapy: Using the Patient Voice to Improve Care
Hadjistavropoulos, H. D., Faller, Y. N., Klatt, A., Nugent, M. N., Dear, B. F., & Titov, N. (2018) · Community Mental Health Journal · doi:10.1007/s10597-018-0286-0 · Cited by 37 · see citing works
The Efficacy of PowerPoint-based CBT Delivered Through Email: Breaking the Barriers to Treatment for Generalized Anxiety Disorder
ALAVI, N., & HIRJI, A. (2020) · Journal of Psychiatric Practice · doi:10.1097/pra.0000000000000455 · Cited by 33 · see citing works
Exposing Worry’s Deceit: Percentage of Untrue Worries in Generalized Anxiety Disorder Treatment
LaFreniere, L. S., & Newman, M. G. (2020) · Behavior Therapy · doi:10.1016/j.beth.2019.07.003 · Cited by 35 · see citing works
Mitigating COVID-19 Impact on the Portuguese Population Mental Health: The Opportunity That Lies in Digital Mental Health
Mendes-Santos, C., Andersson, G., Weiderpass, E., & Santana, R. M. (2020) · Frontiers in Public Health · doi:10.3389/fpubh.2020.553345 · Cited by 32 · see citing works
Self-citation
Digital Interventions for Generalized Anxiety Disorder (GAD): Systematic Review and Network Meta-Analysis
Saramago, P., Gega, L., Marshall, D. C., Nikolaidis, G. F., Janković, D., Melton, H., Dawson, S., Churchill, R. C., & Bojke, L. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.726222 · Cited by 33 · see citing works
Classification models for subthreshold generalized anxiety disorder in a college population: Implications for prevention
Kanuri, N., Taylor, C. B., Cohen, J. M., & Newman, M. G. (2015) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2015.05.011 · Cited by 32 · see citing works
TRANSDIAGNOSTIC INTERNET TREATMENT FOR ANXIETY AND DEPRESSION
Titov, N., Dear, B. F., Johnston, L., & Terides, M. D. (2012) · Revista de Psicopatología y Psicología Clínica · Cited by 31 · see citing works
Online physical activity interventions for mental disorders: A systematic review
Rosenbaum, S., Newby, J. M., Steel, Z., Andrews, G., & Ward, P. B. (2015) · Internet Interventions · doi:10.1016/j.invent.2015.04.001 · Cited by 29 · see citing works
Remote cognitive‐behavioral therapy for generalized anxiety disorder: A preliminary meta‐analysis
Trenoska Basile, V., Newton‐John, T., & Wootton, B. M. (2022) · Journal of Clinical Psychology · doi:10.1002/jclp.23360 · Cited by 28 · see citing works
Digitally Delivered Psychological Interventions for Anxiety Disorders: a Comprehensive Review
Stefanopoulou, E., Lewis, D., Taylor, M., Broscombe, J., & Larkin, J. (2018) · Psychiatric Quarterly · doi:10.1007/s11126-018-9620-5 · Cited by 28 · see citing works
Efficacy of a cognitive-behavioural therapy administered by videoconference for generalized anxiety disorder
Théberge-Lapointe, N., Marchand, A., Langlois, F., Gosselin, P., & Watts, S. (2015) · European Review of Applied Psychology · doi:10.1016/j.erap.2014.10.001 · Cited by 24 · see citing works
Personality change after Internet-delivered cognitive behavior therapy for depression
Johansson, R., Lyssarides, C., Andersson, G., & Rousseau, A. (2013) · PeerJ · doi:10.7717/peerj.39 · Cited by 26 · see citing works
Self-citation
Internet-Delivered Cognitive Behaviour Therapy
Richards, D., Enrique, Á., Palacios, J. E., & Duffy, D. J. (2018) · InTech eBooks · doi:10.5772/intechopen.71412 · Cited by 24 · see citing works
Information technology-based versus face-to-face cognitive-behavioural therapy for anxiety and depression: A systematic review and meta-analysis
Chow, D. Y.-W., Jiang, X., & You, J. H. S. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.05.048 · Cited by 23 · see citing works
Internet-Based Cognitive Behavior Therapy
Andersson, G., Carlbring, P., & Hadjistavropoulos, H. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-803457-6.00021-0 · Cited by 24 · see citing works
Self-citation
The effect of internet-delivered cognitive behavioral therapy for depression and anxiety on quality of life: A meta-analysis of randomized controlled trials
Maj, A., Michalak, N., Graczykowska, A., & Andersson, G. (2023) · Internet Interventions · doi:10.1016/j.invent.2023.100654 · Cited by 22 · see citing works
Self-citation
Internet‐based cognitive behavioral therapy for anxiety in an outpatient specialized care setting: A qualitative study of the patients’ experience of the therapy
Pedersen, M. K., Mohammadi, R., Mathiasen, K., & Elmose, M. (2020) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12665 · Cited by 22 · see citing works
Experiences and engagement with the design features and strategies of an internet-delivered treatment programme for generalised anxiety disorder: a service-based evaluation
Walsh, A., & Richards, D. (2017) · British Journal of Guidance & Counselling · doi:10.1080/03069885.2016.1153039 · Cited by 20 · see citing works
Implementation of a Guided, Digital Cognitive Behavioral Program for Anxiety in Primary Care: Preliminary Findings of Engagement and Effectiveness
Yu, J. S., Szigethy, E., Wallace, M., Solano, F., & Oser, M. (2018) · Telemedicine and e-Health · doi:10.1089/tmj.2017.0280 · Cited by 15 · see citing works
Are Trials of Computerized Therapy Generalizable? A Multidimensional Meta-analysis
Wilks, C. R., Zieve, G. G., & Lessing, H. K. (2016) · Telemedicine and e-Health · doi:10.1089/tmj.2015.0129 · Cited by 18 · see citing works
Internet-delivered acceptance-based behavior therapy for generalized anxiety disorder: A pilot study
Dahlin, M., Ryberg, M., Vernmark, K., Annas, N., Carlbring, P., & Andersson, G. (2016) · Internet Interventions · doi:10.1016/j.invent.2016.08.004 · Cited by 17 · see citing works
“In the first study 89 participants were randomized to treatment or wait list control (Paxling et al., 2011).”
BackgroundSelf-citation
A randomized controlled study comparing internet-based cognitive behavioral therapy and counselling by standard care for fear of birth – A study protocol
Ternström, E., Hildingsson, I., Haines, H., Karlström, A., Sundin, Ö., Ekdahl, J., Segeblad, B., Larsson, B., Rondung, E., & Rubertsson, C. (2017) · Sexual & Reproductive Healthcare · doi:10.1016/j.srhc.2017.06.001 · Cited by 17 · see citing works
From research to routine care: A historical review of internet-based cognitive behavioral therapy for adult mental health problems in Sweden
Vernmark, K., Buhrman, M., Carlbring, P., Hedman‐Lagerlöf, E., Kaldo, V., & Andersson, G. (2024) · Digital Health · doi:10.1177/20552076241287059 · Cited by 19 · see citing works
Self-citation
Delivering an Online Cognitive Behavioral Therapy Program to Address Mental Health Challenges Faced by Correctional Workers and Other Public Safety Personnel: Protocol for a Mixed Methods Study
Alavi, N., Stephenson, C., Omrani, M., Gerritsen, C. J., Martin, M. S., Knyahnytskyi, A., Zhu, Y., Kumar, A., Jagayat, J., Shirazi, A., et al. (2021) · JMIR Research Protocols · doi:10.2196/30845 · Cited by 18 · see citing works
Low-intensity internet-delivered treatment for generalized anxiety symptoms in routine care: protocol for a randomized controlled trial
Richards, D., Timulak, L., Doherty, G., Sharry, J., McLoughlin, O., Rashleigh, C., Colla, A., & Joyce, C. (2014) · Trials · doi:10.1186/1745-6215-15-145 · Cited by 16 · see citing works
“Firstly, can an online treatment for GAD symptoms be effective for an adult student population in a service-based setting? Secondly, what do participants find helpful and hindering in their online treatment for GAD symptoms? Thirdly, are participants satisfied with accessing and using an online treatment? Fourth and f…”
BackgroundResultInfluential
What are Clients Asking Their Therapist During Therapist-Assisted Internet-Delivered Cognitive Behaviour Therapy? A Content Analysis of Client Questions
Soucy, J. N., Hadjistavropoulos, H. D., Pugh, N. E., Dear, B. F., & Titov, N. (2019) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465818000668 · Cited by 16 · see citing works
Worry-specific versus self-tailored internet-based treatments for generalized anxiety disorder, with scheduled support or support on demand: A pilot factorial design trial
Dahlin, M., Johansson, A., Romare, H., Carlbring, P., & Andersson, G. (2022) · Internet Interventions · doi:10.1016/j.invent.2022.100531 · Cited by 15 · see citing works
Self-citation
Comparative efficacy of face-to-face and internet-based cognitive behavior therapy for generalized anxiety disorder: A meta-analysis of randomized controlled trial
Zhang, W., Du, Y., Yang, X., Wang, E., Fang, J., Liu, Z., Wu, S., Liu, Q., & Hu, Y. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.832167 · Cited by 15 · see citing works
Guided self-help for generalized anxiety disorder in older adults.
Landreville, P., Gosselin, P., Grenier, S., Hudon, C., & Lorrain, D. (2016) · Aging & Mental Health · doi:10.1080/13607863.2015.1060945 · Cited by 14 · see citing works
The impact of technology systems and level of support in digital mental health interventions: a secondary meta-analysis
Sasseville, M., LeBlanc, A., Tchuente, J., Boucher, M., Dugas, M., Mbemba, G. I. C., Barony, R., Chouinard, M., Beaulieu, M., Beaudet, N., et al. (2023) · Systematic Reviews · doi:10.1186/s13643-023-02241-1 · Cited by 16 · see citing works
A meta-analysis on the efficacy of low-intensity cognitive behavioural therapy for generalised anxiety disorder
Powell, C., Chiu, C.-Y., Sun, X.-Q., & So, S. (2024) · BMC Psychiatry · doi:10.1186/s12888-023-05306-6 · Cited by 13 · see citing works
Transdiagnostic internet treatment for anxiety and depression = Tratamiento transdiagnóstico por internet de la ansiedad y la depresión
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Authors: Paxling, B., Almlöv, J., Dahlin, M., Carlbring, P., Breitholtz, E., Eriksson, T., & Andersson, G.
Affiliations: Linköping University (SE)
Umeå University (SE)
Stockholm University (SE)
Corresponding author: Paxling, Björn
ORCID: Carlbring, Per
Andersson, Gerhard
Venue: Cognitive Behaviour Therapy
Publisher: Informa UK Limited
Published: 2011-09
Volume: 40
Issue: 3
Pages: 159-173
ISSN: 1650-6073 (ISSN-L)
1651-2316
DOI: 10.1080/16506073.2011.576699
OpenAlex: W2011115931
Semantic Scholar: 4134d19f3f8627e9c98ea9f112eee8268272cdda
Cited by: 147
References: 67
Citations by year: 2026: 2 · 2025: 2 · 2024: 7 · 2023: 10 · 2022: 7 · 2021: 8 · 2020: 15 · 2019: 8 · 2018: 10 · 2017: 9 · 2016: 8 · 2015: 16 · 2014: 17 · 2013: 18 · 2012: 10
FWCI: 19.25
Type: journal article
Language: en
Open access: closed
Locations: Cognitive Behaviour Therapy (publishedVersion)
PubMed (publishedVersion)
Funders: Pennsylvania State University
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: generalized anxiety disorder, internet-based cognitive behavioral therapy, guided self-help, applied relaxation, therapist support, Penn State Worry Questionnaire, worry, depression, quality of life, maintenance therapy
MeSH terms: Adolescent, Adult, Aged, Anxiety Disorders, Depression, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Quality of Life, Therapy, Computer-Assisted, Waiting Lists, Cognitive Behavioral Therapy, Internet

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Guided Internet-Delivered Cognitive Behavior Therapy for Generalized Anxiety Disorder: A Randomized Controlled Trial

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