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Guided Internet-Delivered Cognitive Behavior Therapy for Generalized Anxiety Disorder: A Randomized Controlled Trial
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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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 Paxling et al., 2011
In the citing paper
“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]
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 [49]
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 [49]
In the citing paper
“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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Metadata
- 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
- 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
- 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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