Effectiveness and cost-effectiveness of web-based treatment for phobic outpatients on a waiting list for psychotherapy: protocol of a randomised controlled trial
Open accessAbstract
BACKGROUND: Phobic disorders are highly prevalent and constitute a considerable burden for patients and society. As patients wait for face-to-face psychotherapy for phobic disorders in outpatient clinics, this time can be used for guided self-help interventions. The aim of this study is to investigate a five week internet-based guided self-help programme of exposure therapy in terms of clinical effectiveness and impact on speed of recovery in psychiatric outpatients, as well as the cost-effectiveness of this pre-treatment waiting list intervention. METHODS/DESIGN: A randomised controlled trial will be conducted among 244 Dutch adult patients recruited from waiting lists of outpatient clinics for face-to-face psychotherapy for phobic disorders. Patients suffering from at least one DSM-IV classified phobic disorder (social phobia, agoraphobia or specific phobia) are randomly allocated (at a 1:1 ratio) to either a five-week internet-based guided self-help program followed by face-to-face psychotherapy, or a control group followed by face-to-face psychotherapy. Waiting list status and duration are unchanged and actual need for further treatment is evaluated prior to face-to-face psychotherapy. Clinical and economic self-assessment measurements take place at baseline, post-test (five weeks after baseline) and at 3, 6, 9 and 12 months after baseline. DISCUSSION: Offering pre-treatment internet-based guided self-help efficiently uses time otherwise lost on a waiting list and may increase patient satisfaction. Patients are expected to need fewer face-to-face sessions, reducing total treatment cost and increasing speed of recovery. Internet-delivered treatment for phobias may be a valuable addition to psychotherapy as demand for outpatient treatment increases while budgets decrease. TRIAL REGISTRATION: Netherlands Trial Register NTR2233.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
There were no changes from the published study protocol.
“There were no changes from the published study protocol [38].”
From Short-term effectiveness of web-based guided self-help for phobic outpatients: randomized controlled trial. (2014) · cites this paper as [38]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
Radloff, L. S. (1977) · Applied Psychological Measurement · doi:10.1177/014662167700100306 · Cited by 53,267 · see citing works
EuroQol: the current state of play
Brooks, R. (1996) · Health Policy · doi:10.1016/0168-8510(96)00822-6 · Cited by 5,815 · see citing works
Eysenbach, G. (2005) · Journal of Medical Internet Research · doi:10.2196/jmir.7.1.e11 · Cited by 2,524 · see citing works
The CAGE Questionnaire: Validation of a New Alcoholism Screening Instrument
Mayfield, D. G., McLeod, G. A., & Hall, P. B. (1974) · American Journal of Psychiatry · doi:10.1176/ajp.131.10.1121 · Cited by 2,261 · see citing works
Brief standard self-rating for phobic patients
Marks, I. M., & Mathews, A. M. (1979) · Behaviour Research and Therapy · doi:10.1016/0005-7967(79)90041-x · Cited by 1,801 · see citing works
Andrews, G., Cuijpers, P., Craske, M. G., McEvoy, P., & Titov, N. (2010) · PLoS ONE · doi:10.1371/journal.pone.0013196 · Cited by 1,311 · see citing works
Self-citationBijl, R. V., Ravelli, A., & van Zessen, G. (1998) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s001270050098 · Cited by 1,216 · cited 1× · see citing works
“8% [1].”
A meta-analysis of psychotherapy dropout
Wierzbicki, M., & Pekarik, G. (1993) · Professional Psychology: Research and Practice · doi:10.1037/0735-7028.24.2.190 · Cited by 1,118 · see citing works
Quality of Life in Individuals With Anxiety Disorders
Mendlowicz, M. V., & Stein, M. B. (2000) · American Journal of Psychiatry · doi:10.1176/appi.ajp.157.5.669 · Cited by 955 · see citing works
Cost‐effectiveness acceptability curves – facts, fallacies and frequently asked questions
Fenwick, E. A. L., OʼBrien, B. J., & Briggs, A. H. (2004) · Health Economics · doi:10.1002/hec.903 · Cited by 946 · see citing works
Cuijpers, P., Donker, T., van Straten, A., Li, J., & Andersson, G. (2010) · Psychological Medicine · doi:10.1017/s0033291710000772 · Cited by 832 · see citing works
Self-citationKushner, M. G. (2000) · Clinical Psychology Review · doi:10.1016/s0272-7358(99)00027-6 · Cited by 782 · see citing works
Assessment of patient satisfaction: Development and refinement of a Service Evaluation Questionnaire
Nguyen, T. D., Attkisson, C. C., & Stegner, B. L. (1983) · Evaluation and Program Planning · doi:10.1016/0149-7189(83)90010-1 · Cited by 736 · see citing works
Dropout from Internet‐based treatment for psychological disorders
Melville, K. M., Casey, L. M., & Kavanagh, D. J. (2010) · British Journal of Clinical Psychology · doi:10.1348/014466509x472138 · Cited by 597 · see citing works
[Measuring the quality of life in economic evaluations: the Dutch EQ-5D tariff].
Lamers, L. M., Stalmeier, P. F. M., McDonnell, J., Krabbe, P. F. M., & Busschbach, J. J. V. (2005) · PubMed · Cited by 574 · see citing works
THE COMPOSITE INTERNATIONAL DIAGNOSTIC INTERVIEW (CIDI)
Robins, L. N. (1994) · IX World Congress of Psychiatry · doi:10.1142/9789814440912_0056 · Cited by 574 · see citing works
Computer‐Aided Psychotherapy for Anxiety Disorders: A Meta‐Analytic Review
Cuijpers, P., Marks, I. M., van Straten, A., Cavanagh, K., Gega, L., & Andersson, G. (2009) · Cognitive Behaviour Therapy · doi:10.1080/16506070802694776 · Cited by 429 · see citing works
Self-citationA randomized controlled trial of online versus clinic-based CBT for adolescent anxiety.
Spence, S. H., Donovan, C. L., March, S., Gamble, A., Anderson, R. E., Prosser, S., & Kenardy, J. (2011) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0024512 · Cited by 381 · cited 1× · see citing works
“A recent small scale study found a large effect size of internet-based treatment for panic disorder in a psychiatric outpatient setting [13] and internet-based cognitive behavioural therapy (CBT) for adolescent anxiety appeared to be as efficacious as clinic-based FTF psychotherapy [14].”
BackgroundTest-retest reliability of health state valuations collected with the EuroQol questionnaire
van Agt, H. M. E., Essink‐Bot, M., Krabbe, P. F. M., & Bonsel, G. J. (1994) · Social Science & Medicine · doi:10.1016/0277-9536(94)90005-1 · Cited by 343 · see citing works
Leyfer, O. T., Ruberg, J. L., & Woodruff-Borden, J. (2006) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2005.05.004 · Cited by 305 · cited 1× · see citing works
“The BAI has been validated for patients with agoraphobia [25] and other anxiety disorders [26].”
Griffiths, K. M., Farrer, L., & Christensen, H. (2010) · Medical Journal of Australia · doi:10.5694/j.1326-5377.2010.tb03685.x · Cited by 303 · see citing works
Hedman, E., Andersson, G., Ljótsson, B., Andersson, E., Rück, C., Mörtberg, E., & Lindefors, N. (2011) · PLoS ONE · doi:10.1371/journal.pone.0018001 · Cited by 285 · see citing works
Bradley, K. A., Bush, K. R., McDonell, M. B., Malone, T., & Fihn, S. D. (1998) · PubMed · Cited by 268 · see citing works
Internet-based cognitive-behavioural therapy for severe health anxiety: randomised controlled trial
Hedman, E., Andersson, G., Andersson, E., Ljótsson, B., Rück, C., Asmundson, G. J. G., & Lindefors, N. (2011) · British Journal of Psychiatry · doi:10.1192/bjp.bp.110.086843 · Cited by 212 · see citing works
Screening for problem drinking
the Ambulatory Care Quality Improvement Project (ACQUIP), Bradley, K. A., Bush, K. R., McDonell, M. B., Malone, T., & Fihn, S. D. (1998) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.1998.00118.x · Cited by 211 · see citing works
The Composite International Diagnostic Interview (CIDI) web site.
Nelson, C. (1999) · Europe PMC (PubMed Central) · Cited by 199 · see citing works
Blankers, M., Koeter, M. W. J., & Schippers, G. M. (2010) · Journal of Medical Internet Research · doi:10.2196/jmir.1448 · Cited by 194 · see citing works
A meta-analytic study of self-help interventions for anxiety problems.
Hirai, M., & Clum, G. (2006) · The Behavior Therapist · doi:10.1016/j.beth.2005.05.002 · Cited by 181 · see citing works
Cost-of-illness studies and cost-effectiveness analyses in anxiety disorders: A systematic review
Konnopka, A., Leichsenring, F., Leibing, E., & König, H.-H. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2008.07.014 · Cited by 161 · see citing works
Pretreatment attrition and dropout in an outpatient clinic for anxiety disorders
Issakidis, C., & Andrews, G. (2004) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0047.2004.00264.x · Cited by 149 · see citing works
Paxling, B., Almlöv, J., Dahlin, M., Carlbring, P., Breitholtz, E., Eriksson, T., & Andersson, G. (2011) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2011.576699 · Cited by 147 · see citing works
Eskildsen, A., Hougaard, E., & Rosenberg, N. K. (2010) · Nordic Journal of Psychiatry · doi:10.3109/08039480903426929 · Cited by 122 · see citing works
A cross-national validation of the client satisfaction questionnaire: the Dutch experience
De Brey, H. (1983) · Evaluation and Program Planning · doi:10.1016/0149-7189(83)90018-6 · Cited by 109 · see citing works
Brief self-rated screening for depression on the Internet
Donker, T., van Straten, A., Marks, I., & Cuijpers, P. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.07.013 · Cited by 88 · see citing works
Self-citationThe Fear Questionnaire: Some Data on Validity, Reliability and Layout
Van Zuuren, F. J. (1988) · British Journal of Psychiatry · doi:10.1192/bjp.153.5.659 · Cited by 79 · see citing works
Bergström, J., Andersson, G., Karlsson, A., Andréewitch, S., Rück, C., Carlbring, P., & Lindefors, N. (2008) · Nordic Journal of Psychiatry · doi:10.1080/08039480802191132 · Cited by 63 · see citing works
The fear questionnaire: a validity study
MAVISSAKALIAN, M. R. (1986) · Behaviour Research and Therapy · doi:10.1016/0005-7967(86)90154-3 · Cited by 56 · see citing works
Therapist Effects in Guided Internet-Delivered CBT for Anxiety Disorders
Almlöv, J., Carlbring, P., Källqvist, K., Paxling, B., Cuijpers, P., & Andersson, G. (2011) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s135246581000069x · Cited by 48 · see citing works
Self-citationValue of the Fear Questionnaire in Differentiating Agoraphobia and Social Phobia
Cox, B. J., Swinson, R. P., & Shaw, B. F. (1991) · The British Journal of Psychiatry · doi:10.1192/bjp.159.6.842 · Cited by 47 · see citing works
van Oppen, P., van Balkom, A. J. L. M., Smit, J. H., Schuurmans, J., van Dyck, R., & Emmelkamp, P. M. G. (2010) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.08m04990blu · Cited by 36 · see citing works
Dingemans, A. E., van Vliet, I. M., Couvée, J., & Westenberg, H. G. (2001) · Journal of Affective Disorders · doi:10.1016/s0165-0327(00)00238-x · Cited by 23 · see citing works
de Beurs, E., Wilson, K. A., Chambless, D. L., Goldstein, A. J., & Feske, U. (1997) · Depression and Anxiety · doi:10.1002/(sici)1520-6394(1997)6:4
Flagged first, then by citations
Cited by
Sorted by citations
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. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011565.pub2 · Cited by 390 · see citing works
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
Mayo-Wilson, E., & Montgomery, P. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005330.pub4 · Cited by 112 · see citing works
Kok, R. N., van Straten, A., Beekman, A. T. F., & Cuijpers, P. (2014) · Journal of Medical Internet Research · doi:10.2196/jmir.3429 · Cited by 50 · see citing works
“Outcome measures are described in more detail elsewhere [38].”
InfluentialSelf-citationHermes, E. D. A., & Rosenheck, R. A. (2016) · Psychiatric Services · doi:10.1176/appi.ps.201400532 · Cited by 12 · see citing works
- Authors
- Kok, R. N., van Straten, A., Beekman, A., Bosmans, J., de Neef, M., & Cuijpers, P.
- Affiliations
- Amsterdam Public Health (NL)
- Corresponding author
- Kok, Robin N
- Venue
- BMC Psychiatry
- Published
- 2012-08-31
- Volume
- 12
- Issue
- 1
- Pages
- 131-131
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC3507751
- OpenAlex
- W2016784855
- Cited by
- 12
- References
- 42
- Citations by year
- 2021: 1 · 2018: 1 · 2017: 2 · 2016: 3 · 2015: 2 · 2014: 1 · 2013: 2
- FWCI
- 2.26
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (acceptedVersion, other-oa)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- VU Research Portal (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- ZonMw (80-82310-97-10015)
- 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 › Social Psychology › Mental Health Treatment and Access
- Keywords
- phobia, exposure therapy, waiting lists, outpatient psychotherapy, social anxiety disorder, agoraphobia, specific phobia, cost-effectiveness
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Clinical Protocols, Cost-Benefit Analysis, Female, Humans, Implosive Therapy, Male, Middle Aged, Outpatients, Phobic Disorders, Research Design, Therapy, Computer-Assisted, Treatment Outcome, Patient Selection, Remote Consultation, Internet
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
