A randomized controlled trial examining the efficacy of an internet-based cognitive behavioral therapy program for adolescents with anxiety disorders
Open accessAbstract
BACKGROUND: Anxiety disorders are highly prevalent in adolescence, but access to health care services is limited and only few receive professional help. Internet-based cognitive behavioral therapy (ICBT) has been proposed to increase accessibility and reduce costs of treatment. OBJECTIVE: The study evaluated the efficacy of a Danish version of the guided ICBT program ChilledOut Online, developed at the Centre for Emotional Health, Macquarie University, Australia. METHOD: At the Centre for Psychological Treatment of Children and Adolescents, Aarhus University, Denmark, a randomized controlled trial was conducted with 70 adolescents (13-17 years) with anxiety disorders according to DSM-IV. Participants were randomly assigned to a 14-weeks therapist-guided ICBT or to a waitlist condition. Outcomes were evaluated post-treatment and at 3- and 12-month follow-up. RESULTS: At post-treatment, the ICBT group significantly outperformed the waitlist condition with moderate to large between-group effect sizes on diagnostic severity and anxiety symptoms rated by clinicians, and by adolescents and their parents. Forty percent of adolescents in ICBT were free of their primary diagnosis compared to 16% in the waitlist condition. Treatment gains were maintained at 3- and 12-month follow-up. CONCLUSION: Results of the study provide support for the efficacy of guided ICBT for adolescents with anxiety disorders. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02535403.
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In a Danish randomized controlled trial, the iCBT group exhibited significant improvement based on both adolescent and parent ratings and moderate to large effect sizes between groups.
“the iCBT group exhibited significant improvement based on both adolescent and parent ratings and that iCBT exhibited moderate to large effect sizes between groups [10].”
Multiple previous studies have indicated positive treatment outcomes for iACT for adolescents with anxiety.
“Multiple previous studies have indicated positive treatment outcomes for iACT for adolescents with anxiety [9-12], but few have performed follow-ups at 12 months after treatment or longer.”
From The Impact of Parental Support on Adherence to Therapist-Assisted Internet-Delivered Acceptance and Commitment Therapy in Primary Care for Adolescents With Anxiety: Naturalistic 12-Month Follow-Up Study (2025) · cites this paper as [10]
The Introduction (page unavailable) describes positive outcomes in multiple previous studies of ICBT for anxious adolescents, not iACT. A search for internet-based acceptance and commitment therapy found no passage in our copy addressing iACT outcomes, so the cited paper does not verify that treatment-specific claim. (LLM, conf=0.76)
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- Authors
- Stjerneklar, S., Hougaard, E., McLellan, L. F., & Thastum, M.
- Affiliations
- Aarhus University (DK)
- Macquarie University (AU)
- Corresponding author
- Stjerneklar, Silke
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2019-09-18
- Volume
- 14
- Issue
- 9
- Pages
- e0222485
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC6750608
- OpenAlex
- W2973964588
- Cited by
- 71
- References
- 88
- Citations by year
- 2026: 8 · 2025: 14 · 2024: 9 · 2023: 8 · 2022: 15 · 2021: 9 · 2020: 7 · 2019: 1
- FWCI
- 9.00
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Scopus (Elsevier) (submittedVersion, cc-by)
- 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 disorders, treatment efficacy, maintenance of treatment gains, access to mental health care, anxiety symptom severity
- MeSH terms
- Adolescent, Anxiety, Anxiety Disorders, Australia, Cost-Benefit Analysis, Denmark, Female, Humans, Male, Waiting Lists, Cognitive Behavioral Therapy, Treatment Outcome, Internet
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