Anxiety Online—A Virtual Clinic: Preliminary Outcomes Following Completion of Five Fully Automated Treatment Programs for Anxiety Disorders and Symptoms

Klein, Britt; Meyer, Denny; Austin, David William; Kyrios, Michael

doi:10.2196/jmir.1918

Cited by 118Digital Mental Health InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and Access

Anxiety Online—A Virtual Clinic: Preliminary Outcomes Following Completion of Five Fully Automated Treatment Programs for Anxiety Disorders and Symptoms

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Klein, Britt, Meyer, Denny, Austin, David William, Kyrios, Michael·2011·Journal of Medical Internet Research

DOI 10.2196/jmir.1918PMC PMC3222205

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Abstract

BACKGROUND: The development of e-mental health interventions to treat or prevent mental illness and to enhance wellbeing has risen rapidly over the past decade. This development assists the public in sidestepping some of the obstacles that are often encountered when trying to access traditional face-to-face mental health care services. OBJECTIVE: The objective of our study was to investigate the posttreatment effectiveness of five fully automated self-help cognitive behavior e-therapy programs for generalized anxiety disorder (GAD), panic disorder with or without agoraphobia (PD/A), obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and social anxiety disorder (SAD) offered to the international public via Anxiety Online, an open-access full-service virtual psychology clinic for anxiety disorders. METHODS: We used a naturalistic participant choice, quasi-experimental design to evaluate each of the five Anxiety Online fully automated self-help e-therapy programs. Participants were required to have at least subclinical levels of one of the anxiety disorders to be offered the associated disorder-specific fully automated self-help e-therapy program. These programs are offered free of charge via Anxiety Online. RESULTS: A total of 225 people self-selected one of the five e-therapy programs (GAD, n = 88; SAD, n = 50; PD/A, n = 40; PTSD, n = 30; OCD, n = 17) and completed their 12-week posttreatment assessment. Significant improvements were found on 21/25 measures across the five fully automated self-help programs. At postassessment we observed significant reductions on all five anxiety disorder clinical disorder severity ratings (Cohen d range 0.72-1.22), increased confidence in managing one's own mental health care (Cohen d range 0.70-1.17), and decreases in the total number of clinical diagnoses (except for the PD/A program, where a positive trend was found) (Cohen d range 0.45-1.08). In addition, we found significant improvements in quality of life for the GAD, OCD, PTSD, and SAD e-therapy programs (Cohen d range 0.11-0.96) and significant reductions relating to general psychological distress levels for the GAD, PD/A, and PTSD e-therapy programs (Cohen d range 0.23-1.16). Overall, treatment satisfaction was good across all five e-therapy programs, and posttreatment assessment completers reported using their e-therapy program an average of 395.60 (SD 272.2) minutes over the 12-week treatment period. CONCLUSIONS: Overall, all five fully automated self-help e-therapy programs appear to be delivering promising high-quality outcomes; however, the results require replication.

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Adherence in open access research settings is typically very low, ranging from around 1% to 10%.
“Previous research of This Way Up clinic data has indicated that approximately 60% of patients complete all 6 courses [7]–[10], a much higher level than the levels of adherence in open access research settings, which are typically very low, ranging from around 1% [22] to 10% [23].”
From A Naturalistic Study of the Acceptability and Effectiveness of Internet-Delivered Cognitive Behavioural Therapy for Psychiatric Disorders in Older Australians (2013) · cites this paper as [23]

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[41]Nguyen D Klein B Meyer D Austin D The psychometric properties and user experience of an online clinical assessment schedule 2011 International Society for Research into Internet Interventions (ISRII) International Conference April 6-8, 2011 Sydney, Australia

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Authors: Klein, B., Meyer, D., Austin, D. W., & Kyrios, M.
Affiliations: Swinburne University of Technology (AU)
Corresponding author: Klein, Britt
ORCID: Klein, Britt
Meyer, Denny
Austin, David William
Kyrios, Michael
Venue: Journal of Medical Internet Research
Publisher: JMIR Publications Inc.
Published: 2011-11-04
Volume: 13
Issue: 4
Pages: e89
ISSN: 1438-8871 (ISSN-L)
DOI: 10.2196/jmir.1918
PMC: PMC3222205
OpenAlex: W2149707241
Cited by: 118
References: 46
Citations by year: 2026: 2 · 2025: 4 · 2024: 6 · 2023: 5 · 2022: 6 · 2021: 6 · 2020: 5 · 2019: 5 · 2018: 11 · 2017: 3 · 2016: 18 · 2015: 15 · 2014: 20 · 2013: 6 · 2012: 6
FWCI: 13.69
Type: journal article
Language: en
Open access: gold
doi.org
Licence: other-oa
Locations: Journal of Medical Internet Research (publishedVersion, other-oa)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
ANU Open Research (Australian National University) (submittedVersion, cc-by)
FedUni ResearchOnline (Federation University Australia) (submittedVersion, cc-by)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Deakin Research Online (Deakin University) (submittedVersion)
Figshare (submittedVersion, cc-by)
Swinburne figshare (Swinburne University of Technology) (submittedVersion, cc-by)
Swinburne figshare (Swinburne University of Technology) (cc-by)
Funders: Australian Government
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: anxiety disorders, digital mental health interventions, generalized anxiety disorder, panic disorder with agoraphobia, obsessive-compulsive disorder, post-traumatic stress disorder, social anxiety disorder, treatment satisfaction, quality of life, psychological distress, mental health self-management, access to mental health care, subclinical anxiety
MeSH terms: Adolescent, Adult, Aged, Anxiety Disorders, Australia, Female, Humans, Male, Middle Aged, Patient Dropouts, Surveys and Questionnaires, Self Care, Therapy, Computer-Assisted, Time Factors, User-Computer Interface, Treatment Outcome, Patient Satisfaction, Internet, Young Adult

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Anxiety Online—A Virtual Clinic: Preliminary Outcomes Following Completion of Five Fully Automated Treatment Programs for Anxiety Disorders and Symptoms

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