The Role of Learning Support and Chat-Sessions in Guided Internet-Based Cognitive Behavioral Therapy for Adolescents With Anxiety: A Factorial Design Study
Open accessAbstract
Background: Increased awareness of anxiety in adolescents emphasises the need for effective interventions. Internet-based cognitive behaviour therapy (ICBT) could be a resource-effective and evidence-based treatment option, but little is known about how to optimize ICBT or which factors boost outcomes. Recently, the role of knowledge in psychotherapy has received increased focus. Further, chat-sessions are of interest when trying to optimize ICBT for youths. This study aimed to evaluate the role of learning support and chat-sessions during ICBT for adolescent anxiety, using a factorial design. Method: A total of 120 adolescents were randomised to one of four treatment groups, in a 2x2 design with two factors: with or without learning support and/or chat-sessions. Results: Anxiety and depressive symptoms were reduced (Beck Anxiety Inventory- BAI; Cohen’s d =0.72; Beck Depression Inventory- BDI; d =0.97). There was a main effect of learning support on BAI (d =0.37), and learning support increased knowledge gain (d =0.42). There were no main effects or interactions related to the chat-sessions. Treatment effects were maintained at six-months, but the added effect of learning support had by then vanished. Conclusion: ICBT can be an effective alternative when treating adolescents with anxiety. Learning support could be of importance to enhance short-term treatment effects, and should be investigated further.
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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 [12]
The Introduction reports positive findings from previous studies of internet-based cognitive behavioral therapy (ICBT) for adolescents, and the Discussion reports positive outcomes in this trial. The Method > Treatment identifies the intervention as ICBT, not internet-based acceptance and commitment therapy (iACT), so the cited paper does not establish the claim for iACT. (LLM, conf=0.85)
Experimental — accuracy not yet measuredIn a Swedish study, iCBT was determined to be an effective treatment method for adolescents with anxiety and depression.
“the authors determined iCBT to be an effective treatment method for adolescents with anxiety and depression.”
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- Authors
- Berg, M., Rozental, A., de Brun Mangs, J., Näsman, M., Strömberg, K., Viberg, L., Wallner, E., Åhman, H., Silfvernagel, K., Zetterqvist, M., Topooco, N., Capusan, A., & Andersson, G.
- Affiliations
- Linköping University (SE)
- Karolinska Institutet (SE)
- Corresponding author
- Berg, Matilda
- ORCID
- Venue
- Frontiers in Psychiatry
- Publisher
- Frontiers Media SA
- Published
- 2020-06-10
- Volume
- 11
- Pages
- 503-503
- ISSN
- 1664-0640 (ISSN-L)
- PMC
- PMC7298729
- OpenAlex
- W3035713262
- Cited by
- 35
- References
- 78
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 4 · 2023: 8 · 2022: 6 · 2021: 4 · 2020: 1
- FWCI
- 4.29
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DiVA (Linkoping University) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Riksbankens Jubileumsfond
- 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, learning support, chat sessions, knowledge improvement, depressive symptoms, maintenance therapy
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