Elsevier

Journal of Anxiety Disorders

Volume 63, April 2019, Pages 51-60
Journal of Anxiety Disorders

Preference trial of internet-delivered cognitive behaviour therapy comparing standard weekly versus optional weekly therapist support

https://doi.org/10.1016/j.janxdis.2019.02.002Get rights and content
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Highlights

  • Internet-delivered cognitive behaviour therapy (ICBT) often involves weekly support.

  • In this trial, patients chose ICBT with standard or optional therapist support.

  • Few patients chose optional support (22%) compared to standard support (78%).

  • Patients who chose optional support had lower symptoms of anxiety and panic.

  • Engagement, completion rates, and outcomes were similar between groups.

Abstract

Emerging evidence from research trials suggests that Internet-delivered cognitive behaviour therapy (ICBT) produces similar symptom improvements whether patients receive weekly therapist support (standard support) or therapist support only when requested (optional support). It remains unknown, however, how many patients receiving ICBT as part of routine clinical care would prefer optional support compared to standard support and how outcomes compare when patients select their preferred treatment option. In this uncontrolled trial, we investigated patient preference and outcomes for standard versus optional support among patients with depression and or anxiety who were offered an 8-week transdiagnostic ICBT intervention in routine care. Of 401 patients accepted for ICBT, 22% selected optional support and 78% selected standard support. At assessment, patients who selected optional support had lower symptoms of anxiety and panic than patients who selected standard support. At post-treatment, both groups achieved similar large improvements in symptoms of anxiety and depression, with improvements sustained at 3-month follow-up. Patients receiving optional support sent and received fewer messages compared to patients receiving standard support. This study demonstrates the potential of optional therapist support to meet the needs and preferences of patients and to also reduce therapist costs in routine care.

Keywords

Depression
Generalized anxiety
Internet-delivered
Therapist-assisted
Cognitive behaviour therapy
Patient preference

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