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

H D Hadjistavropoulos; L H Schneider; S Mehta; E Karin; B F Dear; N Titov

doi:10.1016/j.janxdis.2019.02.002

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

J Anxiety Disord. 2019 Apr:63:51-60. doi: 10.1016/j.janxdis.2019.02.002. Epub 2019 Feb 22.

Authors

H D Hadjistavropoulos¹, L H Schneider², S Mehta³, E Karin⁴, B F Dear⁵, N Titov⁶

Affiliations

¹ Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada. Electronic address: [email protected].
² Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada. Electronic address: [email protected].
³ Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada. Electronic address: [email protected].
⁴ eCentreClinic, Department of Psychology, Macquarie University, Sydney, NSW, 2109, Australia. Electronic address: [email protected].
⁵ eCentreClinic, Department of Psychology, Macquarie University, Sydney, NSW, 2109, Australia. Electronic address: [email protected].
⁶ MindSpot Clinic, eCentreClinic, Department of Psychology, Macquarie University, Sydney, NSW, 2109, Australia. Electronic address: [email protected].

PMID: 30844613
DOI: 10.1016/j.janxdis.2019.02.002

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

Publication types

Comparative Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Anxiety / psychology
Anxiety / therapy
Anxiety Disorders / psychology
Anxiety Disorders / therapy
Cognitive Behavioral Therapy / methods*
Depression / psychology
Depression / therapy
Depressive Disorder / psychology
Depressive Disorder / therapy
Female
Humans
Internet*
Male
Panic
Patient Preference*
Social Workers*
Time Factors
Treatment Outcome

Abstract

Publication types

MeSH terms

Grants and funding