Large-Scale Dissemination of Internet-Based Cognitive Behavioral Therapy for Youth Anxiety: Feasibility and Acceptability Study
| Autor: | March, Sonja, Spence, Susan H, Donovan, Caroline L, Kenardy, Justin A |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
050103 clinical psychology medicine.medical_specialty Adolescent Service delivery framework medicine.medical_treatment Health Informatics Anxiety Session (web analytics) law.invention 03 medical and health sciences 0302 clinical medicine anxiety disorders Randomized controlled trial law Intervention (counseling) eHealth Humans Medicine 0501 psychology and cognitive sciences Original Paper child Internet Cognitive Behavioral Therapy business.industry Public health public health 05 social sciences Patient Acceptance of Health Care 030227 psychiatry Cognitive behavioral therapy Feasibility Studies Female medicine.symptom business Clinical psychology |
| Zdroj: | Journal of Medical Internet Research |
| ISSN: | 1438-8871 |
| Popis: | Background: Internet-based cognitive behavioral therapy (iCBT) for child and adolescent anxiety has demonstrated efficacy in randomized controlled trials, but it has not yet been examined when disseminated as a public health intervention. If effective, iCBT programs could be a promising first-step, low-intensity intervention that can be easily accessed by young people. Objective: The objective of our study was to examine the feasibility and acceptability of a publicly available online, self-help iCBT program (BRAVE Self-Help) through exploration of program adherence, satisfaction, and changes in anxiety. Methods: This study was an open trial involving the analysis of data collected from 4425 children and adolescents aged 7-17 years who presented with elevated anxiety at registration (baseline) for the iCBT program that was delivered through an open-access portal with no professional support. We assessed the program satisfaction via a satisfaction scale and measured adherence via the number of completed sessions. In addition, anxiety severity was assessed via scores on the Children’s Anxiety Scale, 8-item (CAS-8) at four time points: baseline, Session 4, Session 7, and Session 10. Results: Participants reported moderate satisfaction with the program and 30% completed three or more sessions. Statistically significant reductions in anxiety were evident across all time points for both children and adolescents. For users who completed six or more sessions, there was an average 4-point improvement in CAS-8 scores (Cohen d=0.87, children; Cohen d=0.81, adolescents), indicating a moderate to large effect size. Among participants who completed nine sessions, 57.7% (94/163) achieved recovery into nonelevated levels of anxiety and 54.6% (89/163) achieved statistically reliable reductions in anxiety. Conclusions: Participant feedback was positive, and the program was acceptable to most young people. Furthermore, significant and meaningful reductions in anxiety symptoms were achieved by many children and adolescents participating in this completely open-access and self-directed iCBT program. Our results suggest that online self-help CBT may offer a feasible and acceptable first step for service delivery to children and adolescents with anxiety. |
| Databáze: | OpenAIRE |
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