Article2017

Treating anxiety and depression in young adults: A randomised controlled trial comparing clinician-guided versus self-guided Internet-delivered cognitive behavioural therapy

Blake Farran Dear · Vincent J. Fogliati · Rhiannon Fogliati · Bareena Johnson · Olivia Boyle · Eyal Karin +4 more

93 citations0/0 files storedAustralian & New Zealand Journal of Psychiatry

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Digital Mental Health Interventions Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Mental Health Treatment and Access

Abstract

BACKGROUND: Internet-delivered cognitive behaviour therapy may increase access by young adults to evidence-based treatments for anxiety and depression. OBJECTIVE: The aim of this study was to compare the efficacy of an Internet-delivered cognitive behaviour therapy intervention designed for adults aged 18-24 years, when delivered in clinician-guided versus self-guided formats. DESIGN: The intervention, the Mood Mechanic Course, is a transdiagnostic treatment that simultaneously targets symptoms of anxiety and depression using cognitive and behavioural skills. The brief intervention comprised four lessons, delivered over 5 weeks. Following a brief telephone interview, young adults ( n = 191) with symptoms of anxiety and depression were randomly allocated to either (1) clinician-guided treatment ( n = 96) or (2) self-guided treatment ( n = 95). RESULTS: At post treatment, large reductions (average improvement; clinician guided vs self-guided) were observed in symptoms of anxiety (44% vs 35%) and depression (40% vs 31%) in both groups. Significant improvements were also observed in general psychological distress (33% vs 29%), satisfaction with life (18% vs 15%) and disability (36% vs 29%). No marked or consistent differences in clinical outcomes emerged between conditions at post-treatment, at 3-month or 12-month follow-up. Satisfaction was high with both treatment formats, but slightly higher for clinician-guided treatment. CONCLUSION: These results indicate the potential of carefully developed Internet-delivered cognitive behaviour therapy interventions for young adults with anxiety and depression provided in either self or therapist-guided format. Further large-scale research is required to determine the short- and long-term advantages and disadvantages of different models of support.

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References

2001The PHQ-9 1985The Satisfaction With Life Scale 2006A Brief Measure for Assessing Generalized Anxiety Disorder 2002Short screening scales to monitor population prevalences and trends in non-specific psychological distress 2007Mental health of young people: a global public-health challenge 2010Service Utilization for Lifetime Mental Disorders in U.S. Adolescents: Results of the National Comorbidity Survey–Adolescent Supplement (NCS-A)2004Toward a unified treatment for emotional disorders 2010Computer Therapy for the Anxiety and Depressive Disorders Is Effective, Acceptable and Practical Health Care: A Meta-Analysis

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