Online Cognitive Behavioural Therapy for Anxiety
Palo Alto (17 mi)Age: 18+
Sex: Any
Travel: May be covered
Time Reimbursement: Varies
Trial Phase: N/A
Recruiting
Sponsor: University of Regina
No Placebo Group
Approved in 3 jurisdictions
Trial Summary
What is the purpose of this trial?This study is a randomized factorial trial designed to evaluate unguided (i.e., purely self-help), transdiagnostic internet delivered cognitive behaviour therapy tailored for public safety personnel with tunneled of personalized course delivery and with or without the incorporation of social learning resources.
Is Internet-delivered Cognitive Behaviour Therapy a promising treatment for anxiety?Yes, Internet-delivered Cognitive Behaviour Therapy (ICBT) is a promising treatment for anxiety. It helps make effective therapy more available to children and adolescents who might not otherwise get help. ICBT combines therapy with technology to reduce anxiety and is considered an effective approach for treating anxiety in young people.346810
What safety data exists for online CBT for anxiety?The research indicates that Internet-delivered cognitive behavioral therapy (iCBT) is a promising and effective treatment for anxiety disorders, with benefits comparable to face-to-face CBT. Systematic reviews and randomized controlled trials have shown substantial benefits, and effectiveness trials demonstrate strong effects in primary care settings. However, research studies typically exclude individuals with anxiety secondary to schizophrenia, bipolar disorder, substance abuse, or those who are actively suicidal. This suggests that while iCBT is generally safe and effective for most people with primary anxiety disorders, it may not be suitable for everyone.234910
Do I need to stop my current medications to join the trial?The trial protocol does not specify whether you need to stop taking your current medications.
What data supports the idea that Online Cognitive Behavioural Therapy for Anxiety is an effective treatment?The available research shows that Online Cognitive Behavioural Therapy (ICBT) is effective in reducing anxiety in both children and adults. Studies indicate that ICBT can significantly lower anxiety levels, especially when there is some support from a therapist. For example, one study found that ICBT led to significant reductions in anxiety for children and adolescents. Another study highlighted that therapist support during ICBT is important for achieving good outcomes. Overall, ICBT is a promising option for treating anxiety, especially for those who may not have easy access to traditional therapy.135711
Eligibility Criteria
This trial is for public safety personnel struggling with PTSD, depression, or anxiety. Participants should be comfortable using the internet for therapy and willing to try self-help cognitive behavior therapy (CBT). Specific eligibility details are not provided.Treatment Details
The study tests unguided internet-delivered CBT tailored for public safety workers. It compares different delivery methods: tunneled vs personalized, and the addition of social learning resources.
4Treatment groups
Experimental Treatment
Group I: Tunneled Delivery/Standard ResourcesExperimental Treatment3 Interventions
In this arm, participants will be guided through the Self-Guided PSP Wellbeing Course in a predetermined order and using predetermined timing. Future lessons will "unlock" as previous lessons are completed.
Participants receiving the standard resources will be presented with resources that are typically presented in PSPNET courses. This includes lesson slides case stories, do-it yourself guides, and frequently asked questions pages.
Group II: Tunneled Delivery/Enhanced Social Learning ResourcesExperimental Treatment3 Interventions
In this arm, participants will be guided through the Self-Guided PSP Wellbeing Course in a predetermined order and using predetermined timing. Future lessons will "unlock" as previous lessons are completed.
Participants receiving the enhanced social learning resources will receive the same resources offered in the standard conditions (i.e., lesson slides, case stories, do-it-yourself guides, and frequently asked questions pages) and will also receive additional resources. Additional resources will include homework records to accompany the case stories, de-identified quotations from previous clients for each lesson, and a motivational video encouraging them to engage with the course.
Group III: Personalized Delivery/Standard ResourcesExperimental Treatment3 Interventions
In this arm, participants will be able to navigate through the course modules in whichever order and at whatever pace they like. Participants will not have to complete one lesson in order to gain access to the following lesson.
Participants receiving the standard resources will be presented with resources that are typically presented in the course. This includes lesson slides, case stories, do-it yourself guides, and frequently asked questions pages.
Group IV: Personalized Delivery/Enhanced Social Learning ResourcesExperimental Treatment3 Interventions
In this arm, participants will be able to navigate through the course modules in whichever order and at whatever pace they like. Participants will not have to complete one lesson in order to gain access to the following lesson.
Participants receiving the enhanced social learning resources will receive the same resources offered in the standard conditions (i.e., lesson slides, case stories, do-it-yourself guides, and frequently asked questions pages) and will also receive additional resources. Additional resources will include homework records to accompany the case stories, de-identified quotations from previous clients for each lesson, and a motivational video encouraging them to engage with the course.
Internet-delivered Cognitive Behaviour Therapy is already approved in Canada, European Union, United States for the following indications:
🇨🇦 Approved in Canada as ICBT for:
- Major Depressive Disorder
- Generalized Anxiety Disorder
- Post-Traumatic Stress Disorder
🇪🇺 Approved in European Union as ICBT for:
- Depression
- Anxiety Disorders
- PTSD
🇺🇸 Approved in United States as ICBT for:
- Depression
- Anxiety Disorders
- PTSD
Find a clinic near you
Research locations nearbySelect from list below to view details:
Department of Psychology, University of ReginaRegina, Canada
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Who is running the clinical trial?
University of ReginaLead Sponsor
Government of CanadaCollaborator
References
Therapist behaviours in internet-delivered cognitive behaviour therapy: analyses of e-mail correspondence in the treatment of generalized anxiety disorder. [2022]Internet-delivered cognitive behaviour therapy (iCBT) has been found to be an effective way to disseminate psychological treatment, and support given by a therapist seems to be important in order to achieve good outcomes. Little is known about what the therapists actually do when they provide support in iCBT and whether their behaviour influences treatment outcome.
Internet-delivered cognitive behavior therapy for anxiety disorders is here to stay. [2022]Anxiety disorders are common and disabling. Cognitive behavior therapy is the treatment of choice but is often difficult to obtain. Automated, internet-delivered, cognitive behavior therapy (iCBT) courses may be an answer. There are three recent systematic reviews of randomized controlled trials that show that the benefits are substantial (d = 1.0) and similar to face to face CBT. There are two large effectiveness trials that demonstrate strong effects when iCBT is used in primary care; 60 % of patients who complete the courses no longer meet diagnostic criteria. The courses are suitable for most people with a primary anxiety disorder. Research studies usually exclude people whose anxiety is secondary to schizophrenia, bipolar disorder, or substance abuse or who are actively suicidal. Little additional input from clinicians is required. Patients find the courses very convenient. Clinically, the principal advantage is the fidelity of the treatment. What you prescribe is what the patient sees.
Internet-delivered cognitive behavioural therapy for children with anxiety disorders: A randomised controlled trial. [2022]Cognitive behaviour therapy (CBT) has been shown to be an effective treatment for anxiety disorders in children, but few affected seek or receive treatment. Internet-delivered CBT (ICBT) could be a way to increase the availability of empirically supported treatments.
Internet-delivered cognitive behavioural therapy for young children with obsessive-compulsive disorder: development and initial evaluation of the BIP OCD Junior programme. [2022]Internet-delivered cognitive behavioural therapy (ICBT) is a promising approach for increasing access to evidence-based treatments.
What are Clients Asking Their Therapist During Therapist-Assisted Internet-Delivered Cognitive Behaviour Therapy? A Content Analysis of Client Questions. [2019]Although internet-delivered cognitive behaviour therapy (ICBT) yields large clinical outcomes when accompanied by therapeutic support, a portion of clients do not benefit from treatment. In ICBT, clients review treatment materials online typically on a weekly basis. A key component of therapist-assistance involves answering questions as clients review and work on assignments related to the treatment materials.
Design and Delivery Features That May Improve the Use of Internet-Based Cognitive Behavioral Therapy for Children and Adolescents With Anxiety: A Realist Literature Synthesis With a Persuasive Systems Design Perspective. [2020]Internet-based cognitive behavioral therapy (iCBT) is a persuasive system as its design combines therapeutic content, technological features, and interactions between the user and the program to reduce anxiety for children and adolescents. How iCBT is designed and delivered differs across programs. Although iCBT is considered an effective approach for treating child and adolescent anxiety, rates of program use (eg, module completion) are highly variable for reasons that are not clear. As the extent to which users complete a program can impact anxiety outcomes, understanding what iCBT design and delivery features improve program use is critical for optimizing treatment effects.
Internet-delivered cognitive behavior therapy with minimal therapist support for anxious children and adolescents: predictors of response. [2021]In general, Internet-delivered cognitive behavior therapy (iCBT) produces significant reductions in child and adolescent anxiety, but a proportion of participants continue to show clinical levels of anxiety after treatment. It is important to identify demographic, clinical, and family factors that predict who is most likely to benefit from iCBT in order to better tailor treatment to individual needs.
An Internet-Based Cognitive Behavioral Program for Adolescents With Anxiety: Pilot Randomized Controlled Trial. [2020]Internet-based cognitive behavioral therapy (ICBT) is a treatment approach recently developed and studied to provide frontline treatment to adolescents with anxiety disorders.
Dismantling, optimising, and personalising internet cognitive behavioural therapy for depression: a systematic review and component network meta-analysis using individual participant data. [2022]Internet cognitive behavioural therapy (iCBT) is a viable delivery format of CBT for depression. However, iCBT programmes include training in a wide array of cognitive and behavioural skills via different delivery methods, and it remains unclear which of these components are more efficacious and for whom.
An Internet-Based Cognitive Behavioral Therapy Program for Anxiety and Depression (Tranquility): Adaptation Co-design and Fidelity Evaluation Study. [2022]Internet-based cognitive behavioral therapy (iCBT) is a necessary step toward increasing the accessibility of mental health services. Yet, few iCBT programs have been evaluated for their fidelity to the therapeutic principles of cognitive behavioral therapy (CBT) or usability standards. In addition, many existing iCBT programs do not include treatments targeting both anxiety and depression, which are commonly co-occurring conditions.
The Overall Anxiety Severity and Impairment Scale as an Outcome Measure in Internet-Delivered Cognitive Behavioral Therapy for Anxiety Disorders: Observational Study. [2023]Internet-delivered cognitive behavioral therapy (iCBT) is effective in the treatment of anxiety disorders. iCBT clinical trials use relatively long and time-consuming disorder-specific rather than transdiagnostic anxiety measurements. Overall Anxiety Severity and Impairment Scale (OASIS) is a brief self-report scale that could offer a universal, easy-to-use anxiety measurement option in disorder-specific and transdiagnostic iCBT programs.