Anxiety online-A virtual clinic: Preliminary outcomes following completion of five fully automated treatment programs for anxiety disorders and symptoms

Journal of Medical Internet Research

Volumn 13, Issue 4, 2011, Pages

  Klein, Britt ^a   Meyer, Denny ^a   Austin, David William ^a   Kyrios, Michael ^a  

^a SWINBURNE UNIVERSITY OF TECHNOLOGY   (Australia)

Author keywords

Cognitive behavior therapy; E mental health; E Therapy; Fully automated; Generalized anxiety disorder; Internet interventions; Obsessive compulsive disorder; Panic disorder; Posttraumatic stress disorder; Self help; Social anxiety disorder; Web treatment

Indexed keywords

ADOLESCENT; ADULT; AGED; ANXIETY DISORDER; ARTICLE; AUSTRALIA; CLINICAL TRIAL; COMPUTER ASSISTED THERAPY; COMPUTER INTERFACE; FEMALE; HUMAN; INTERNET; MALE; METHODOLOGY; MIDDLE AGED; PATIENT; PATIENT SATISFACTION; QUESTIONNAIRE; SELF CARE; STATISTICS; TIME; TREATMENT OUTCOME;

ADOLESCENT; ADULT; AGED; ANXIETY DISORDERS; AUSTRALIA; FEMALE; HUMANS; INTERNET; MALE; MIDDLE AGED; PATIENT DROPOUTS; PATIENT SATISFACTION; QUESTIONNAIRES; SELF CARE; THERAPY, COMPUTER-ASSISTED; TIME FACTORS; TREATMENT OUTCOME; USER-COMPUTER INTERFACE; YOUNG ADULT;

EID: 81855173621     PISSN: None     EISSN: 14388871     Source Type: Journal    
DOI: 10.2196/jmir.1918     Document Type: Article

References (55)

1. Henderson S, Andrews G, Hall W. Australia's mental health: an overview of the general population survey. Aust N Z J Psychiatry 2000 Apr;34(2):197-205. [Medline: 10789524] (Pubitemid 30206759)
2. Australian Bureau of Statistics. National Survey of Mental Health and Wellbeing: Summary of Results. ABS Cat No. 4326.0. Canberra: ABS; 2008.
3. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005 Jun;62(6):593-602 [FREE Full text] [doi: 10.1001/archpsyc.62.6.593] [Medline: 15939837] (Pubitemid 40973434)
4. Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005 Jun;62(6):617-627 [FREE Full text] [doi: 10.1001/archpsyc.62.6.617] [Medline: 15939839] (Pubitemid 40973437)
5. Burgess PM, Pirkis JE, Slade TN, Johnston AK, Meadows GN, Gunn JM. Service use for mental health problems: findings from the 2007 National Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry 2009 Jul;43(7):615-623. [doi: 10.1080/00048670902970858] [Medline: 19530018]
6. Andrews G, Creamer M, Crino R, Hunt C, Lampe L, Page A. The Treatment of Anxiety Disorders: Clinician Guides and Patient Manuals. 2nd edition. Cambridge, UK: Cambridge University Press; 2003.
7. Parslow RA, Jorm AF. Who uses mental health services in Australia? An analysis of data from the National Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry 2000 Dec;34(6):997-1008. [Medline: 11127632]
8. Klein B, Mitchell J, Gilson K, Shandley K, Austin D, Kiropoulos L, et al. A therapist-assisted Internet-based CBT intervention for posttraumatic stress disorder: preliminary results. Cogn Behav Ther 2009 Jun;38(2):121-131. [doi: 10.1080/16506070902803483] [Medline: 20183691]
9. Bennett-Levy J, Richards D, Farrand P, Christensen H, Griffiths K, Kavanagh D, et al. Oxford Guide to Low Intensity CBT Interventions (Oxford Guides in Cognitive Behavioural Therapy). Oxford, UK: Oxford University Press; 2010.
10. Christensen H. e-hub, Centre for Mental Health Research, Australian National University. Beacon Home Page URL: http://www.beacon.anu.edu.au/ [accessed 2011-05-27] [WebCite Cache ID 5yzKacLtO]
11. Christensen H, Murray K, Calear AL, Bennett K, Bennett A, Griffiths KM. Beacon: a web portal to high-quality mental health websites for use by health professionals and the public. Med J Aust 2010 Jun 7;192(11 Suppl):S40-S44. [Medline: 20528708]
12. Barak A, Klein B, Proudfoot JG. Defining internet-supported therapeutic interventions. Ann Behav Med 2009 Aug;38(1):4-17. [doi: 10.1007/s12160-009-9130- 7] [Medline: 19787305]
13. Carlbring P, Nilsson-Ihrfelt E, Waara J, Kollenstam C, Buhrman M, Kaldo V, et al. Treatment of panic disorder: live therapy vs. self-help via the Internet. Behav Res Ther 2005 Oct;43(10):1321-1333. [doi: 10.1016/j.brat.2004. 10.002] [Medline: 16086983] (Pubitemid 41116275)
14. Klein B, Austin D, Pier C, Kiropoulos L, Shandley K, Mitchell J, et al. Internet-based treatment for panic disorder: does frequency of therapist contact make a difference? Cogn Behav Ther 2009 Jun;38(2):100-113. [doi: 10.1080/16506070802561132] [Medline: 19306149]
15. Titov N, Andrews G, Choi I, Schwencke G, Mahoney A. Shyness 3: randomized controlled trial of guided versus unguided Internet-based CBT for social phobia. Aust N Z J Psychiatry 2008 Dec;42(12):1030-1040. [doi: 10.1080/00048670802512107] [Medline: 19016091]
16. Klein B, Mitchell J, Abbott J, Shandley K, Austin D, Gilson K, et al. A therapist-assisted cognitive behavior therapy internet intervention for posttraumatic stress disorder: pre-, post- and 3-month follow-up results from an open trial. J Anxiety Disord 2010 Aug;24(6):635-644. [doi: 10.1016/j.janxdis. 2010.04.005] [Medline: 20447802]
17. Lange A, Rietdijk D, Hudcovicova M, van de Ven JP, Schrieken B, Emmelkamp PM. Interapy: a controlled randomized trial of the standardized treatment of posttraumatic stress through the internet. J Consult Clin Psychol 2003 Oct;71(5):901-909. [doi: 10.1037/0022-006X.71.5.901] [Medline: 14516238] (Pubitemid 37151552)
18. Christensen H, Griffiths KM, Mackinnon AJ, Kalia K, Batterham PJ, Kenardy J, et al. Protocol for a randomised controlled trial investigating the effectiveness of an online e health application for the prevention of Generalised Anxiety Disorder. BMC Psychiatry 2010;10:25 [FREE Full text] [doi: 10.1186/1471-244X-10-25] [Medline: 20302678]
19. Kenardy J, McCafferty K, Rosa V. Internet-delivered indicated prevention for anxiety disorders: a randomized controlled trial. Behav Cogn Psychother 2003;31:279-289. [doi: 10.1017/S1352465803003047] (Pubitemid 36960882)
20. Christensen H, Griffiths KM, Jorm AF. Delivering interventions for depression by using the internet: randomised controlled trial. BMJ 2004 Jan 31;328(7434):265 [FREE Full text] [doi: 10.1136/bmj.37945.566632.EE] [Medline: 14742346]
21. Proudfoot J, Ryden C, Everitt B, Shapiro DA, Goldberg D, Mann A, et al. Clinical efficacy of computerised cognitive-behavioural therapy for anxiety and depression in primary care: randomised controlled trial. Br J Psychiatry 2004 Jul;185:46-54 [FREE Full text] [Medline: 15231555] (Pubitemid 38951629)
22. Titov N, Andrews G, Davies M, McIntyre K, Robinson E, Solley K. Internet treatment for depression: a randomized controlled trial comparing clinician vs. technician assistance. PLoS One 2010;5(6):e10939 [FREE Full text] [doi: 10.1371/journal.pone.0010939] [Medline: 20544030]
23. Andersson G, Bergström J, Holländare F, Carlbring P, Kaldo V, Ekselius L. Internet-based self-help for depression: randomised controlled trial. Br J Psychiatry 2005 Nov;187:456-461 [FREE Full text] [doi: 10.1192/bjp.187.5.456] [Medline: 16260822] (Pubitemid 41546576)
24. Ruwaard J, Schrieken B, Schrijver M, Broeksteeg J, Dekker J, Vermeulen H, et al. Standardized web-based cognitive behavioural therapy of mild to moderate depression: a randomized controlled trial with a long-term follow-up. Cogn Behav Ther 2009 Dec;38(4):206-221. [doi: 10.1080/16506070802408086] [Medline: 19221919]
25. Ritterband LM, Thorndike FP, Gonder-Frederick LA, Magee JC, Bailey ET, Saylor DK, et al. Efficacy of an Internet-based behavioral intervention for adults with insomnia. Arch Gen Psychiatry 2009 Jul;66(7):692-698 [FREE Full text] [doi: 10.1001/archgenpsychiatry.2009.66] [Medline: 19581560]
26. Riper H, Kramer J, Smit F, Conijn B, Schippers G, Cuijpers P. Web-based self-help for problem drinkers: a pragmatic randomized trial. Addiction 2008 Feb;103(2):218-227. [doi: 10.1111/j.1360-0443.2007.02063.x] [Medline: 18199300]
27. Kiropoulos LA, Klein B, Austin DW, Gilson K, Pier C, Mitchell J, et al. Is internet-based CBT for panic disorder and agoraphobia as effective as face-to-face CBT? J Anxiety Disord 2008 Dec;22(8):1273-1284. [doi: 10.1016/j.janxdis.2008.01.008] [Medline: 18289829]
28. Griffiths KM, Farrer L, Christensen H. The efficacy of internet interventions for depression and anxiety disorders: a review of randomised controlled trials. Med J Aust 2010 Jun 7;192(11 Suppl):S4-11. [Medline: 20528707]
29. White A, Kavanagh D, Stallman H, Klein B, Kay-Lambkin F, Proudfoot J, et al. Online alcohol interventions: a systematic review. J Med Internet Res 2010;12(5):e62 [FREE Full text] [doi: 10.2196/jmir.1479] [Medline: 21169175]
30. Andersson G, Ljótsson B, Weise C. Internet-delivered treatment to promote health. Curr Opin Psychiatry 2011 Mar;24(2):168-172. [doi: 10.1097/YCO.0b013e3283438028] [Medline: 21285706]
31. Barak A, Hen L, Boniel-Nissim M, Shapira N. A comprehensive review and a meta-analysis of the effectiveness of internet-based psychotherapeutic interventions. J Technol Hum Serv 2008;26:109-160. [doi: 10.1080/ 15228830802094429]
32. Spek V, Cuijpers P, Nyklícek I, Riper H, Keyzer J, Pop V. Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis. Psychol Med 2007 Mar;37(3):319-328. [doi: 10.1017/S0033291706008944] [Medline: 17112400]
33. e-hub e-mental Health Research & Development. Centre for Mental Health Research, Australian National University. e-hub Self-Help Programs for Mental Health & Wellbeing URL: http://www.ehub.anu.edu.au/welcome.php [accessed 2011-05-27] [WebCite Cache ID 5yzKEK4E1]
34. Centre for Emotional Health, Macquarie University. eCentreClinic URL: http://www.ecentreclinic.org/[accessed 2011-08-21] [WebCite Cache ID 616CwDFrW]
35. National eTherapy Centre. Swinburne University of Technology. Anxiety Online Home Page URL: http://www.anxietyonline.org.au/[accessed 2011-05-26] [WebCite Cache ID 5yypM2wx4]
36. Bennett K, Reynolds J, Christensen H, Griffiths KM. e-hub: an online self-help mental health service in the community. Med J Aust 2010 Jun 7;192(11 Suppl):S48-S52. [Medline: 20528710]
37. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. 4th edition, text revision. Washington, DC: American Psychiatric Association; 2000.
38. Shandley K, Klein B, Kyrios M, Austin D, Ciechomski L, Murray G. Training postgraduate psychology students to deliver psychological services online. Aust Psychol 2011;46:120-125. [doi: 10.1111/j.1742-9544.2011.00034.x]
39. National eTherapy Centre. Swinburne University of Technology. Anxietyonline: Health Professional Enquiry URL: http://www.anxietyonline.org.au/ health-professionals [accessed 2011-05-27] [WebCite Cache ID 5yzKHfAVy]
40. National eTherapy Centre. Swinburne University of Technology. Anxietyonline: Terms and Conditions URL: http://www.anxietyonline.org.au/terms- and-conditions [accessed 2011-05-27] [WebCite Cache ID 5yzKM1f2Z]
41. Nguyen D, Klein B, Meyer D, Austin D. The psychometric properties and user experience of an online clinical assessment schedule. 2011 Presented at: International Society for Research into Internet Interventions (ISRII) International Conference; April 6-8, 2011; Sydney, Australia.
42. Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E, et al. Screening for serious mental illness in the general population. Arch Gen Psychiatry 2003 Feb;60(2):184-189 [FREE Full text] [Medline: 12578436] (Pubitemid 36173125)
43. Furukawa TA, Kessler RC, Slade T, Andrews G. The performance of the K6 and K10 screening scales for psychological distress in the Australian National Survey of Mental Health and Well-Being. Psychol Med 2003 Feb;33(2):357-362. [Medline: 12622315] (Pubitemid 36221468)
44. Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd edition. Hillsdale, NJ: Erlbaum; 1988.
45. Heckman JJ. Sample selection bias as a specification error. Econometrica 1979;47(1):153-161.
46. Rubin DB. Estimating causal effects from large data sets using propensity scores. Ann Intern Med 1997 Oct 15;127(8 Pt 2):757-763. [Medline: 9382394] (Pubitemid 27446562)
47. Faul F, Erdfelder E, Lang AG, Buchner A. G Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007 May;39(2):175-191. [Medline: 17695343]
48. Australian Psychological Society. APS. 2011. Fees and Rebates URL: http://www.psychology.org.au/community/fees-rebates/[accessed 2011-05-27] [WebCite Cache ID 5yzLk6klT]
49. Klein B, Richards JC, Austin DW. Efficacy of internet therapy for panic disorder. J Behav Ther Exp Psychiatry 2006 Sep;37(3):213-238. [doi: 10.1016/j.jbtep.2005.07.001] [Medline: 16126161] (Pubitemid 43866643)
50. Corrigan P. How stigma interferes with mental health care. Am Psychol 2004 Oct;59(7):614-625. [doi: 10.1037/0003-066X.59.7.614] [Medline: 15491256] (Pubitemid 39442875)
51. Mojtabai R. Mental illness stigma and willingness to seek mental health care in the European Union. Soc Psychiatry Psychiatr Epidemiol 2010 Jul;45(7):705-712. [doi: 10.1007/s00127-009-0109-2] [Medline: 19680588]
52. Dasgupta A, Lawson KA, Wilson JP. Evaluating equivalence and noninferiority trials. Am J Health Syst Pharm 2010 Aug 15;67(16):1337-1343. [doi: 10.2146/ajhp090507] [Medline: 20689122]
53. Proudfoot J, Klein B, Andersson G, Carlbring P, Kyrios M, Munro C, et al. Guided CBT internet interventions: specific issues in supporting clients with depression, anxiety and co-morbid conditions. In: Bennett-Levy J, Richards D, Farrand P, Christensen H, Griffiths K, Kavanagh DJ, et al, editors. Bennett-Levy J, Richards D, Farrand P, Christensen H, Griffiths K, Kavanagh DJ, Klein B, Lau MA, Proudfoot J, editors. Oxford Guide to Low Intensity CBT Interventions. Oxford, UK: Oxford University Press; 2010:253-267.
54. Proudfoot J, Klein B, Barak A, Carlbring P, Cuijpers P, Lange A, et al. Establishing guidelines for executing and reporting internet intervention research. Cogn Behav Ther 2011;40(2):82-97. [doi: 10.1080/16506073.2011.573807]
55. Australian Government, Department of Health and Ageing. 2011 May 10. Health Budget 2011-2012 URL: http://www.health.gov.au/internet/budget/ publishing.nsf/Content/budget2011-hmedia02.htm [accessed 2011-05-28] [WebCite Cache ID 5z18YXGnz]