Guided and unguided CBT for social anxiety disorder and/or panic disorder via the Internet and a smartphone application

• Background: As Acceptance and Commitment Therapy (ACT) becomes a part of the clinical practice, the interest for alternative ways of providing it continue to grow. Internet-based CBT, both guided and unguided, has proved to be effective for the treatment of a wide range of psychiatric disorders, including anxiety disorders. Moreover, the tremendous accessibility of smartphones makes them a potentially powerful instrument for providing psychological treatment. The purpose of this study was to investigate the effects of an Internet-based ACT-program for social anxiety disorder and panic disorder using both computers and smartphones, and with and without therapist support. Method: The participants were recruited from the general public by filling out an online screening form, which consisted of LSAS, PDSS-SR, GAD-7, PHQ-9, QOLI (the scales later served as outcome measures) and demographic questions. The individuals who met the inclusion criteria were contacted for a diagnostic telephone interview. The 152 people chosen for participation were then randomized into two treatment groups (guided and unguided) and a waiting list control group. The participants in the treatment groups were given access to an Internet-provided ACT-based treatment program consisting of 8 modules, as well as a smartphone application with content that corresponded to the Internet treatment program. Additionally, the participants in the guided group received minimum therapist support (15 min/week) through the smartphone application from psychology students undergoing their clinical training. The participants worked with the program for 10 weeks. They were evaluated twice during treatment, once after completing treatment, and once again 12-months later as a follow-up measure. A mixed effect model was used to analyze the data. Results: Regardless of diagnosis, as a whole the treated groups showed significant decreases in anxiety, with a moderate within-group effect size. This improvement appeared to be maintained when the groups were evaluated again during the follow-up. The participants suffering primarily from social anxiety disorder showed significant improvements, with moderate within-group effect sizes in both the guided (Cohen's d = 0.79) and unguided group (Cohen's d = 0.71). This improvement also appeared to be maintained when these participants were evaluated during the follow-up. No significant changes were observed in the symptoms of the participants suffering primarily from panic disorder. Discussion: Internet-delivered ACT-based treatment provided via both computer and smartphone can be effective for reducing general anxiety symptoms, as well as social anxiety symptoms. The guided treatment was not clearly superior to the unguided treatment. Some of the study’s uncertainties are likely due to the presence of a large number of different components, which made it difficult to isolate the effects of each individual component.

Subject headings

SAMHÄLLSVETENSKAP  -- Psykologi (hsv//swe)

SOCIAL SCIENCES  -- Psychology (hsv//eng)

Keyword

guided CBT

unguided CBT

social anxiety disorder

panic disorder

internet

smartphone

Psychology

psykologi

Publication and Content Type

vet (subject category)

kon (subject category)