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A RCT of a Transdiagnostic Internet-Delivered Treatment for Three Anxiety Disorders: Examination of Support Roles and Disorder-Specific Outcomes

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  • Luke Johnston
  • Nickolai Titov
  • Gavin Andrews
  • Jay Spence
  • Blake F Dear

Abstract

Background: Anxiety disorders share common vulnerabilities and symptoms. Disorder-specific treatment is efficacious, but few access evidence-based care. Administering transdiagnostic cognitive-behavioral therapy via the internet (iCBT) may increase access to evidence-based treatment, with a recent randomized controlled trial (RCT) providing preliminary support for this approach. This study extends those findings and aims to answer three questions: Is a transdiagnostic iCBT program for anxiety disorders efficacious and acceptable? Does it result in change for specific disorders? Can good clinical outcomes be obtained when guidance is provided via a Coach rather than a Clinician? Method: RCT (N = 131) comparing three groups: Clinician-supported (CL) vs. Coach-supported (CO) vs. waitlist control (Control). Individuals met DSM-IV criteria for a principal diagnosis of generalized anxiety disorder (GAD), social phobia (SP) or panic disorder with or without agoraphobia (Pan/Ag). Treatment consisted of an 8-lesson/10 week iCBT program with weekly contact from a Clinician or Coach, and follow-up at 3-months post-treatment. Results: Outcomes for the pooled treatment groups (CL+CO) were superior to the Control group on measures of anxiety, depression and disability, were associated with medium to large effect sizes (Cohen's d = .76 – 1.44) (response rate = 89–100%), and were maintained at follow-up. Significant reductions were found on disorder-specific outcomes for each of the target diagnoses, and were associated with large effect sizes. CO participants achieved similar outcomes to CL participants at post-treatment, yet had significantly lower symptom severity scores on general anxiety, panic-disorder, depression and disability at follow-up (d = .45 – .46). Seventy-four percent of CO and 76% of CL participants completed the program. Less than 70 minutes of Clinician or Coach time was required per participant during the program. Discussion: This transdiagnostic iCBT course for anxiety appears to be efficacious, associated with significant change for three target disorders, and is efficacious when guided by either a Clinician or Coach. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12610000242022

Suggested Citation

  • Luke Johnston & Nickolai Titov & Gavin Andrews & Jay Spence & Blake F Dear, 2011. "A RCT of a Transdiagnostic Internet-Delivered Treatment for Three Anxiety Disorders: Examination of Support Roles and Disorder-Specific Outcomes," PLOS ONE, Public Library of Science, vol. 6(11), pages 1-13, November.
    • Handle: RePEc:plo:pone00:0028079
    DOI: 10.1371/journal.pone.0028079
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    References listed on IDEAS

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    1. Emma Robinson & Nickolai Titov & Gavin Andrews & Karen McIntyre & Genevieve Schwencke & Karen Solley, 2010. "Internet Treatment for Generalized Anxiety Disorder: A Randomized Controlled Trial Comparing Clinician vs. Technician Assistance," PLOS ONE, Public Library of Science, vol. 5(6), pages 1-9, June.
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    Cited by:

    1. Filip K Arnberg & Steven J Linton & Monica Hultcrantz & Emelie Heintz & Ulf Jonsson, 2014. "Internet-Delivered Psychological Treatments for Mood and Anxiety Disorders: A Systematic Review of Their Efficacy, Safety, and Cost-Effectiveness," PLOS ONE, Public Library of Science, vol. 9(5), pages 1-13, May.

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