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Internet and Computer-Based Cognitive Behavioral Therapy for Anxiety and Depression in Youth: A Meta-Analysis of Randomized Controlled Outcome Trials

Author

Listed:
  • David Daniel Ebert
  • Anna-Carlotta Zarski
  • Helen Christensen
  • Yvonne Stikkelbroek
  • Pim Cuijpers
  • Matthias Berking
  • Heleen Riper

Abstract

Background: Anxiety and depression in children and adolescents are undertreated. Computer- and Internet-based cognitive behavioral treatments (cCBT) may be an attractive treatment alternative to regular face-to-face treatment.This meta-analysis aims to evaluate whether cCBT is effective for treating symptoms of anxiety and depression in youth. Methods and Findings: We conducted systematic searches in bibliographical databases (Pubmed, Cochrane controlled trial register, PsychInfo) up to December 4, 2013. Only randomized controlled trials in which a computer-, Internet- or mobile-based cognitive behavioral intervention targeting either depression, anxiety or both in children or adolescents up to the age of 25 were compared to a control condition were selected. We employed a random-effects pooling model in overall effect analyses and a mixed effect model for sub-group analyses. Searches resulted in identifying 13 randomized trials, including 796 children and adolescents that met inclusion criteria. Seven studies were directed at treating anxiety, four studies at depression, and two were of a transdiagnostic nature, targeting both anxiety and depression. The overall mean effect size (Hedges’ g) of cCBT on symptoms of anxiety or depression at post-test was g=0.72 (95% CI:0.55-0.90, numbers needed to be treated (NNT)=2.56). Heterogeneity was low (I²=20.14%, 95% CI: 0-58%). The superiority of cCBT over controls was evident for interventions targeting anxiety (g=0.68; 95% CI: 0.45-0.92; p

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  • David Daniel Ebert & Anna-Carlotta Zarski & Helen Christensen & Yvonne Stikkelbroek & Pim Cuijpers & Matthias Berking & Heleen Riper, 2015. "Internet and Computer-Based Cognitive Behavioral Therapy for Anxiety and Depression in Youth: A Meta-Analysis of Randomized Controlled Outcome Trials," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-15, March.
    • Handle: RePEc:plo:pone00:0119895
    DOI: 10.1371/journal.pone.0119895
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    References listed on IDEAS

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    1. Gretchen J. Bjornstad & Shreya Sonthalia & Benjamin Rouse & Luke Timmons & Laura Whybra & Nick Axford, 2020. "PROTOCOL: A comparison of the effectiveness of cognitive behavioural interventions based on delivery features for elevated symptoms of depression in adolescents," Campbell Systematic Reviews, John Wiley & Sons, vol. 16(1), March.
    2. Braciszewski, Jordan M. & Tzilos Wernette, Golfo K. & Moore, Roland S. & Bock, Beth C. & Stout, Robert L. & Chamberlain, Patricia, 2018. "A pilot randomized controlled trial of a technology-based substance use intervention for youth exiting foster care," Children and Youth Services Review, Elsevier, vol. 94(C), pages 466-476.
    3. Nick Midgley & Brenda Guerrero-Tates & Rose Mortimer & Julian Edbrooke-Childs & Jakob Mechler & Karin Lindqvist & Susan Hajkowski & Liat Leibovich & Peter Martin & Gerhard Andersson & George Vlaescu &, 2021. "The Depression: Online Therapy Study (D:OTS)—A Pilot Study of an Internet-Based Psychodynamic Treatment for Adolescents with Low Mood in the UK, in the Context of the COVID-19 Pandemic," IJERPH, MDPI, vol. 18(24), pages 1-20, December.
    4. Lane, Julie & Manceau, Luiza Maria & de Chantal, Pier-Luc & Chagnon, Alexandre & Cardinal, Michael & Lauzier-Jobin, François & Lanoue, Sèverine, 2024. "Implementing a mental health app library in primary care: A feasibility study," Evaluation and Program Planning, Elsevier, vol. 103(C).
    5. Harald Baumeister & Yannik Terhorst & Cora Grässle & Maren Freudenstein & Rüdiger Nübling & David Daniel Ebert, 2020. "Impact of an acceptance facilitating intervention on psychotherapists’ acceptance of blended therapy," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-15, August.
    6. Christina Gallinat & Markus Moessner & Sandra Apondo & Philipp A. Thomann & Sabine C. Herpertz & Stephanie Bauer, 2021. "Feasibility of an Intervention Delivered via Mobile Phone and Internet to Improve the Continuity of Care in Schizophrenia: A Randomized Controlled Pilot Study," IJERPH, MDPI, vol. 18(23), pages 1-13, November.
    7. Sanne P.A. Rasing & Yvonne A.J. Stikkelbroek & Wouter den Hollander & Heleen Riper & Maja Deković & Maaike H. Nauta & Daan H.M. Creemers & Marianne C.P. Immink & Mariken Spuij & Denise H.M. Bodden, 2021. "Pragmatic Quasi-Experimental Controlled Trial Evaluating the Outcomes of Blended CBT Compared to Face-to-Face CBT and Treatment as Usual for Adolescents with Depressive Disorders," IJERPH, MDPI, vol. 18(6), pages 1-17, March.
    8. Daniel Núñez & Jorge Gaete & Daniela Meza & Javiera Andaur & Jo Robinson, 2022. "Testing the Effectiveness of a Blended Intervention to Reduce Suicidal Ideation among School Adolescents in Chile: A Protocol for a Cluster Randomized Controlled Trial," IJERPH, MDPI, vol. 19(7), pages 1-15, March.
    9. Matilda Berg & Gerhard Andersson & Alexander Rozental, 2020. "Knowledge About Treatment, Anxiety, and Depression in Association With Internet-Based Cognitive Behavioral Therapy for Adolescents: Development and Initial Evaluation of a New Test," SAGE Open, , vol. 10(1), pages 21582440198, January.
    10. Sanne P. A. Rasing & Yvonne A. J. Stikkelbroek & Denise H. M. Bodden, 2019. "Is Digital Treatment the Holy Grail? Literature Review on Computerized and Blended Treatment for Depressive Disorders in Youth," IJERPH, MDPI, vol. 17(1), pages 1-18, December.
    11. Keya Ding & Hui Li, 2023. "Digital Addiction Intervention for Children and Adolescents: A Scoping Review," IJERPH, MDPI, vol. 20(6), pages 1-21, March.

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