Web-based therapist-assisted cognitive behavioral treatment of panic symptoms

Ruwaard, J., Broeksteeg, J., Schrieken, B., Emmelkamp, P., & Lange, A. (2010). Web-based therapist-assisted cognitive behavioral treatment of panic symptoms: A randomized controlled trial with a three-year follow-up. Journal of Anxiety Disorders, 24, pp. 387-396. doi: 10.1016/j.janxdis.2010.01.010

Abstract BACKGROUND Internet-delivered treatment may reduce barriers to care in those unwilling or unable to access traditional forms of treatment. OBJECTIVE To assesses the efficacy of web-based therapist-assisted cognitive behavioral treatment (web-CBT) of panic symptoms. DESIGN A randomized waiting-list controlled trial with an uncontrolled three-year follow-up. PARTICIPANTS A community sample of 58 participants with chronic panic symptoms of varying severity (immediate treatment: n = 27, waiting-list control: n = 31). OUTCOME MEASURES The primary outcome measures were a one-week Panic Diary and the Panic Disorder Severity Scale – Self-Report (PDSS-SR); secondary measures were the Agoraphobic Cognitions Questionnaire (ACQ), the Body Sensations Questionnaire (BSQ), the Mobility Inventory – Alone subscale (MI-AAL), and the Depression Anxiety Stress Scales (DASS-42). RESULTS In the RCT, 54 participants (93%) completed posttest measurements. With regard to the primary outcome measures, intention-to-treat ANCOVAs revealed that participants in the treatment condition improved more than the participants in the waiting-list control condition (p < .03), with a pooled between-group effect size of d = .7. After three years (n = 47; 81% study compliance), effects were more pronounced. CONCLUSION The results demonstrate the efficacy of therapist-assisted web-CBT in the treatment of panic symptoms.




Keywords Cognitive behavior therapy; Computer assisted protocol directed therapy; Controlled clinical trials; Randomized; Follow-up studies; Internet intervention; Panic disorder; Treatment outcome