J. Med. Internet Res. - Anxiety online: a virtual clinic: preliminary outcomes following completion of five fully automated treatment programs for anxiety disorders and symptoms.


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CKGROUND: The development of e-mental health interventions to treat or prevent mental illness and to enhance wellbeing has risen rapidly over the past decade. This development assists the public in sidestepping some of the obstacles that are often encountered when trying to access traditional face-to-face mental health care services.OBJECTIVE: The objective of our study was to investigate the posttreatment effectiveness of five fully automated self-help cognitive behavior e-therapy programs for generalized anxiety disorder (GAD), panic disorder with or without agoraphobia (PD/A), obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and social anxiety disorder (SAD) offered to the international public via Anxiety Online, an open-access full-service virtual psychology clinic for anxiety disorders.METHODS: We used a naturalistic participant choice, quasi-experimental design to evaluate each of the five Anxiety Online fully automated self-help e-therapy programs. Participants were required to have at least subclinical levels of one of the anxiety disorders to be offered the associated disorder-specific fully automated self-help e-therapy program. These programs are offered free of charge via Anxiety Online.RESULTS: A total of 225 people self-selected one of the five e-therapy programs (GAD, n = 88; SAD, n = 50; PD/A, n = 40; PTSD, n = 30; OCD, n = 17) and completed their 12-week posttreatment assessment. Significant improvements were found on 21/25 measures across the five fully automated self-help programs. At postassessment we observed significant reductions on all five anxiety disorder clinical disorder severity ratings (Cohen d range 0.72-1.22), increased confidence in managing one's own mental health care (Cohen d range 0.70-1.17), and decreases in the total number of clinical diagnoses (except for the PD/A program, where a positive trend was found) (Cohen d range 0.45-1.08). In addition, we found significant improvements in quality of life for the GAD, OCD, PTSD, and SAD e-therapy programs (Cohen d range 0.11-0.96) and significant reductions relating to general psychological distress levels for the GAD, PD/A, and PTSD e-therapy programs (Cohen d range 0.23-1.16). Overall, treatment satisfaction was good across all five e-therapy programs, and posttreatment assessment completers reported using their e-therapy program an average of 395.60 (SD 272.2) minutes over the 12-week treatment period.CONCLUSIONS: Overall, all five fully automated self-help e-therapy programs appear to be delivering promising high-quality outcomes; however, the results require replication.

Resumo Limpo

ckground develop ement health intervent treat prevent mental ill enhanc wellb risen rapid past decad develop assist public sidestep obstacl often encount tri access tradit facetofac mental health care servicesobject object studi investig posttreat effect five fulli autom selfhelp cognit behavior etherapi program general anxieti disord gad panic disord without agoraphobia pda obsessivecompuls disord ocd posttraumat stress disord ptsd social anxieti disord sad offer intern public via anxieti onlin openaccess fullservic virtual psycholog clinic anxieti disordersmethod use naturalist particip choic quasiexperiment design evalu five anxieti onlin fulli autom selfhelp etherapi program particip requir least subclin level one anxieti disord offer associ disorderspecif fulli autom selfhelp etherapi program program offer free charg via anxieti onlineresult total peopl selfselect one five etherapi program gad n sad n pda n ptsd n ocd n complet week posttreat assess signific improv found measur across five fulli autom selfhelp program postassess observ signific reduct five anxieti disord clinic disord sever rate cohen d rang increas confid manag one mental health care cohen d rang decreas total number clinic diagnos except pda program posit trend found cohen d rang addit found signific improv qualiti life gad ocd ptsd sad etherapi program cohen d rang signific reduct relat general psycholog distress level gad pda ptsd etherapi program cohen d rang overal treatment satisfact good across five etherapi program posttreat assess complet report use etherapi program averag sd minut week treatment periodconclus overal five fulli autom selfhelp etherapi program appear deliv promis highqual outcom howev result requir replic

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