Short-term effectiveness of web-based guided self-help for phobic outpatients: Randomized controlled trial

Research output: Journal contributionsJournal articlesResearchpeer-review

Authors

  • Robin N. Kok
  • Annemieke Van Straten
  • Aartjan T F Beekman
  • Pim Cuijpers

Background: Internet-based guided self-help has been successfully used in the general population, but it is unknown whether this method can be effectively used in outpatient clinics for patients waiting for face-to-face psychotherapy for phobias. Objective: The aim was to assess the clinical effectiveness of Phobias Under Control, an Internet-based intervention based on exposure therapy with weekly guidance. Methods: We conducted a randomized controlled trial, recruiting 212 outpatients scheduled to receive face-to-face psychotherapy for any type of phobia at an outpatient clinic. Participants suffering from at least 1 DSM-IV or ICD-10 classified phobia (social phobia, agoraphobia with or without panic disorder, and/or specific phobia as ascertained by a telephone interview at baseline) were randomly allocated to either a 5-week Internet-based guided self-help program based on exposure therapy with weekly student support followed by face-to-face psychotherapy (n=105) or a wait-list control group followed by face-to-face psychotherapy (n=107). Primary outcome was the Fear Questionnaire (FQ). Secondary outcomes were the Beck Anxiety Inventory (BAI) and Center of Epidemiological Studies-Depression scale (CES-D). Assessments took place by telephone at baseline (T0) and on the Internet at posttest (T1, self-assessment at 5 weeks after baseline). Missing data at T1 were imputed. Results: At posttest, analysis of covariance on the intention-to-treat sample showed significant but small effect sizes between intervention and control groups on the FQ (d=0.35, P=.02), CES-D (d=0.34, P=.03), and a nonsignificant effect size on the BAI (d=0.28. P=.05). Although initial acceptance was good, high nonresponse was observed, with 86 of 212 participants (40.5%) lost to follow-up at T1 and only 14 of 105 (13.3%) intervention participants finishing all 5 weeks. Conclusions: Phobias Under Control is modestly effective in lowering phobic and depressive symptoms in a relatively short period and may be clinically beneficial when implemented in routine outpatient practice. Trial Registration: Netherlands Trial Register NTR2233; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2233 (Archived by WebCite at http://www.webcitation.org/6O2ioOQSs).

Original languageEnglish
Article numbere226
JournalJournal of Medical Internet Research
Volume16
Issue number9
Number of pages16
ISSN1439-4456
DOIs
Publication statusPublished - 29.09.2014

    Research areas

  • Health sciences - Anxiety disorders, Internet therapy, Outpatients, Phobias, Phobic disorders, Randomized controlled trial, Web-based intervention

Documents

DOI

Recently viewed

Publications

  1. The effects of contemporaneous peer punishment on cooperation with the future
  2. Abschluss des Vertrages
  3. Ammonia volatilization after application of biogas slurries in a coastal marsh region of Northern Germany
  4. Hildegard Domizlaff
  5. Modernisierung im Wiederaufbau oder Restauration?
  6. How Organizations Manage the Future
  7. The Territory as Creative Force
  8. Unternehmensbewertung von KMU
  9. Sondernummer TEMI – Teaching Enquiry with Mysteries incorporated
  10. Response shifts in mental health interventions
  11. Contradictions in German Penal Practices
  12. Handbook on Maritime Hybrid Threats — 10 Scenarios and Legal Scans
  13. Balloons, Sweat and Technologies
  14. Emission pathways towards a low-carbon energy system for Europe:
  15. Dissensuelle Partizipation
  16. Design und Evaluation von interaktiven webbasierten Bruchrechenaufgaben
  17. Key questions and uncertainties associated with the assessment of the cropland greenhouse gas balance
  18. Long-term degradation of Sahelian rangeland detected by 27 years of field study in Senegal
  19. Stratified prevention: opportunities and limitations
  20. Das Kunstwerk ist nicht a priori gegeben. Der Benutzer bringt es hervor
  21. The TPPA, Agribusiness and Rural Livelihoods
  22. Rekonstruktive Forschung mit Akteuren im frühpädagogischen Praxisfeld
  23. The art of gentrification
  24. Distracted by the unthought - Suppression and reappraisal of mind wandering under stereotype threat
  25. RAF und der neue "Faschismus"
  26. Introduction
  27. Property Meeting the Challenge of the Commons
  28. Berufsbezogene Psychotherapie
  29. Bildung, Biografie und Anerkennung
  30. Reacting against treaty breaches
  31. Customer Engagement Benefits
  32. Interdisziplinäres Arbeiten der Zivilgerichte
  33. Cologne: Inside Out
  34. Das Linzer Konzept der Klassenführung (LKK)
  35. Mit allem rechnen
  36. Solid state recycling of different chip types of aluminum alloy 6060 by hot extrusion
  37. Buden. Lichter. Volk. (Woyzeck)
  38. Solidarität in postmigrantischen Allianzen:
  39. Rückbau und Entsorgung in der deutschen Atomwirtschaft