None listed
Conditions
Brief summary
Traditionally, youth anxiety programs have adopted a generic approach where the same treatment program is used regardless of the particular anxiety disorder. The failure to tailor treatment to the specific anxiety disorder may partly explain why a significant proportion of young people fail to respond to such treatments. We propose that a disorder-specific approach will more effective than a generic program in internet-based therapy for youth anxiety. The study involves a randomised controlled trial in which young people with social phobia are randomly assigned to either generic (transdiagnositic) or specific cognitive behaviour therapy, through online delivery, or to a wait list control condition. The impact on anxiety symptoms will then be evaluated over time.
Interventions
The Generic/Transdiagnostic intervention includes CBT anxiety management strategies including: psychoeducation, relaxation training, recognition of the physiological symptoms of anxiety, cognitive strategies of coping self-talk and cognitive restructuring, graded exposure, problem solving, and self-reinforcement. Parent sessions also teach anxiety management skills, in addition to parenting strategies to empower parents to help their child implement anxiety management skills.
The intervention
The Generic/Transdiagnostic intervention includes CBT anxiety management strategies including: psychoeducation, relaxation training, recognition of the physiological symptoms of anxiety, cognitive strategies of coping self-talk and cognitive restructuring, graded exposure, problem solving, and self-reinforcement. Parent sessions also teach anxiety management skills, in addition to parenting strategies to empower parents to help their child implement anxiety management skills. The intervention comprises ten, one-hour online youth sessions and five, online one-hour parent sessions completed over a 12-week period. Booster sessions are completed at one- and three-months following treatment by both the young person and his/her parent(s). Sessions are designed to be engaging, interactive, and age-appropriate. Eye-catching graphics, sounds, games and quizzes are used to maintain the youths’ level of interest. Information is presented through interactive exercises and followed by quizzes that check for correct understanding and provide personalized corrective or positive feedback through pop up messages. The content of the intervention is designed to meet the developmental and cognitive level of youths, with age-appropriate scenarios, examples, and activities (example situations include school exams, job interviews, dating, and oral presentations). The program is (minimally) therapist-assisted, rather than self-help. Each family is assigned an online therapist (BRAVE Trainer) who monitors their progress through the program and provides brief email feedback following each session. At no stage do any participants have face-to-face contact with their therapist and all other contact (i.e., email or phone) was minimal. Clinician contact is restricted to brief, weekly emails. Most other contact with the ‘online therapist’ is computer generated. Client responses to all session and homework activities are stored in an administrator section of the program and can be viewed by the therapist to guide the content of the weekly email. In addition, automated computer-generated emails are sent on behalf of the online therapist to congratulate participants for completion of sessions and personalized emails are sent to provide feedback about responses to quiz tasks. Personalized automated reminder emails are sent to advise when the next session is available for completion, or to provide prompts if not completed by the due date. The first session also includes a picture of the therapist, and some brief biographical information about them, to which the client responds by providing information about themselves. The wait list control condition will complete the pre-treatment assessment and will then be reassessed after 12-weeks. After this point they will be offered treatment by the research team, using the transdiagnostic, standard treatment approach.
Sponsors
Griffith University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
7 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
Children and adolescents will be included in the study if they meet DSM-IV criteria for a primary diagnosis of social phobia with a clinical severity rating (CSR) of at least 4 (on a 0-8 scale). Comorbidity with other anxiety disorders and externalising disorders will be permissible as long as the social phobia is considered primary. Families must have access to a suitable computer and the internet, and be willing to participate in any of the three conditions.
Exclusion criteria
As the internet program requires a minimum reading age of 8 years, children with an identified intellectual handicap or learning disability will not be included. Children with a pervasive developmental disorder will also be excluded. For ethical reasons pertaining to the danger of potential self-harm, youngsters with clinical levels of depression (Clinician Severity Rating of 4 or higher on a 0-8 scale on the ADIS-C/P) will not be included in the program and will be referred elsewhere for assistance.
Outcome results
None listed