Trial of an Online Cognitive Behaviour Therapy Intervention for Death Anxiety

This Phase I trial is designed to assess the efficacy, safety, and feasibility of a novel online treatment for death anxiety. The Overcoming Death Anxiety program consists of 7 online modules, all of which are based on the principles of Cognitive Behavior Therapy (CBT). Across the 7 modules, participants will be given psychoeducation about the relationship between thoughts and emotion and will be shown how to challenge unhelpful thoughts related to their own specific fears about death. The role of avoidance in maintaining anxiety will also be explained, with modules incorporating specific individualised exposure tasks. Tasks to increase the participant’s sense of meaning in life will also be included. Information regarding relapse prevention will also be provided. Much of the content has been designed specifically for this study, and is not based on a freely available resource. All modules are based on well-evaluated standard CBT approaches to anxiety. The online program can be completed at the participant’s own pace, and from any computer. While the completion time will vary for each participant, the online modules are expected to take an average of 9 hours in total to complete. These modules can be completed across multiple sessions or days, at the participant’s convenience. Participants will have up to 5 months from commencement to access the modules. Elements of the program are personalised for participants. For instance, the answers to survey questions at the beginning of the program are used by the software to select homework assignments for participants, such as specific exposure tasks (e.g., watching a film about death, talking to a loved one about death) based on their earlier responses. Adherence will be assessed by number of modules completed. Number of log-ins and time spent on the program will also be assessed. The primary strategy employed to reduce attrition will be automated email reminders. As well as receiving emails congratulating participants for completing each module, they will also receive reminders if they have not logged on to the program for 3, 7, 10,14, 21 or 28 days. If they still do not respond, they will not be contacted further until the end of the program, at which point attempts to contact them will be made in order to gain end-of-treatment data.