Get access

THE EFFECTIVENESS OF INTERNET COGNITIVE BEHAVIOURAL THERAPY FOR GENERALIZED ANXIETY DISORDER IN CLINICAL PRACTICE

Authors

  • Louise Mewton Ph.D.,

    Corresponding author
    • School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
    Search for more papers by this author
  • Nora Wong B.Comm., B.S.Sci,

    1. Clinical Research Unit for Anxiety and Depression (CRUfAD), St. Vincent's Hospital, Sydney, New South Wales, Australia
    Search for more papers by this author
  • Gavin Andrews A.O., M.D.

    1. School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
    2. Clinical Research Unit for Anxiety and Depression (CRUfAD), St. Vincent's Hospital, Sydney, New South Wales, Australia
    Search for more papers by this author

  • Contract grant sponsor: Australian National Health and Medical Research Council Capacity Building Grant; Contract grant number: 568940; Contract grant sponsor: Australian Government Department of Health and Ageing.

  • Conflict of interest: None

Correspondence to: Louise Mewton, Clinical Research Unit for Anxiety and Depression, Level 4, O'Brien Centre, St. Vincent's Hospital, 394–404 Victoria Street, Darlinghurst, NSW, Australia. E-mail: louisem@unsw.edu.au

Abstract

Background

Clinical trials have demonstrated the efficacy of internet cognitive behavioral therapy (iCBT) in the treatment of generalized anxiety disorder (GAD). The current study aims to determine whether these efficacy findings, established under controlled research conditions, translate into effectiveness in practice.

Methods

The sample comprised 588 patients who completed at least one iCBT lesson for GAD through CRUfAD clinic (www.crufadclinic.org). This six-lesson course became available to primary care physicians to prescribe in 2009. Routine data collection included demographics, GAD symptomatology (GAD-7), psychological distress (K-10), and disability (WHODAS).

Results

All six lessons were completed by 324/588 (55.1%) patients. When compared with completers, noncompleters tended to be younger and based in rural locations. Prior to discontinuing the course, noncompleters demonstrated statistically significant reductions in psychological distress. For those who completed the course, effect sizes on all outcome measures were medium to large and over 60% of moderate-to-severe GAD cases met criteria for remission upon treatment completion.

Conclusions

The current study indicates that computerized CBT for GAD is effective in generating positive, clinically significant outcomes among typical patients treated under the usual conditions in primary care. Future research should focus on reducing treatment discontinuation among younger people and those based in rural locations.

Ancillary