Internet-based cognitive behavior therapy for depression, social anxiety disorder, and panic disorder: Effectiveness and predictors of response in a teaching clinic

Andrea N. Niles, Erland Axelsson, Erik Andersson, Erik Hedman-Lagerlöf, Per Carlbring, Gerhard Andersson, Robert Johansson, Sara Widén, Jens Driessen, Fredrik Santoft, Brjánn Ljótsson*

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Abstrakt

Though therapist-guided Internet-based cognitive behavior therapy (ICBT) appears to be efficacious for depression, social anxiety disorder, and panic disorder, relatively little is known about real-world settings and predictors of treatment effects derived from cognitive-behavioral theory. We examined treatment effectiveness and predictors of improvement in a prospective cohort study where patients took part in 10 weeks of ICBT for depression (n = 114), social anxiety disorder (n = 150), or panic disorder (n = 106) at a teaching clinic. Patients self-reported symptoms before, during, and after treatment. Effect sizes were large for improvement in the primary symptom domain of each treatment group: depression (d = 1.48), social anxiety disorder (d = 1.01), and panic disorder (d = 1.15). In ICBT for depression, having no previous experience of psychological treatment (r = 0.21), and more frequent baseline negative automatic thoughts (r = 0.20) predicted larger improvement. In ICBT for panic disorder, having more baseline safety behaviors (r = 0.25) predicted larger improvement. Predictors remained significant when baseline symptoms were included in the statistical models. We conclude that ICBT can be effective in a real-world teaching clinic, and that patients with greater deficits at baseline benefit the most.

OriginalsprogEngelsk
Artikelnummer103767
TidsskriftBehaviour Research and Therapy
Vol/bind136
ISSN0005-7967
DOI
StatusUdgivet - jan. 2021

Bibliografisk note

Funding Information:
Andrea Niles was supported by the Advanced Women's Health Fellowship at the San Francisco VA Medical Center .

Publisher Copyright:
© 2020 Elsevier Ltd

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

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