All at Once or One at a Time? A Randomized Controlled Trial Comparing Two Ways to Deliver Bibliotherapy for Panic Disorder

Carlbring, Per; Maurin, Tommy; Sjömark, Josefin; Maurin, Linda; Westling, Bengt E.; Ekselius, Lisa; Cuijpers, Pim; Andersson, Gerhard

doi:10.1080/16506073.2011.553629

Cited by 13 publications

(7 citation statements)

References 37 publications

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“…On the one hand, it could be expected that a flexible format may produce better results, given research showing that when patients had at least one treatment preference met (i.e., time, venue, type of treatment, therapist gender) they experience greater improvements in outcome variables (Williams et al, ). On the other hand, previous research of fixed versus flexible bibliotherapy for panic disorder showed no significant differences between the formats over a 2‐year period (Carlbring et al, ), with both associated with large within‐group effect size decreases in panic. The current research seeks to investigate whether: (a) completion of a 3‐ versus 8‐module version of unguided ICBT‐P produced similar effect size changes in our outcome variables (i.e., is shorter just as effective as longer?…”

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confidence: 79%

Internet‐based cognitive behaviour therapy for perfectionism: More is better but no need to be prescriptive

Wade

Kay

Valle

et al. 2019

Clinical Psychologist

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Background: The current study explored whether higher-(up to 8 modules) versus lower-dose (3 or less modules) unguided internet Cognitive Behaviour Therapy for perfectionism (ICBT-P) was more effective, and the best method to promote higher dosage. Methods: Two sequential randomised ICBT-P studies were conducted with participants who self-identified as having difficulties with perfectionism; in the first participants (N = 51) received 3-module ICBT-P or wait-list, and in the second participants (N = 55) received fixed (asked to complete all 8 modules two per week over 4-weeks) or flexible format (after completing the first psychoeducational module, participants decided how many/in what order they completed the modules). We examined impact on our primary variables, perfectionistic concerns and standards, and secondary outcomes of negative affect, body image flexibility, and self-efficacy. Results: More modules were completed in the higher-(M modules = 4.36, SD = 3.29) versus lower-dose (M = 1.96, SD = 1.23) ICBT-P, d = 0.86 (95% confidence interval: 0.39, 1.34). The latter impacted perfectionism but not secondary outcomes; the former impacted all outcomes (except for self-efficacy), and withingroup effect size improvements were double in the high-compared to low-dose ICBT-P. There was no difference between the fixed and flexible formats in terms of the number of modules completed or impact. Conclusions: We can offer a patient-centred approach to ICBT-P that is effective, while suggesting completion of more modules can result in larger, more pervasive improvements. ANZCTR Trial Number: ACTRN12619000147189. K E Y W O R D S body image flexibility, fixed or flexible format, internet cognitive-behavioural therapy, negative affect, perfectionism

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confidence: 79%

Internet‐based cognitive behaviour therapy for perfectionism: More is better but no need to be prescriptive

Wade

Kay

Valle

et al. 2019

Clinical Psychologist

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“…When using bibliotherapy, providing information all at one time was as effective as pacing [157], and therapist support does not appear to be essential [75,158]. Most ICBT programs have some therapist contact by either telephone or email, and once weekly contact appeared to be as effective as more frequent contact [168].…”

Section: Panic Disorder and Agoraphobiamentioning

confidence: 99%

Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders

et al. 2014

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BackgroundAnxiety and related disorders are among the most common mental disorders, with lifetime prevalence reportedly as high as 31%. Unfortunately, anxiety disorders are under-diagnosed and under-treated.MethodsThese guidelines were developed by Canadian experts in anxiety and related disorders through a consensus process. Data on the epidemiology, diagnosis, and treatment (psychological and pharmacological) were obtained through MEDLINE, PsycINFO, and manual searches (1980–2012). Treatment strategies were rated on strength of evidence, and a clinical recommendation for each intervention was made, based on global impression of efficacy, effectiveness, and side effects, using a modified version of the periodic health examination guidelines.ResultsThese guidelines are presented in 10 sections, including an introduction, principles of diagnosis and management, six sections (Sections 3 through 8) on the specific anxiety-related disorders (panic disorder, agoraphobia, specific phobia, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder), and two additional sections on special populations (children/adolescents, pregnant/lactating women, and the elderly) and clinical issues in patients with comorbid conditions.ConclusionsAnxiety and related disorders are very common in clinical practice, and frequently comorbid with other psychiatric and medical conditions. Optimal management requires a good understanding of the efficacy and side effect profiles of pharmacological and psychological treatments.

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“…All treatment modules will be accessible from the online platform at once, allowing individual pacing [38]. …”

Section: Methodsmentioning

confidence: 99%

Guided and unguided CBT for social anxiety disorder and/or panic disorder via the Internet and a smartphone application: study protocol for a randomised controlled trial

Lindner

Ivanova

et al. 2013

Trials

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BackgroundSmartphone technology presents a novel and promising opportunity to extend the reach of psychotherapeutic interventions by moving selected parts of the therapy into the real-life situations causing distress. This randomised controlled trial will investigate the effects of a transdiagnostic, Internet-administered cognitive behavioural (iCBT) self-help program for anxiety, supplemented with a smartphone application. The effect of added therapist support will also be studied.Methods/DesignOne hundred and fifty participants meeting diagnostic criteria for social anxiety disorder and/or panic disorder will be evenly randomised to either one of three study groups: 1, smartphone-supplemented iCBT with therapist support; 2, smartphone-supplemented iCBT without therapist support; or 3, an active waiting list control group with delayed treatment. Primary outcome measure will be the Generalised Anxiety Disorder 7-item self-rating scale. Secondary measures include other anxiety, depression and quality of life measures. In addition to pre- and post-treatment measurements, the study includes two mid-treatment (days 24 and 48) and two follow-up assessments (12 and 36 months) to assess rapid and long-term effects.DiscussionTo our knowledge, this is the first study to investigate the effectiveness of smartphone-supplemented iCBT for anxiety disorders. Hence, the findings from this trial will constitute great advancements in the burgeoning and promising field of smartphone-administered psychological interventions. Limitations are discussed.Trial registrationClinicaltrials.gov: NCT01963806

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All at Once or One at a Time? A Randomized Controlled Trial Comparing Two Ways to Deliver Bibliotherapy for Panic Disorder

Cited by 13 publications

References 37 publications

Internet‐based cognitive behaviour therapy for perfectionism: More is better but no need to be prescriptive

Internet‐based cognitive behaviour therapy for perfectionism: More is better but no need to be prescriptive

Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders

Guided and unguided CBT for social anxiety disorder and/or panic disorder via the Internet and a smartphone application: study protocol for a randomised controlled trial

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