Strengths and Limitations of Internet-Based Cognitive-Behavioral Treatments for Anxiety Disorders

Abstract

This commentary discusses the strengths and limitations of internet-based cognitive-behavioral treatments (ICBT) for anxiety disorders, as highlighted by the case studies described in Ciuca, Berger, and Miclea (2017), and in Schulz, Vincent, and Berger (2017). In comparing the course of treatment for patients with contrasting clinical outcomes, the authors offer insights into the many benefits and challenges of ICBT. Suggestions for improving ICBT interventions for anxiety disorders, implications for implementation and dissemination, and ethical considerations are discussed.

Internet-delivered cognitive processing therapy for individuals with a history of bullying victimization: a randomized controlled trial

“…Stronger therapeutic alliance is associated with better outcomes in CBT for SAD (Hays, Hope, VanDyke, & Heimberg, 2007), and face-to-face intervention offers opportunities for modification to the individual needs of the client, such as in terms of motivation for treatment, which could lead to better alliance compared to internet interventions. Furthermore, clinicians seeing clients in-person can offer feedback about interpersonal skills and provide opportunities to practice skills that the client perceives as defective (Schulz, Vicent, & Berger, 2017;Woods, Stults, Terry, & Rego, 2017).…”

Comparing online cognitive behavioural therapy versus online positive psychotherapy, well-being theory (PERMA)on test anxiety of online learning students: A randomised control study.

“…The reasons for not seeking treatment include existing barriers such as: financial costs, travel time needed to attend face-to-face treatments, fear of being stigmatised and peer rejection (Ebert et al, 2015). Internet-based interventions have been shown to be effective in overcoming some of these limitations (Woods et al, 2017).…”

Konseling Daring Pendukung Siswa Cerdas (KDPSC): A Preliminary Evaluation of iCBT Treatments for Indonesian Freshmen with Social Anxiety

“…On the other hand, people with social anxiety can experience chronic worries when having to deal with others, including interacting with counsellors who help them overcome their anxiety disorder (Woods et al, 2017). There is a need for a strategy that connects those who suffer social anxiety with counsellors without them having to conduct face-to-face counselling.…”

“…The internet allows counsellors and clients to interact and hold counselling sessions without a face-to-face meeting. Although online counselling cannot replace face-to-face counselling, it is an available option which can serve as the initial step in overcoming social anxiety (Woods et al, 2017). In a study by McKenna, Green, and Gleason (2002), participants who had social anxiety reported that they experienced decreasing levels of social anxiety after interacting with other people online for two years.…”

“…Offline CBT conducted in groups has proven effective in the intervention of children and adolescents with social anxiety(Ciuca, Berger & Miclea, 2017;Herbert et al, 2009; Schulz, Vincent & Berger, 2017). However, considering the characteristics of individuals with social anxiety(Tillfors et al, 2011;Woods et al, 2017) as well as the minimum healthservices and professionals (Putri et al, 2019), internet-based CBT internet can become an alternative individual-level intervention for social anxiety which has been proven to work in an adolescent sample (Spence et al, 2008; Tillfors et al, 2011). According to Beck and Dozois (2011), the intervention process in a CBT begins with the identification of maladaptive thoughts (exploration).…”