The relative efficacy of bona fide cognitive behavioral therapy and applied relaxation for generalized anxiety disorder at follow-up: A longitudinal multilevel meta-analysis.

Flückiger, Christoph; Carratta, Katja; Re, A. C. Del; Probst, Greta Helene; Vîslă, Andreea; Wampold, Bruce E.

doi:10.1037/ccp0000717

Cited by 13 publications

(12 citation statements)

References 69 publications

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“…It is often used as component in CBT programs. A meta-analysis contrasting AR with CBT without AR did not find a difference in efficacy [27].…”

Section: Limitationsmentioning

confidence: 95%

Internet psychotherapeutic interventions for anxiety disorders – a critical evaluation

Bandelow¹,

Wedekind²

2022

BMC Psychiatry

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Background During the COVID-19 pandemic, internet-delivered psychotherapeutic interventions (IPI) move increasingly into the focus of attention. Method We reviewed 39 randomized controlled studies of IPIs with 97 study arms (n = 4122 patients) for anxiety disorders (panic disorder/agoraphobia, generalized anxiety disorder, and social anxiety disorder) and performed a meta-analysis. Most studies were conducted with cognitive behavioural approaches (iCBT). Results were compared with a previous meta-analysis examining medications and face-to-face (F2F) psychotherapy. Results In direct comparisons, IPIs were as effective as F2F-CBT and superior to waitlist controls. Programs with more intensive therapist contact yielded higher effect sizes (ES). We compared the obtained ES with a previous comprehensive meta-analysis of 234 studies. In this comparison, iCBT was less effective than individual F2F-CBT and medications, not different from pill placebos, and more effective than psychological placebo and waitlist (p > .0001 for all comparisons). ES of IPIs may be overestimated. Treatments were only compared to waitlist, which is not a sufficient control condition. 97% of the studies were not blinded with regard to the main outcome measure. 32% of the participants received antianxiety drugs during the trials. In 89%, participants were recruited by advertisements rather than from clinical settings, and 63% of the participants had an academic background (students or university employees) which might affect the generalizability of the findings. Remote diagnoses were often made by students without completed training in psychotherapy. In only 15% of the studies, diagnoses were made in personal contact with a psychiatrist or psychologist. In 44% of the studies, the ‘therapists’ maintaining remote contact with the participants were mostly students without completed psychotherapy education. Conclusions IPIs may be a useful tool when face-to-face psychotherapy is not easily available, or as an add-on to standard psychotherapeutic or psychopharmacological treatments but should perhaps not be used as monotherapy. We have suggested standards for future research and the practical use of IPIs.

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“…It is often used as component in CBT programs. A meta-analysis contrasting AR with CBT without AR did not find a difference in efficacy [27].…”

Section: Limitationsmentioning

confidence: 95%

Internet psychotherapeutic interventions for anxiety disorders – a critical evaluation

Bandelow¹,

Wedekind²

2022

BMC Psychiatry

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“…Second, the included sample was relatively young, and the investigated relations in this study might be different in an older GAD sample (Vîslă et al, 2022). Third, more measurement repetitions (even in the form of single items) and shorter measurement intervals are required to better understand the dynamic interplay between expectations and symptoms.…”

Section: Data Analytic Strategymentioning

confidence: 99%

Within‐ and between‐patients associations between self‐efficacy, outcome expectation, and symptom change in cognitive behavioral therapy for generalized anxiety disorder

2022

Self Cite

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Objectives: There is limited information on how a change in patients' expectations over time results in symptom change in psychotherapy. This study aimed to investigate the changes in patients' expectations and symptoms during treatment and across follow-up as well as to determine the within-and between-patient relationships between two types of patient expectations, that is, self-efficacy and outcome expectation, and symptom change.Methods: Participants (80 participants × 6 repeated measures; 480 observations) with generalized anxiety disorder were treated using cognitive behavioral therapy and the within-and between-patient scores of self-efficacy and outcome expectation were evaluated in multilevel models as predictors of symptom change.Results: Patients' self-efficacy and outcome expectation increased, whereas severity of their symptoms reduced during and after treatment. At the within-patient (WP) level, an increase in self-efficacy was associated with a decrease in worry and depressive symptoms, and an increase in outcome expectation was associated with a decrease in depressive symptoms. The between-patient

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“…In den letzten beiden Dekaden wurden präzise Erklärungsmodelle ausgearbeitet, um die auslösenden und aufrechterhaltenden Faktoren von Sorgen- und Angstprozessen besser zu verstehen 5 und für die Therapie anzuwenden 6 . Im Folgenden werden fünf Erklärungsmodelle vorgestellt, die jeweils unterschiedliche Schwerpunkte setzen, sich jedoch teilweise inhaltlich überschneiden bzw.…”

Section: Angst Und Sorgen – Moderne Erklärungsmodelleunclassified

“…Moderne Angstmodelle haben das Potenzial, die Wirksamkeit kognitiver Verhaltenstherapie auch bei diffusen Ängsten zu verbessern. Parallel dazu erweisen sich aber auch bewährte Verfahren wie beispielsweise die Angewandte Entspannung in vielen Fällen wirksam 6 , 20 .…”

Section: Angst Und Sorgen – Moderne Erklärungsmodelleunclassified

Angst- und Sorgenmodelle in der modernen Kognitiven Verhaltenstherapie

Flückiger¹,

Hoyer²

2022

PiD - Psychotherapie im Dialog

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Angst ist ein zentraler Bestandteil des menschlichen Erlebens und Verhaltens. Überzogene, klinische relevante Ängste sind nicht ausschließlich phobischer, situationsgebundener Natur, sondern sie können sich auch auf emotive Erwartungen, Grundannahmen und Verhaltenstendenzen beziehen. Der vorliegende Beitrag bietet einen Überblick über aktuelle Modelle solcher nicht-phobischen Ängste, die in der kognitiven Verhaltenstherapie eingesetzt werden.

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The relative efficacy of bona fide cognitive behavioral therapy and applied relaxation for generalized anxiety disorder at follow-up: A longitudinal multilevel meta-analysis.

Cited by 13 publications

References 69 publications

Internet psychotherapeutic interventions for anxiety disorders – a critical evaluation

Internet psychotherapeutic interventions for anxiety disorders – a critical evaluation

Within‐ and between‐patients associations between self‐efficacy, outcome expectation, and symptom change in cognitive behavioral therapy for generalized anxiety disorder

Angst- und Sorgenmodelle in der modernen Kognitiven Verhaltenstherapie

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