Abstract
Generalized anxiety disorder (GAD) is a disabling and often chronic condition. Internet-based treatments for GAD have been shown to be effective, but many studies include weekly contact with a therapist with the aim to increase adherence and clinical outcomes. The current study evaluated a less therapist-intensive alternative: support on demand and automatic messages. Thirty-three participants with GAD went through a self-help program targeting excessive worry. Treatment lasted 9 weeks and consisted of seven modules. Participants received short messages with reminders and encouragement. Therapist support was given when asked for. The intervention led to significant and large within-group effects on the primary outcome, Penn State Worry Questionnaire (PSWQ; Cohen’s d = 1.17), as well as on secondary outcomes such as Generalized Anxiety Disorder Questionnaire-IV (GAD-Q-IV; Cohen’s d = 2.71) and Patient Health Questionaire-9 (PHQ-9; Cohen’s d = 1.05). The exception was a small effect on quality of life (d = −0.34). Twenty-four (74.9%) were satisfied with the treatment and one dropped out. Therapist support was used by 65.6%. Limitations include lack of control condition and a small sample. While preliminary, the findings suggest that self-guided internet interventions can work and be acceptable when automated messages and support on demand is provided.
Acknowledgements
The authors would like to thank Tomas Johansson, Johan Sjögren and Magnus Pettersson for their valuable work with the RCT which made this study possible.
Disclosure statement
Mats Dahlin is employed Psykologpartners, the company that owns the program Oroshjälpen that was used in this study. No other author has any conflicting interests. Data collection and calculations have been done in collaboration among the authors as a way to minimize risk of biased interpretations.
Additional information
Funding
Notes on contributors
Mats Dahlin
Mats Dahlin is a PhD student as well as a licensed psychologist and psychotherapist. His main research focus is on internet-based treatments for generalized anxiety disorder.
Per Carlbring
Professor Per Carlbring is a licensed psychologist and psychotherapist as well as a specialist in clinical psychology. He is the leader of the clinical psychology research group at Stockholm University. He is also an affiliated professor at Southern Denmark University, Odense, Denmark. His main research focus is effectiveness and efficacy of Internet interventions for depression, anxiety disorders and pathological gambling.
Andreas Håkansson
Andreas Håkansson is a clinical neuropsychologist and researcher at the Department of Neurology at Førde Central Hospital, Norway. His clinical practice and research focuses on patients with various types of brain injury (mainly neurodegenerative dementias and stroke).
Gerhard Andersson
Gerhard Andersson is full professor of Clinical Psychology at Linköping University, Sweden and affiliated researcher at Karolinska Institute, Stockholm, Sweden. In addition to degrees in psychology and medicine. His research mainly focus on clinical psychology. He has published several books in the area of clinical psychology and more than 700 articles and book chapters.