Internet-delivered cognitive behavior therapy for anxiety and insomnia in a higher education context

ABSTRACT

Background and Objectives: Anxiety and insomnia can be treated with internet-delivered Cognitive Behavioral Therapy (iCBT). iCBT may be well-suited to students who are known to be poor help-seekers and suffer these symptoms. iCBT can offer easy access to treatment and increase service availability. The aim of this study was to evaluate the efficacy of anxiety and insomnia iCBT programs in students. Design: A randomized, controlled study. Methods: Students were randomly allocated to intervention (“Anxiety Relief”: n = 43; “Insomnia Relief”: n = 48; control: n = 47). Interventions lasted six weeks. Outcome measures were the State-Trait Anxiety Inventory and the Pittsburgh Sleep Quality Index. Results: Significant within-group reductions in anxiety (t(31) = 2.00, p = .03) with moderate between-groups (compared to control) effect size (d = .64) and increases in sleep quality (t(31) = 3.46, p = .002) with a moderate between-groups effect size (d = .55) were found for completers of the anxiety program from pre- to post-intervention. Significant within-group increases in sleep quality were found for completers of the insomnia program from pre- to post-intervention (t(35) = 4.28, p > .001) with a moderate between-groups effect size (d = .51). Conclusions: Findings support the use of iCBT for anxiety and insomnia in students, and indicate that further research is needed.

KEYWORDS:

• Internet-delivered Cognitive Behavior Therapy
• CCBT
• student mental health
• undergraduates
• anxiety
• insomnia

Disclosure statement

At the time this research was undertaken, the corresponding author an employee of Ultrasis UK Ltd., which makes the products ‘Anxiety Relief’ and ‘Insomnia Relief’. The corresponding author is a minor shareholder in this company.

Notes

1. Approximately 20% of these texts received a reply, mainly to confirm continued engagement with the program.

2. Usage data detailed the pages accessed, but not the length of time spent on the last page accessed in an individual session. As such, it was possible to distinguish between those who cannot have spent 20 minutes engaging, from those who probably did. Precise usage data was not stored by the program, due to the exit time only being recorded if users logged out rather than simply closed their browser.

3. Between-groups effect sizes are between the intervention group in question and the control group.

Additional information

Funding

This work was supported by the European Commission Seventh Framework Programme [grant number 248544 (known as “Optimi”)].