Can the Patient Decide Which Modules to Endorse? An Open Trial of Tailored Internet Treatment of Anxiety Disorders

Abstract

Internet-delivered cognitive behaviour therapy commonly consists of disorder-specific modules that are based on face-to-face manuals. A recent development in the field is to tailor the treatment according to patient profile, which has the potential to cover comorbid conditions in association with anxiety and mood disorders. However, it could be that the patients themselves are able to decide what modules to use. The authors tested this in an open pilot trial with 27 patients with mixed anxiety disorders. Modules were introduced with a brief description, and patients could choose which modules to use. The exception was the two first modules and the last, which involved psychoeducation and relapse prevention. The treatment period lasted for 10 weeks. Results showed large within-group effect sizes, with an average Cohen's d of 0.88. In a structured clinical interview, a majority (54%) had significantly improved 10 weeks after commencing treatment. Only one person dropped out. On the basis of results of this preliminary study, the authors suggest that the role of choice and tailoring should be further explored in controlled trials and that patient choice could be incorporated into Internet-delivered treatment packages.

Keywords:

• anxiety
• depression
• patient choice
• Internet-based treatment

Acknowledgements

This study was funded by a grant from the Swedish Council for Working Life and Social Research. We would like to thank Linda Maurin, Charlotta Törngren, Emma Linna, Thomas Eriksson, Elisabeth Sparthan, and Jonas Almlöv for their help with the original trial as well as Ulrika Wennerström, Wadad Mahmud, Paola Törneaus and Lena Jonsson for their help with the interviews.