514 Therapist-supported internet CBT effective for adult anxiety disorders

August 24, 2017

written by Brian R McAvoy.

Clinical question
How effective is therapist-supported internet cognitive behavioural therapy (CBT) for anxiety disorders in adults?

Bottom line
Therapist-supported internet CBT was more efficacious in treating anxiety disorders among adults than a control of waiting list, attention, information or online discussion group (low-to-moderate quality evidence). There was no significant difference in the effectiveness of internet CBT with therapist support and unguided internet CBT, though the quality of the evidence was very low. Patient satisfaction was generally reported to be higher with therapist-supported internet CBT. Internet CBT with therapist support might not differ in effectiveness compared with face-to-face CBT (low-quality evidence). Adverse events were rarely reported in the studies.

Caveat
There was a large degree of heterogeneity in a number of the meta-analyses, reducing the quality of some of the evidence. The nature of the internet CBT interventions was quite diverse in terms of length, number of online modules, and nature of therapist contact. At 6–12-month follow-up, results generally mirrored the post-treatment findings but were limited by the small number of studies and the degree of variability in the interventions under investigation across studies.

Context
CBT is an evidence-based treatment for anxiety disorders. Many people have difficulty accessing treatment due to costs, long waiting lists, lack of available time for appointments, transportation problems and limited numbers of qualified therapists. Internet CBT provides a possible solution to overcome many of the barriers to accessing face-to-face therapy.

Cochrane Systematic Review
Olthuis JV et al. Therapist-supported Internet cognitive behavioural therapy for anxiety disorders in adults. Cochrane Reviews, 2016, Issue 3. Art. No.: CD011565.DOI: 10.1002/14651858. CD011565.pub2. This review contains 38 studies involving 3214 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.