Online CBT is ineffective for treating adolescent anxiety

Last updated 13 May 2020

Researchers in Reading, UK have assessed whether self-completed, therapist-supported online cognitive behavioural therapy (CBT) for adolescent anxiety disorders is an effective treatment approach. Data obtained from 60 adolescents showed that there is no difference in patient outcomes between those receiving the “BRAVE for Teenagers-ONLINE” treatment1 and waitlist controls. There was also no improvement in outcomes when parents also received online sessions.

While this data needs to be replicated in future studies, these findings suggest that this online CBT treatment, with or without parent sessions, is ineffective at treating anxiety disorders. Although the treatment uptake by adolescents with anxiety is low, and waiting times for treatment are often high,2,3 the researchers propose that routine use of this online therapy by clinical services to help overcome anxiety issues is premature.

Referring to

Waite, P., Marshall, T. & Creswell C. (2019), A randomized trial of internet-delivered cognitive behaviour therapy for adolescent anxiety disorders in a routine clinical care setting with and without parent sessions. Child Adolesc. Ment. Health. 24: 242-250. doi: 10.111/camh.12311.

See also

BRAVE-Online

Clarification – Isobel Hayman

The current Covid-19 situation has enhanced the need to carry out psychological therapies remotely with families, including pointers to self-help. Self-help and guided-self-help for children and adolescents has been the subject of several research studies. The Bridge wants to remind readers that an article in the last edition ‘Online CBT is ineffective for treating adolescent anxiety’ was a summary of a single important article, and the title was not intended to represent the overall status of the efficacy of online anxiety treatments in youth. There are well evaluated and effective online and other remote interventions for a range of conditions – including anxiety – in children and young people. The readers might want to read a summary published in an earlier issue of The Bridge.

References

(1) Spence, S.H. et al. (2006), BRAVE for Teenagers-ONLINE: An Internet based program for adolescents with anxiety. Brisbane, Australia: University of Queensland.

(2) Merikangas, K.R. et al. (2011), Service utilization for lifetime mental disorders in U.S. adolescents: Results of the National Comorbidity Survey-Adolescent supplement (NSC-A). J. Am. Acad. Child Adolesc. Psychiatry 50: 32-45. doi: 10.1016/j.jaac.2010.10.006.

(3) Frith, E. (2016), CentreForum Commission on Children and young people’s mental health: State of the nation. Centreforum. Available from: http://centreforum.org/live/wp-content/ uploads/2016/04/State-of-the-Nation-report-web.pdf.

Glossary

Cognitive-behavioural therapy: a form of talking therapy that encourages patients to manage their psycho-social problems by changing the way they think and behave; CBT focuses on current problems and finds practical ways to improve state-of-mind on a day-by-day basis.

Clarification

Tuesday 5 May 2020

The current Covid-19 situation has enhanced the need to carry out psychological therapies remotely with families, including pointers to self-help. Self-help and guided-self-help for children and adolescents has been the subject of several research studies. The Bridge wants to remind readers that this article was a summary of a single important article, and the title was not intended to represent the overall status of the efficacy of online anxiety treatments in youth. There are well evaluated and effective online and other remote interventions for a range of conditions – including anxiety – in children and young people. Readers might want to read a summary published in an earlier issue of The Bridge ‘Help yourself (but get some support): meta-analysis of self-help interventions for children’

Dr Jessica Edwards
Jessica received her MA in Biological Sciences and her DPhil in Neurobehavioural Genetics from the University of Oxford (Magdalen College). After completing her post-doctoral research, she moved into scientific editing and publishing, first working for Spandidos Publications (London, UK) and then moving to Nature Publishing Group. Jessica is now a freelance editor and science writer, and started writing for “The Bridge” in December 2017.

Discussion

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Great article, but misleading heading, just because one online approach to CBT training is ineffective does not mean, or even suggest, that all are. There are countervailing studies.

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I would really like to see the correlation of the intervention treatment of CBT and the reduction of anxiety particularly for ongoing issues such as bullying rather than an over the time issue such as exams – where time often ends or significantly diminishes the anxiety. My experience is that it does not work. My practice is built on working with individuals where CBT has been ineffective and has often made symptoms worst. It is a combination of both education and psychotherapy that proves to be most effective. I have developed a working model for anxiety which I would happily put up for study.

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