Clinic Plus Internet Delivery of Cognitive-Behavior Therapy for Australian Children with Anxiety Disorders

The Internet is increasingly used to deliver various components of mental health services, including cognitive behavioral therapy (CBT) for adults. To test the feasibility and efficacy of partially delivering CBT for child anxiety disorders via the Internet, an Australian research team randomized 72 7-14-year-olds to receive group CBT at a university clinic (designated as the CLINIC group), similar CBT for which half the sessions were delivered via the Internet (designated as the CLIN-NET group), or a waiting list control condition (designated as the WL group) (Spence et al., 2006).

Diagnostic status was determined via a structured diagnostic interview with each child’s parent. The children completed anxiety and depression scales, while parents completed the CBCL and the Spence Children’s Anxiety Scale-Parent Version (SCAS-P). According to clinicians’ ratings of severity and the CBCL Internalizing scale, the CLINIC and CLIN-NET groups showed significantly greater reductions in problems from pre- to post-treatment than the WL group, with no significant differences between the CLINIC and CLIN-NET groups.

The other measures showed more varied patterns of results. The significant improvement in CBCL Internalizing scores continued at 6- and 12-month follow-ups, with no significant differences between the CLINIC and CLIN-NET conditions. Compliance, acceptability, client retention, and client satisfaction were all found to be high for parents and children in the CLIN-NET group.

The authors concluded that “the Internet delivery of CBT sessions for child anxiety disorders is clearly feasible and may provide a valuable adjunct to clinic-based treatment. Future research is now warranted to determine the feasibility and efficacy of full delivery of CBT for the treatment of clinically anxious children” (p. 619).

Reference: Spence, S.H., Holmes, J.M., March, S., & Lipp, O.V. (2006). The feasibility and outcome of clinic plus internet delivery of cognitive-behavior therapy for childhood anxiety. Journal of Consulting and Clinical Psychology, 74, 614-621.