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An Internet-Based Cognitive Behavioral Program for Adolescents With Anxiety: Pilot Randomized Controlled Trial.
Kathleen O'Connor1, Alexa Bagnell2,3, Patrick McGrath2,3
1Glenrose Rehabilitation Hospital, Edmonton, AB, Canada.
JMIR Mental Health
|July 25, 2020
Summary
Internet-based cognitive behavioral therapy (ICBT) showed moderate adolescent satisfaction but requires program adjustments for better retention and completion. A definitive trial is feasible with protocol improvements for recruitment and data collection.
Area of Science:
- Mental Health
- Digital Therapeutics
- Adolescent Psychology
Background:
- Internet-based cognitive behavioral therapy (ICBT) is an emerging frontline treatment for adolescent anxiety disorders.
- The study piloted procedures for a definitive randomized controlled trial (RCT) of a self-managed ICBT program called Breathe.
Purpose of the Study:
- To determine the feasibility of a definitive RCT for the Breathe ICBT program.
- To gather data on methodological processes and intervention satisfaction among adolescents with anxiety concerns.
Main Methods:
- A two-arm, multisite, pilot RCT comparing 8 weeks of ICBT (Breathe) with ad hoc support to a control group accessing static online resources.
- Recruited adolescents aged 13-17 online across Canada.
- Primary outcome: change in self-reported anxiety; Secondary outcomes: recruitment, retention, satisfaction, and resource use.
Main Results:
- 94 adolescents enrolled; 74% completed baseline measures. Retention at 8 weeks was 28% for Breathe and 58% for the control group.
- Adolescents reported moderate satisfaction and ease of use, but difficulty with exposure activities was a barrier.
- Power analysis indicated a need for 177 participants per group for a definitive trial.
Conclusions:
- Adolescents were moderately satisfied with the Breathe ICBT program.
- Program adjustments are necessary to address attrition and barriers to completion.
- A definitive RCT is feasible with improved recruitment, retention, and data completeness strategies.
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