Symposia
Technology
Jacqueline R. Bullis, Ph.D.
McLean Hospital/Harvard Medical School
Boston, Massachusetts
Harris E. Bajwa, PhD
Research Assistant and CBT Coach
Massachusetts General Hospital
Bridgewater, Massachusetts
Sara Mei, B.S.
Research Assistant
McLean Hospital
Belmont, Massachusetts
Scott Rauch, MD
Psychologist
McLean Hospital
Belmont, Massachusetts
Courtney Beard, Ph.D.
Psychologist
McLean Hospital
Belmont, Massachusetts
Anxiety and depressive disorders are the mostly commonly occurring psychological disorders, affecting approximately one third of adults in their lifetime. These disorders are associated with significant distress and functional impairment in social, occupational, and health-related domains, resulting in considerable economic and societal costs. Although cognitive behavioral therapy (CBT) interventions have been shown to be effective in treating these conditions, access to CBT in the community remains limited due to insufficient availability of providers, time, and financial constraints. One avenue for increasing access to these evidence-based treatments is internet-delivered CBT (iCBT) interventions. Prior studies suggest that guided iCBT produces overall effects comparable to face-to-face CBT, but less is known about the durability of these effects beyond acute outcome.
The present study will present four-month follow-up data from an iCBT program delivered over eight weeks to individuals with elevated symptoms of anxiety and/or depression. In addition to access to the iCBT program, patients received weekly coaching to provide support and maximize treatment engagement. Clinical outcomes included symptoms of anxiety, depression, and functional impairment. Following eight weeks of active treatment, patients complete one-, two-, three-, and four-month follow-up assessments. To date, 86 patients have completed the 8-week iCBT treatment, five are currently receiving treatment, and 34 patients have completed the four-month follow-up assessment. Preliminary analyses from this study suggest that iCBT has a large effect on symptoms of anxiety and depression at acute outcome, with over 50% of patient achieving “recovery” (i.e., 50% reduction in symptom severity). This study will evaluate whether treatment gains observed at acute outcome are maintained over the follow-up period, as well as the durability of recovery rates.
The large effect sizes commonly observed at post-treatment for guided iCBT has led to some concern that these effects may be overestimated. However, if iCBT is shown to have enduring effects, it will increase confidence that these brief and low-intensity intervention represent a viable pathway for increasing access to high-quality, evidence-based treatments for the most commonly occurring disorders.