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BMC Medical Research Methodology
Published in: BMC Medical Research Methodology 1/2011

Open Access 01-12-2011 | Study protocol

Cell phone-supported cognitive behavioural therapy for anxiety disorders: a protocol for effectiveness studies in frontline settings

Authors: Joakim Ekberg, Toomas Timpka, Magnus Bång, Anders Fröberg, Karin Halje, Henrik Eriksson

Published in: BMC Medical Research Methodology | Issue 1/2011

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Abstract

Background

Reviews of randomized controlled trials (RCTs) of cognitive behavioural therapy (CBT) for anxiety disorders have reported large pre- to post-treatment within-group effect sizes on measures of anxiety when supplied in therapist consultations and in technology-supported settings. However, the stringent experimental control of RCTs results in a lack of external validity, which limits the generalizability of findings to real-world frontline clinical practice. We set out to examine the specification of a protocol for study of the effectiveness of cell phone-supported CBT for in situ management of anxiety disorders.

Methods and design

Nominal group methods were used for requirements analysis and protocol design. Making a distinction between different forms of technology-supported therapy, examination of therapists' role, and implementing trials in existing organizational and community contexts were found to be the central requirements in the protocol.

Discussion

The resulting protocol (NCT01205191 at clinicaltrials.gov) for use in frontline clinical practice in which effectiveness, adherence, and the role of the therapists are analyzed, provides evidence for what are truly valuable cell phone-supported CBT treatments and guidance for the broader introduction of CBT in health services.
Appendix
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Literature
1.
WHO: The world health report: 2001 - mental health: new understanding, new hope. 2001, Geneva: World Health Organization
2.
Goisman RM, Warshaw MG, Keller MB: Psychosocial treatment prescriptions for generalized anxiety disorder, panic disorder, and social phobia, 1991-1996. Am J Psychiatry. 1999, 156: 1819-1821.PubMed
3.
Taylor CB, Chang VY: Issues in the dissemination of cognitive-behavior therapy. Nord J Psychiatry. 2008, 62 (Suppl 47): 37-44. 10.1080/08039480802315673.CrossRefPubMed
4.
UK Department of Health: Improving access to psychological therapies: national guideline for regional delivery. 2008, London: Department of Health
5.
Wang PS, Demler O, Kessler RC: Adequacy of treatment for serious mental illness in the United States. Am J Public Health. 2002, 92: 92-98. 10.2105/AJPH.92.1.92.CrossRefPubMedPubMedCentral
6.
Mitte K: Meta-analysis of cognitive-behavioral treatments for generalized anxiety disorder: a comparison with pharmacotherapy. Psychol Bull. 2005, 131: 785-795. 10.1037/0033-2909.131.5.785.CrossRefPubMed
7.
Butler AC, Chapman JE, Forman EM, Beck AT: The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clin Psychol Rev. 2006, 26: 17-31. 10.1016/j.cpr.2005.07.003.CrossRefPubMed
8.
Proudfoot J, Goldberg D, Mann A, Everitt B, Marks I, Gray JA: Computerized, interactive, multimedia cognitive-behavioural program for anxiety and depression in general practice. Psychol Med. 2003, 33: 217-227. 10.1017/S0033291702007225.CrossRefPubMed
9.
Marks IM, Mataix-Cols D, Kenwright M, Cameron R, Hirsch S, Gega L: Pragmatic evaluation of computer-aided self-help for anxiety and depression. Br J Psychiatry. 2003, 183: 57-65. 10.1192/bjp.183.1.57.CrossRefPubMed
10.
Andersson G, Carlbring P, Holmstrom A, Sparthan E, Furmark T, Nilsson-Ihrfelt E, Buhrman M, Ekselius L: Internet-based self-help with therapist feedback and in vivo group exposure for social phobia: a randomized controlled trial. J Consult Clin Psychol. 2006, 74: 677-686. 10.1037/0022-006X.74.4.677.CrossRefPubMed
11.
Carlbring P, Bohman S, Brunt S, Buhrman M, Westling BE, Ekselius L, Andersson G: Remote treatment of panic disorder: a randomized trial of internet-based cognitive behavior therapy supplemented with telephone calls. Am J Psychiatry. 2006, 163: 2119-2125. 10.1176/appi.ajp.163.12.2119.CrossRefPubMed
12.
SoS Socialstyrelsen: Depressionssjukdom och ångestsyndrom: Vetenskapligt underlag för Nationella riktlinjer. 2009
13.
Kehle SM: The effectiveness of cognitive behavioral therapy for generalized anxiety disorder in a frontline service setting. Cogn Behav Ther. 2008, 37: 192-198. 10.1080/16506070802190262.CrossRefPubMed
14.
Kopta SM, Lueger RJ, Saunders SM, Howard KI: Individual psychotherapy outcome and process research: challenges leading to greater turmoil or a positive transition?. Annu Rev Psychol. 1999, 50: 441-469. 10.1146/annurev.psych.50.1.441.CrossRefPubMed
15.
Westen D, Novotny CM, Thompson-Brenner H: The empirical status of empirically supported psychotherapies: assumptions, findings, and reporting in controlled clinical trials. Psychol Bull. 2004, 130: 631-663. 10.1037/0033-2909.130.4.631.CrossRefPubMed
16.
Wade WA, Treat TA, Stuart GL: Transporting an empirically supported treatment for panic disorder to a service clinic setting: a benchmarking strategy. J Consult Clin Psychol. 1998, 66: 231-239. 10.1037/0022-006X.66.2.231.CrossRefPubMed
17.
Bang M, Timpka T, Eriksson H, Holm E, Nordin C: Mobile phone computing for in-situ cognitive behavioral therapy. Stud Health Technol Inform. 2007, 129: 1078-1082.PubMed
18.
Delbanco T, Berwick DM, Boufford JI, Edgman-Levitan S, Ollenschlager G, Plamping D, Rockefeller RG: Healthcare in a land called PeoplePower: nothing about me without me. Health Expect. 2001, 4: 144-150. 10.1046/j.1369-6513.2001.00145.x.CrossRefPubMed
19.
20.
Cuijpers P, Marks I, Straten A, Cavanagh K, Gega L, Andersson G: Computer-aided psychotherapy for anxiety disorders: a meta-analytic review. Cogn Behav Ther. 2009, 38: 66-82. 10.1080/16506070802694776.CrossRefPubMed
21.
Andersson G, Carlbring P, Berger T, Almlov J, Cuijpers P: What makes internet therapy work?. Cogn Behav Ther. 2009, 38 (S1): 55-60. 10.1080/16506070902916400.CrossRefPubMed
22.
Almlov J, Carlbring P, Berger T, Cuijpers P, Andersson G: Therapist factors in internet-delivered cognitive behavioural therapy for major depressive disorder. Cogn Behav Ther. 2009, 38: 247-254. 10.1080/16506070903116935.CrossRefPubMed
23.
24.
Mendel P, Meredith LS, Schoenbaum M, Sherbourne CD, Wells KB: Interventions in organizational and community context: a framework for building evidence on dissemination and implementation in health services research. Adm Policy Ment Health. 2008, 35: 21-37. 10.1007/s10488-007-0144-9.CrossRefPubMed
25.
Beck AT, Steer RA: BAI, Beck Anxiety Inventory. 1990, San Antonio, TX: Psychological Corporation, Harcourt Brave Jovanovich
26.
Tait RJ, Hulse GK, Robertson SI: A review of the validity of the General Health Questionnaire in adolescent populations. Aust N Z J Psychiatry. 2002, 36: 550-557. 10.1046/j.1440-1614.2002.01028.x.CrossRefPubMed
27.
Bjelland I, Dahl AA, Haug TT, Neckelmann D: The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res. 2002, 52: 69-77. 10.1016/S0022-3999(01)00296-3.CrossRefPubMed
28.
Kenardy JA, Dow MG, Johnston DW, Newman MG, Thomson A, Taylor CB: A comparison of delivery methods of cognitive-behavioral therapy for panic disorder: an international multicenter trial. J Consult Clin Psychol. 2003, 71: 1068-1075. 10.1037/0022-006X.71.6.1068.CrossRefPubMed
29.
Everitt BS, Pickles A: Statistical aspects of the design and analysis of clinical trials. 1999, London: Imperial College Press
30.
Heppner PP, Wampold BE, Kivligan DM: Research design in counselling. 2008, Belmont, CA: Thomson, 3
31.
Delbanco T, Sands DZ: Electrons in flight - e-mail between doctors and patients. N Engl J Med. 2004, 350: 1705-1707. 10.1056/NEJMp038209.CrossRefPubMed
32.
Morris ME, Kathawala Q, Leen TK, Gorenstein EE, Guilak F, Labhard M, Deleeuw W: Mobile therapy: case study evaluations of a cell phone application for emotional self-awareness. J Med Internet Res. 2010, 12 (2): e10-10.2196/jmir.1371.CrossRefPubMedPubMedCentral
Metadata
Title
Cell phone-supported cognitive behavioural therapy for anxiety disorders: a protocol for effectiveness studies in frontline settings
Authors
Joakim Ekberg
Toomas Timpka
Magnus Bång
Anders Fröberg
Karin Halje
Henrik Eriksson
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Medical Research Methodology / Issue 1/2011
Electronic ISSN: 1471-2288
DOI
https://doi.org/10.1186/1471-2288-11-3

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