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Anxiety online-A virtual clinic: Preliminary outcomes following completion of five fully automated treatment programs for anxiety disorders and symptoms

- Klein, Britt, Meyer, Denny, Austin, David, Kyrios, Michael

  • Authors: Klein, Britt , Meyer, Denny , Austin, David , Kyrios, Michael
  • Date: 2011
  • Type: Text , Journal article
  • Relation: Journal of Medical Internet Research Vol. 13, no. 4 (2011), p.
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  • Description: Background: The development of e-mental health interventions to treat or prevent mental illness and to enhance wellbeing has risen rapidly over the past decade. This development assists the public in sidestepping some of the obstacles that are often encountered when trying to access traditional face-to-face mental health care services. Objective: The objective of our study was to investigate the posttreatment effectiveness of five fully automated self-help cognitive behavior e-therapy programs for generalized anxiety disorder (GAD), panic disorder with or without agoraphobia (PD/A), obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and social anxiety disorder (SAD) offered to the international public via Anxiety Online, an open-access full-service virtual psychology clinic for anxiety disorders. Methods: We used a naturalistic participant choice, quasi-experimental design to evaluate each of the five Anxiety Online fully automated self-help e-therapy programs. Participants were required to have at least subclinical levels of one of the anxiety disorders to be offered the associated disorder-specific fully automated self-help e-therapy program. These programs are offered free of charge via Anxiety Online. Results: A total of 225 people self-selected one of the five e-therapy programs (GAD, n = 88; SAD, n = 50; PD/A, n = 40; PTSD, n = 30; OCD, n = 17) and completed their 12-week posttreatment assessment. Significant improvements were found on 21/25 measures across the five fully automated self-help programs. At postassessment we observed significant reductions on all five anxiety disorder clinical disorder severity ratings (Cohen d range 0.72-1.22), increased confidence in managing one's own mental health care (Cohen d range 0.70-1.17), and decreases in the total number of clinical diagnoses (except for the PD/A program, where a positive trend was found) (Cohen d range 0.45-1.08). In addition, we found significant improvements in quality of life for the GAD, OCD, PTSD, and SAD e-therapy programs (Cohen d range 0.11-0.96) and significant reductions relating to general psychological distress levels for the GAD, PD/A, and PTSD e-therapy programs (Cohen d range 0.23-1.16). Overall, treatment satisfaction was good across all five e-therapy programs, and posttreatment assessment completers reported using their e-therapy program an average of 395.60 (SD 272.2) minutes over the 12-week treatment period. Conclusions: Overall, all five fully automated self-help e-therapy programs appear to be delivering promising high-quality outcomes; however, the results require replication. © Britt Klein, Denny Meyer, David William Austin, Michael Kyrios.

Study protocol for a randomised controlled trial of internet-based cognitive-behavioural therapy for obsessive-compulsive disorder

- Kyrios, Michael, Nedeljkovic, Maja, Moulding, Richard, Klein, Britt, Austin, David, Meyer, Denny, Ahern, Claire

  • Authors: Kyrios, Michael , Nedeljkovic, Maja , Moulding, Richard , Klein, Britt , Austin, David , Meyer, Denny , Ahern, Claire
  • Date: 2014
  • Type: Text , Journal article
  • Relation: BMC Psychiatry Vol. 14, no. 209 (2014), p. 1-9
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  • Description: BACKGROUND: Obsessive-Compulsive Disorder (OCD) is a common chronic psychiatric disorder that constitutes a leading cause of disability. Although Cognitive-Behaviour Therapy (CBT) has been shown to be an effective treatment for OCD, this specialised treatment is unavailable to many due to access issues and the social stigma associated with seeing a mental health specialist. Internet-based psychological treatments have shown to provide effective, accessible and affordable treatment for a range of anxiety disorders, and two Randomised Controlled Trials (RCTs) have demonstrated the efficacy and acceptability of internet-based CBT (iCBT) for OCD, as compared to waitlist or supportive therapy. Although these initial findings are promising, they do not isolate the specific effect of iCBT. This paper details the study protocol for the first randomised control trial evaluating the efficacy of therapist-assisted iCBT for OCD, as compared to a matched control intervention; internet-based therapist-assisted progressive relaxation training (iPRT). It will aim to examine whether therapist-assisted iCBT is an acceptable and efficacious treatment, and to examine how effectiveness is influenced by patient characteristics. METHOD/DESIGN: A randomised controlled trial using repeated measures with two arms (intervention and matched control) will be used to evaluate the efficacy and acceptability of iCBT for OCD. The RCT will randomise 212 Australian adults with a primary diagnosis of OCD into either the active intervention or control condition, for 12 weeks duration. Outcomes for participants in both study arms will be assessed at baseline and post-intervention. Participants in iCBT will be further assessed at six month follow-up, while participants in the control condition will be crossed over to receive the iCBT intervention and reassessed at post-intervention and six month follow-up. The primary outcome will be clinically significant change in obsessive-compulsive symptom scores. DISCUSSION: This will be the first known therapist assisted internet-based trial of a comprehensive CBT treatment for OCD as compared to a matched control intervention. Demonstrating the efficacy of an internet-based treatment for OCD will allow the development of models of care for broad-based access to an evidence-based but complex treatment.

Training postgraduate psychology students to deliver psychological services online

- Shandley, Kerrie, Klein, Britt, Kyrios, Michael, Austin, David, Ciechomski, Lisa, Murray, Greg

  • Authors: Shandley, Kerrie , Klein, Britt , Kyrios, Michael , Austin, David , Ciechomski, Lisa , Murray, Greg
  • Date: 2011
  • Type: Text , Journal article
  • Relation: Australian psychologist Vol. 46, no. 2 (2011), p. 120-125
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  • Description: Information and communication technologies are increasingly being used to remotely deliver psychological services. This delivery method confers clear advantages to both client and therapist, including the accessibility of services by otherwise unserved populations and cost-effective treatment. Remote services can be delivered in a real-time or delayed manner, providing clients with a wealth of therapy options not previously available. The proliferation of these services has outstripped the development and implementation of all but the most rudimentary of regulatory frameworks, potentially exposing clients to substandard psychological services. Integrating mandatory training on the delivery of online psychological services into accredited postgraduate psychology courses would aid in addressing this issue. The purpose of this article is to outline issues of consideration in the development and implementation of such a training programme. An online etherapy training programme developed by Swinburne University's National eTherapy Centre will be used as an example throughout.

The first two years of Anxiety Online, an international e-mental health service for the anxiety disorders.

- Klein, Britt, Austin, David, Nguyen, David, Smith, Andrew, Donelan, Patrick, Abbott, Jo-Anne, Kyrios, Michael, Mitchell, Joanna, Lauder, Sue, Shandley, Kerrie, Moulding, Richard, Nedeljkovic, Maja, Meyer, Denny, Ciechomski, Lisa, Shields, David, Baulch, Josephine, Williams, Ben

Improving mental health of adolescents with Type 1 diabetes: protocol for a randomized controlled trial of the nothing ventured nothing gained online adolescent and parenting support intervention

- Hackworth, Naomi, Matthews, Jan, Burke, Kylie, Petrovic, Zvezdana, Klein, Britt, Northam, Elisabeth, Kyrios, Michael, Chiechomski, Lisa, Cameron, Fergus

  • Authors: Hackworth, Naomi , Matthews, Jan , Burke, Kylie , Petrovic, Zvezdana , Klein, Britt , Northam, Elisabeth , Kyrios, Michael , Chiechomski, Lisa , Cameron, Fergus
  • Date: 2013
  • Type: Text , Journal article
  • Relation: BMC Public Health Vol. 13, no. 1 (2013), p. 1185.1 -1185.10
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  • Description: Management of Type 1 diabetes comes with substantial personal and psychological demands particularly during adolescence, placing young people at significant risk for mental health problems. Supportive parenting can mitigate these risks, however the challenges associated with parenting a child with a chronic illness can interfere with a parent’s capacity to parent effectively. Interventions that provide support for both the adolescent and their parents are needed to prevent mental health problems in adolescents; to support positive parent-adolescent relationships; and to empower young people to better self-manage their illness. This paper presents the research protocol for a study evaluating the efficacy of the Nothing Ventured Nothing Gained online adolescent and parenting intervention which aims to improve the mental health outcomes of adolescents with Type 1 diabetes.

An evaluation of 'Reach Out Central': An online gaming program for supporting the mental health of young people

- Shandley, Kerrie, Austin, David, Klein, Britt, Kyrios, Michael

  • Authors: Shandley, Kerrie , Austin, David , Klein, Britt , Kyrios, Michael
  • Date: 2010
  • Type: Text , Journal article
  • Relation: Health Education Research Vol. 25, no. 4 (2010), p. 563-574
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  • Description: The objective of this study was to conduct an evaluation of Reach Out Central (ROC), an online gaming program designed to support the mental health of people aged 16-25. The evaluation sought to determine the benefit of playing ROC on alcohol use, use of coping strategies, psychological distress, resilience and satisfaction with life. Changes in mental health literacy, mental health stigma and willingness to seek help and program satisfaction were also investigated. A single group (N=266) quasi-experimental repeated measures (pre-, post-program, 2-month follow-up) design was employed. The results demonstrated positive improvements across all outcome measures for females; however, a non-significant worsening effect was observed for males on seeking support, avoidance and resilience. Improvements for both genders were observed on mental health literacy and help-seeking. However, literacy levels and help-seeking were significantly higher, and stigma significantly lower for females. Program satisfaction ratings were high irrespective of gender. Although some inconsistencies between genders were noted, ROC appears to enhance protective factors for the prevention or early intervention of mental health disorders. The results of this study need to be viewed with its limitations in mind, specifically, the use of an open trial methodology and the small number of male participants. © The Author 2009. Published by Oxford University Press. All rights reserved.
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