Web-based CBT for Symptoms of Mild-to-Moderate Anxiety and Depression in Youth With Chronic Illness
Condition: Depression; Anxiety; Inflammatory Bowel Disease; Systemic Lupus Erythematosus; Juvenile Idiopathic Arthritis
MeSH terms: Arthritis, Juvenile; Inflammatory Bowel Diseases; Lupus Erythematosus, Systemic; Chronic Disease; Depression; Depressive Disorder; Anxiety Disorders
Study type: Interventional

Summary: 
      Symptoms of anxiety and depression are common in adolescents and young adults with chronic
      illnesses and are associated with decreased adherence to medical regimens. However, many
      young patients go untreated for anxiety and depression. The purpose of this study is to
      evaluate an online cognitive behavioral therapy (CBT) program in young adults with chronic
      illness. Prior research has shown online CBT to be effective in multiple other populations,
      but to the investigators' knowledge, this is the first study to examine web-based CBT for
      young adults with chronic illnesses.
    

Detailed description: 
      Emotional problems such as anxiety and depression commonly surface during adolescence and are
      even more common among youth with chronic illness compared to other children. Emotional
      comorbidities are associated with decreased adherence to medical regimens in children and
      adults as well as poorer clinical outcomes for medical conditions and increased medical
      expenditures. It is widely accepted that cognitive behavioral therapy is an effective
      treatment for anxiety and depression and in-person CBT has been shown effective for young
      people with inflammatory bowel disease (IBD). However, despite the presence of this effective
      treatment, the majority of those with anxiety and depression are untreated.

      Offering mental health services in an acceptable, feasible and low cost fashion remains a
      challenge.

      Research suggests that web-based CBT is a promising candidate for offering effective and
      feasible treatment for anxiety and depression to young people. It has been shown effective
      for mild to moderate symptoms of depression and anxiety in adults and adolescents with a
      primary diagnosis of depression. In adults, studies comparing face-to-face CBT treatment to
      web-based CBT with low level therapist support showed comparable clinical outcomes and a 15%
      cost savings for online treatment. Furthermore, an online treatment format may be especially
      appealing for younger populations who spend much of their time online as well as for people
      with chronic illness, who may be home-bound due to symptoms. Despite the well-established
      evidence base for web-based CBT in other populations, the greater affordability of web-based
      CBT compared to face-to-face treatment, and the appeal of the online format for young adults,
      the investigators are aware of no published studies examining the use of web-based CBT for
      young adults with chronic illness. The innovation of the proposed project is to study low-
      cost, web-based CBT in a new population of adolescents and young adults with inflammatory
      conditions that constitute serious chronic illness.
    

Intervention name(s): Web-based Cognitive Behavioral Therapy
Intervention type(s): Behavioral
Intervention description(s): Participants will be asked to complete a web-based cognitive behavioral therapy "self-help" program. The program consists of six weekly modules, in which participants practice new ways of thinking (e.g. how to recognize and change distorted thinking, utilizing a thought change record, identifying cognitive errors, and modifying automatic thoughts) to reduce symptoms of anxiety and depression. Participants receive text message reminders to complete the weekly session.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: anxiety; depression; chronic illness; teen; young adult