Therapist Assisted Online Treatment for Anxiety
Condition: Anxiety Disorders
MeSH terms: Anxiety Disorders
Study type: Interventional

Summary: 
      Therapist assisted, internet-based cognitive behavioral therapy (TAI-CBT) has been shown to
      be effective with patients who have Generalized Anxiety Disorder (GAD) in multiple studies
      from several countries, including: the United Kingdom, Australia, Sweden, and the
      Netherlands. Despite strong evidence of efficacy, TAI-CBT has not been offered in the USA.
      TAI-CBT could provide an effective alternative to face-to-face psychotherapy that would
      expand the availability and convenience of evidence- based treatment anywhere clinical
      availability is limited. The University of Florida (UF) has historically had greater demand
      for psychotherapy than the available supply of psychotherapy hours resulting in waiting lists
      for students needing to receive treatment for anxiety. Anxiety disorders interfere with
      memory and concentration thus impairing academic functioning. Students who must wait for
      treatment for 3-4 weeks are at risk for failing courses or dropping out of school. If TAI-CBT
      proved to be effective with UF students, providing it could increase the number of students
      who would receive effective and timely treatment. This project will create a 6-8 session
      therapist assisted on-line treatment for anxiety disorder. The investigators will offer
      TAI-CBT as an experimental treatment in summer and fall, 2013 comparing outcomes to
      face-to-face individual therapy, group therapy, and wait-list controls. The investigators
      hypothesize that students receiving TAI-CBT will have a reduction in anxiety symptoms
      comparable to face-to-face counseling and greater than wait list controls.
    

Detailed description: 
      Participation is restricted to currently enrolled students at the University of Florida who
      have paid the health fee, and who are seeking treatment for anxiety and the Counseling and
      Wellness Center. Students who meet criteria and agree to participate will select from two
      treatments, individual face-to-face or therapist assisted on-line treatment. Prior to each
      session of individual therapy, or on-line treatment participants will complete the Behavioral
      Health Measure-20 is a normal part of treatment at the CWC.

      If a participant is assigned to the Therapist-assisted on-line (TAO) treatment he/she will be
      asked to complete a seven module on-line treatment. Each module includes interactive,
      educational materials and weekly assignments. Subjects may participate in an on-line
      discussion forum with other participants for each module. The forum will use only first names
      or a pseudonym to protect confidentiality. In addition, participants in the TAO treatment
      will receive a 10-20 minute video-conference weekly with a doctoral level therapist.
      Therapists will review assignments, answer questions, and help to apply the educational
      materials contained in the modules to the subjects life.

      The video conference will be on Adobe Connect. This involves a free download for a computer,
      tablet, or smart phone. Medical records will be kept for ten years, per UF policy. Adobe
      connect is HIPAA and HITECH compliant. Research records will be de-identified and use an
      identifier number that cannot be connected to individual participants.

      Only 2 arms were actually used, Face-to-face therapy and TAO treatment.
    

Intervention name(s): Therapist assisted online treatment; face-to-face individual therapy
Intervention type(s): Behavioral; Behavioral
Intervention description(s): 7 weekly interactive online modules with 10-15 minute counselor consultation via video conference.; weekly individual counseling as usual.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: anxiety treatment; anxiety online treatment; anxiety electronic treatment; anxiety therapist assisted