School of Psychology, Griffith University, Brisbane, Queensland, Australia.
J Consult Clin Psychol. 2011 Oct;79(5):629-42. doi: 10.1037/a0024512.
The study examined the relative efficacy of online (NET) versus clinic (CLIN) delivery of cognitive behavior therapy (CBT) in the treatment of anxiety disorders in adolescents.
Participants included 115 clinically anxious adolescents aged 12 to 18 years and their parent(s). Adolescents were randomly assigned to NET, CLIN, or wait list control (WLC) conditions. The treatment groups received equivalent CBT content. Clinical diagnostic interviews and questionnaire assessments were completed 12 weeks after baseline and at 6- and 12-month follow-ups.
Assessment at 12 weeks post-baseline showed significantly greater reductions in anxiety diagnoses and anxiety symptoms for both NET and CLIN conditions compared with the WLC. These improvements were maintained or further enhanced for both conditions, with minimal differences between them, at 6- and 12-month follow-ups. Seventy-eight percent of adolescents in the NET group (completer sample) no longer met criteria for the principal anxiety diagnosis at 12-month follow-up compared with 80.6% in the CLIN group. Ratings of treatment credibility from both parents and adolescents were high for NET and equivalent to CLIN. Satisfaction ratings by adolescents were equivalent for NET and CLIN conditions, whereas parents indicated slightly higher satisfaction ratings for the CLIN format.
Online delivery of CBT, with minimal therapist support, is equally efficacious as clinic-based, face-to-face therapy in the treatment of anxiety disorders among adolescents. This approach offers a credible alternative to clinic-based therapy, with benefits of reduced therapist time and greater accessibility for families who have difficulty accessing clinic-based CBT.
本研究考察了在线（NET）与诊所（CLIN）两种方式在治疗青少年焦虑障碍中的认知行为疗法（CBT）的相对疗效。
参与者包括 115 名年龄在 12 至 18 岁之间有临床焦虑的青少年及其父母。青少年被随机分配到 NET、CLIN 或等待名单对照（WLC）条件。治疗组接受相同的 CBT 内容。在基线后 12 周和 6 个月及 12 个月随访时进行临床诊断访谈和问卷调查评估。
基线后 12 周的评估显示，与 WLC 相比，NET 和 CLIN 两种条件下的焦虑诊断和焦虑症状均有显著降低。在 6 个月和 12 个月的随访中，这两种条件下的改善均得以维持或进一步增强，两者之间差异极小。在 NET 组（完成者样本）中，78%的青少年在 12 个月随访时不再符合主要焦虑诊断标准，而 CLIN 组为 80.6%。来自父母和青少年的 NET 治疗可信度评分均较高，与 CLIN 相当。青少年对 NET 和 CLIN 条件的满意度评分相当，而父母对 CLIN 格式的满意度评分略高。
在线提供认知行为疗法，只需最少的治疗师支持，与诊所面对面治疗在治疗青少年焦虑障碍方面同样有效。这种方法为基于诊所的治疗提供了一个可信的替代方案，具有减少治疗师时间的优势，并且对于难以获得基于诊所的 CBT 的家庭来说更具可及性。
