Carlbring's Remote Treatment of Panic Disorder-Randomized Trial of Internet-Based CBT Supplemente

Carlbring's Remote Treatment of Panic Disorder-Randomized Trial of Internet-Based CBT Supplemente

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Am J Psychiatry 163:12, December 2006 2119 Article ajp.psychiatryonline.org Remote Treatment of Panic Disorder: A Randomized Trial of Internet-Based Cognitive Behavior Therapy Supplemented With Telephone Calls Per Carlbring, Ph.D. Susanna Bohman, M.Sc. Sara Brunt, M.Sc. Monica Buhrman, M.Sc. Bengt E. Westling, Ph.D. Lisa Ekselius, M.D., Ph.D. Gerhard Andersson, Ph.D. Objective: This study evaluated a 10- week Internet-based bibliotherapy self- help program with short weekly telephone calls for people suffering from panic disor- der with or without agoraphobia. Method: After the authors confirmed the diagnosis by administering the Structured Clinical Interview for DSM-IV by tele- phone, 60 participants were randomly as- signed to either a wait-listed control group or a multimodal treatment pack- age based on cognitive behavior therapy plus minimal therapist contact via e-mail. A 10-minute telephone call was made each week to support each participant. Total mean time spent on each partici- pant during the 10 weeks was 3.9 hours. The participants were required to send in homework assignments before receiving the next treatment module. Results: Analyses were conducted on an intention-to-treat basis, which included all randomly assigned participants. From pre- treatment to posttreatment, all treated participants improved significantly on all measured dimensions (bodily interpreta- tions, maladaptive cognitions, avoidance, general anxiety and depression levels, and quality of life). Treatment gains on self-re- port measures were maintained at the 9- month follow-up. A blind telephone inter- view after the end of treatment revealed that 77% of the treated patients no longer fulfilled the criteria for panic disorder, whereas all of the wait-listed subjects still suffered from it. Conclusions: This study provides evi- dence to support the use of treatment dis- tributed via the Internet with the addition of short weekly telephone calls to treat panic disorder. Replication should be made to compare self-help and telephone treatment based on cognitive behavior methods with nonspecific interventions. (Am J Psychiatry 2006; 163:2119–2125) A s evidenced by several trials, there are highly effec- tive psychological treatments for panic disorder with or without agoraphobia (1). However, only about 25% of the people suffering from panic disorder seek some kind of treatment (2). The reasons for not seeking treatment may be a shortage of skilled therapists, long waiting lists, or the high cost (3). People in rural areas are particularly disad- vantaged because of the time it takes to travel long dis- tances. Another problem that might arise is that people with agoraphobia may not seek treatment because of the fear of leaving their homes or traveling certain distances. Therefore, a major challenge is to increase the accessibility
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This note was uploaded on 04/13/2010 for the course PSYCH 101 taught by Professor Gabbart during the Spring '08 term at Union College.

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Carlbring's Remote Treatment of Panic Disorder-Randomized Trial of Internet-Based CBT Supplemente

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