Using low intensity interventions in the treatment of anxiety disorders

Chapter 15 describes key issues in using low intensity (LI) cognitive behavioural therapy (CBT) interventions for anxiety disorders. Treatment protocols for anxiety disorders were originally developed for high intensity (HI) interventions, which unlike LI interventions, traditionally involve high levels of therapist contact and are usually presented via a face-to-face format. It is therefore important to identify how best to modify treatment protocols for effective and acceptable use in LI interventions, which involve limited therapist contact and may be administered remotely.

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Face-to-face versus Video Teleconference Group Cognitive Behavioural Therapy for Anxiety and Related Disorders: A Preliminary Comparison: Thérapie cognitivo-comportementale de groupe en personne contre par vidéo téléconférence pour l’anxiété et les troubles connexes: une comparaison préliminaire

The Canadian Journal of Psychiatry ◽

10.1177/07067437211027319 ◽

2021 ◽

pp. 070674372110273

Author(s):

Irena Milosevic ◽

Duncan H. Cameron ◽

Melissa Milanovic ◽

Randi E. McCabe ◽

Karen Rowa

Keyword(s):

Anxiety Disorder ◽

Anxiety Disorders ◽

Cognitive Behavioural Therapy ◽

Behavioural Therapy ◽

Symptom Improvement ◽

Face To Face ◽

Compulsive Disorder ◽

Cognitive Behavioural ◽

Group Cbt ◽

Delivery Formats

Objective: Telehealth is being increasingly incorporated into the delivery of mental health care and has received widespread attention during the COVID-19 pandemic for its ability to facilitate care during physical distancing restrictions. Videoconferencing is a common telehealth modality for delivering psychotherapy and has demonstrated similar outcomes to those of face-to-face therapy. Cognitive behavioural therapy (CBT) is the most common psychotherapy evaluated across various telehealth modalities; however, studies on CBT delivered via videoconference, particularly in a group therapy format, are lacking. Further, little research exists on videoconference group CBT for anxiety disorders. Accordingly, the present study compared the outcomes of group CBT for anxiety and related disorders delivered via videoconference versus face-to-face. Method: Using a non-randomized design, data on attendance, dropout, clinical outcomes, and functional impairment were collected from 413 adult outpatients of a tertiary care anxiety disorders clinic who attended a CBT group for panic disorder/agoraphobia, social anxiety disorder, generalized anxiety disorder (GAD), or obsessive-compulsive disorder delivered either face-to-face (pre-COVID-19 pandemic) or via videoconference (since the onset of COVID-19 pandemic). Outcomes were assessed using well-validated self-report measures. Data were collected pre-treatment, across 12 weekly sessions, and post-treatment. Intent-to-treat analyses were applied to symptom outcome measures. Results: Face-to-face CBT conferred only a slight benefit over videoconference CBT for symptom outcomes across all groups, but when assessed individually, only the GAD group showed greater symptom improvement in the face-to-face format. Effect sizes for significant differences between the delivery formats were small. Participants in videoconference groups tended to have slightly higher attendance rates in some instances, whereas functional improvement and treatment dropout were comparable across the delivery formats. Conclusions: Results provide preliminary evidence that videoconference group CBT for anxiety and related disorders may be a promising and effective alternative to face-to-face CBT. Additional research is needed to establish equivalence between these delivery formats.

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Cost-effectiveness of blended vs. face-to-face cognitive behavioural therapy for severe anxiety disorders: study protocol of a randomized controlled trial

BMC Psychiatry ◽

10.1186/s12888-015-0697-1 ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 14

Author(s):

Geke Romijn ◽

Heleen Riper ◽

Robin Kok ◽

Tara Donker ◽

Maartje Goorden ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Cost Effectiveness ◽

Anxiety Disorders ◽

Cognitive Behavioural Therapy ◽

Controlled Trial ◽

Behavioural Therapy ◽

Face To Face ◽

Randomized Controlled ◽

Cognitive Behavioural ◽

Severe Anxiety

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An investigation of general predictors for cognitive–behavioural therapy outcome for anxiety disorders in a routine clinical setting

BMJ Open ◽

10.1136/bmjopen-2015-010898 ◽

2016 ◽

Vol 6 (3) ◽

pp. e010898 ◽

Cited By ~ 1

Author(s):

Sara Kerstine Kaya Nielsen ◽

Signe Vangkilde ◽

Kate B Wolitzky-Taylor ◽

Sarah Ingrid Franksdatter Daniel ◽

Ida Hageman

Keyword(s):

Anxiety Disorders ◽

Cognitive Behavioural Therapy ◽

Clinical Setting ◽

Behavioural Therapy ◽

Therapy Outcome ◽

Cognitive Behavioural ◽

Routine Clinical Setting

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Relapse and Recurrence of Common Mental Health Problems after Low Intensity Cognitive Behavioural Therapy: The WYLOW Longitudinal Cohort Study

Psychotherapy and Psychosomatics ◽

10.1159/000485386 ◽

2018 ◽

Vol 87 (2) ◽

pp. 116-117 ◽

Cited By ~ 5

Author(s):

Jaime Delgadillo ◽

Laura Rhodes ◽

Omar Moreea ◽

Dean McMillan ◽

Simon Gilbody ◽

...

Keyword(s):

Mental Health ◽

Cohort Study ◽

Cognitive Behavioural Therapy ◽

Mental Health Problems ◽

Behavioural Therapy ◽

Health Problems ◽

Longitudinal Cohort Study ◽

Low Intensity ◽

Cognitive Behavioural ◽

Common Mental Health Problems

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Supporting low intensity interventions using the telephone

Oxford Guide to Low Intensity CBT Interventions ◽

10.1093/med:psych/9780199590117.003.0027 ◽

2010 ◽

pp. 275-280 ◽

Cited By ~ 4

Author(s):

Karina Lovell

Keyword(s):

Cognitive Behavioural Therapy ◽

Evidence Base ◽

Behavioural Therapy ◽

Practical Application ◽

Low Intensity ◽

Cognitive Behavioural ◽

Therapy Interventions

Chapter 27 discusses LI interventions using the telephone, and aims to provide the rationale, evidence base, challenges, solutions and practical application of delivering low intensity psychological (mainly cognitive behavioural therapy) interventions by telephone.

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