Cell phone-supported cognitive behavioural therapy for anxiety disorders: a protocol for effectiveness studies in frontline settings

Joakim Ekberg, Toomas Timpka, Magnus Bång, Anders Fröberg, Karin Halje, Henrik Eriksson, Joakim Ekberg, Toomas Timpka, Magnus Bång, Anders Fröberg, Karin Halje, Henrik Eriksson

Abstract

Background: Reviews of randomized controlled trials (RCTs) of cognitive behavioural therapy (CBT) for anxiety disorders have reported large pre- to post-treatment within-group effect sizes on measures of anxiety when supplied in therapist consultations and in technology-supported settings. However, the stringent experimental control of RCTs results in a lack of external validity, which limits the generalizability of findings to real-world frontline clinical practice. We set out to examine the specification of a protocol for study of the effectiveness of cell phone-supported CBT for in situ management of anxiety disorders.

Methods and design: Nominal group methods were used for requirements analysis and protocol design. Making a distinction between different forms of technology-supported therapy, examination of therapists' role, and implementing trials in existing organizational and community contexts were found to be the central requirements in the protocol.

Discussion: The resulting protocol (NCT01205191 at clinicaltrials.gov) for use in frontline clinical practice in which effectiveness, adherence, and the role of the therapists are analyzed, provides evidence for what are truly valuable cell phone-supported CBT treatments and guidance for the broader introduction of CBT in health services.

Figures

Figure 1
Figure 1
Health service perspective on non-adherence to CBT for anxiety disorders.
Figure 2
Figure 2
Flow of study protocol specification and development of requirements during the formulation process.
Figure 3
Figure 3
Overview of the population offered the Unga Vuxna service in Östergötland, Sweden.
Figure 4
Figure 4
Study procedures. The average treatment period at Unga Vuxna is 3 months.

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Source: PubMed

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