Initial effectiveness of an ICBT-protocol for GAD in psychiatric care – A feasibility-pilot study

TL;DR

This study tested a focused online therapy for generalized anxiety disorder in psychiatric care and found it effective and well-received by patients.

Contribution

A novel, theory-driven ICBT protocol targeting intolerance of uncertainty for GAD in routine psychiatric care was developed and tested.

Findings

Significant reduction in GAD symptoms with effect sizes comparable to existing CBT and ICBT treatments.

High patient satisfaction and treatment credibility ratings were reported.

Low dropout rate and high module completion rate indicate strong treatment engagement.

Abstract

Generalized Anxiety Disorder (GAD) is a common and debilitating anxiety disorder with a chronic course and a low rate of spontaneous remission. Previous internet-delivered treatments for GAD in clinical routine care has been shown to be effective but tend to use a mix of many different treatment components, often based in several theoretical models. Another approach could be to instead develop more focused and theory driven treatments, potentially allowing the protocol to be shorter and less demanding for patients. In this pilot-feasibility-trial we implemented a treatment focusing on one target core construct (intolerance of uncertainty) at the internet psychiatry clinic in Stockholm. The treatment was administered to 22 individuals with GAD. We found a significant reduction in GAD symptoms of similar effect size to previous studies of CBT and ICBT for GAD in routine clinical care. Patients rated overall high levels of treatment satisfaction and treatment credibility. Only two patients dropped out from the treatment. Among the remaining patients a median of 7.5 out of 8 modules were completed. We conclude that the treatment protocol is preliminarily effective, acceptable to patients and clinicians, and feasible to implement in routine psychiatric care.

•A construct-focused treatment protocol for GAD based around the intolerance of uncertainty model was tested within routine psychiatric care.•Results showed high ratings on treatment satisfaction and treatment credibility.•Patients had a good level of treatment engagement and low level of drop-out.•Preliminary estimates of within-group effects show large reductions in self-rated GAD symptoms.•Future research should verify effectiveness in a larger sample as well as investigate mechanisms of change.

A construct-focused treatment protocol for GAD based around the intolerance of uncertainty model was tested within routine psychiatric care.

Results showed high ratings on treatment satisfaction and treatment credibility.

Patients had a good level of treatment engagement and low level of drop-out.

Preliminary estimates of within-group effects show large reductions in self-rated GAD symptoms.

Future research should verify effectiveness in a larger sample as well as investigate mechanisms of change.

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