Modernizing Medicine through Internet-delivered Treatments


Because of the efficacy in terms of both cost and outcome of exposure-based cognitive behavioral therapy (CBT) in treating anxiety disorders, it is imperative to make this type of treatment accessible to all of the patients who can potentially benefit from it (Wolitzky-Taylor, Zimmermann, Arch, De Guzman, & Lagomasino, 2015).  One group in particular that can improve from CBT treatment is the child and adolescent population suffering from specific phobia.  According to the DSM-V, the individual with specific phobia has a constant fear of an object, place, or situation, a fear that is disproportional to the threat or danger actually posed by the feared object.  Studies have shown exposure-based CBT to be effective in treating specific phobia in young people, but aside from the lack of awareness about this type of treatment, many children do not receive it because there are not many therapists who have the right training (Vigerland et al. 2013).

One way of providing treatment to a wider range of those who need it is through the Internet using Internet-delivered CBT, or ICBT (Vigerland et al. 2013).  This special kind of cognitive behavioral therapy has done well with adults who have anxiety disorders, and there are also studies that have demonstrated that this method can make for good results with children as well (Vigerland et al. 2013).  In a 2013 study by Vigerland and colleagues, a slightly different approach was taken: here the parents of the child with specific phobia would be the ones primarily helping the child through the treatment.  The parents did have scheduled phone calls with a therapist throughout the treatment process, but moving through the cognitive behavioral therapy was largely reliant on the parents educating themselves with the information provided by the Internet-delivered treatment and following the instructions provided, implementing the treatment with their children (Vigerland et al. 2013).

Exposure-based ICBT for children with specific phobia presents a new and modernized approach to treating this mental health disorder.It takes an evidence-based, effective treatment and adapts it to technological advances, making it more flexible with demanding schedules that leave little spare time for trips to a therapist’s office, thus making treatment a more feasible option for people who have very rigid schedules.  Parents participating in this study were encouraged to follow the time schedule suggested by the researchers, but with this treatment model, each family could work together in treating the child’s specific phobia at their own pace (Vigerland et al. 2013).  Not only is this great for busy, working parents and school-aged children, but this is also a plus for people with mental health disorders who have to rely on public transportation, or getting a ride from a friend, or paying costly taxi fares to get to their therapist appointments. Bringing treatment to the home can save clients a considerable amount of time and money, again making treatment more attainable.  Just as well, speaking to clients over the phone rather than having them come in to the office allows the therapist to treat more clients at a lesser cost for each patient (Vigerland et al. 2013).

This pilot study showed significant reductions in anxiety symptoms reported by both the parents and the children, and almost all of the children responded that they were highly satisfied with the treatment they’d received (Vigerland et al. 2013).  Parents, however, were largely positive about the treatment experience itself, but less so in terms of using the online treatment platform, which did present some difficulties in saving answers and reading therapists’ responses (Vigerland et al. 2013).  Further studies are needed to fine-tune the Internet-based treatment and make it even more effective, but the improvement of Internet-delivered treatments to help those with anxiety disorders is certainly something to look out for in the future.

References:

Vigerland, S., Thulin, U., Ljótsson, B., Svirsky, L., Ost, L., Lindefors, N., & … Serlachius, E. (2013). Internet-delivered CBT for children with specific phobia: a pilot study. Cognitive Behaviour Therapy, 42(4), 303-314.

Wolitzky-Taylor, K., Zimmermann, M., Arch, J. J., De Guzman, & E., Lagomasino, I. (2015). Has evidence-based psychosocial treatment for anxiety disorders permeated usual care in community mental health settings? Behaviour Research and Therapy, 72, 9-17.


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