Abstract
Generalized anxiety disorder (GAD) is a disabling and often chronic condition. Internet-based treatments for GAD have been shown to be effective, but many studies include weekly contact with a therapist with the aim to increase adherence and clinical outcomes. The current study evaluated a less therapist-intensive alternative: support on demand and automatic messages. Thirty-three participants with GAD went through a self-help program targeting excessive worry. Treatment lasted 9 weeks and consisted of seven modules. Participants received short messages with reminders and encouragement. Therapist support was given when asked for. The intervention led to significant and large within-group effects on the primary outcome, Penn State Worry Questionnaire (PSWQ; Cohen’s d = 1.17), as well as on secondary outcomes such as Generalized Anxiety Disorder Questionnaire-IV (GAD-Q-IV; Cohen’s d = 2.71) and Patient Health Questionaire-9 (PHQ-9; Cohen’s d = 1.05). The exception was a small effect on quality of life (d = −0.34). Twenty-four (74.9%) were satisfied with the treatment and one dropped out. Therapist support was used by 65.6%. Limitations include lack of control condition and a small sample. While preliminary, the findings suggest that self-guided internet interventions can work and be acceptable when automated messages and support on demand is provided.
Highlights
The life-time prevalence of generalized anxiety disorder (GAD) is estimated to be between 4.3% and 5.9% [1]
The results indicated that support on demand and automated messages can be an alternative to weekly contact with a therapist during internet-based treatment
The effects were significant when compared to 9 weeks of waiting for treatment in a control condition, even if significant changes was observed during that time as well
Summary
The life-time prevalence of generalized anxiety disorder (GAD) is estimated to be between 4.3% and 5.9% [1]. The worry and associated anxiety have negative effects on the individual’s functioning, well-being, and quality of life [2], and are associated with elevated mortality in medical conditions and suicide [4]. The economic burden on society is comparable to that of major depressive disorder and chronic medical conditions, with an increase in the number of days on sick leave and high utilization of medical care [5]. Given the chronic nature of the condition and substantial negative effects for the individual and society, it is important to establish effective and accessible treatment options that can be delivered in regular care
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