Accepted for/Published in: JMIR Mental Health
Date Submitted: Feb 16, 2021
Date Accepted: Apr 15, 2021
Trajectories of Change in an Open-Access Internet-Based Cognitive Behaviour Program for Childhood and Adolescent Anxiety: Open Trial
ABSTRACT
Background:
Although evidence for the efficacy of internet-based cognitive behaviour therapy (iCBT) in the treatment of childhood anxiety has continued to grow, there is scant empirical research investigating the timing of benefits made in iCBT programs (e.g. early or delayed).
Objective:
The objective of our study was to examine patterns of symptom trajectories (changes in anxiety) across an iCBT program for anxiety (BRAVE Self-Help).
Methods:
Participants were 10,366 Australian youth with elevated anxiety aged 7-17 years (4,140 children aged 7-12 years; 6,226 adolescents aged 12-17 years) who registered for the BRAVE Self-Help program. Participants self-reported on their anxiety symptoms at baseline/Session 1 and then at the commencement of each subsequent session.
Results:
Results found that young people completing the BRAVE Self-Help program tend to fall into two trajectory classes that can be reliably identified in terms of high versus medium baseline levels of anxiety and subsequent reduction in symptoms. Both high and medium anxiety severity trajectory classes show significant reductions in anxiety, with the greatest level of change being achieved within the first six sessions for both classes. However, those in the moderate anxiety severity class tend to show reductions in anxiety symptoms to levels below the elevated range, whereas those in the high symptom group tend to remain in the elevated range despite improvements.
Conclusions:
These findings suggest that those in the high severity group who are not responding well to iCBT on a self-help basis, may benefit from additional support provided alongside the program or a stepped-care approach where progress is monitored and support can be provided as necessary. Clinical Trial: n/a
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