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Internet-Delivered Cognitive Behavioral Therapy Effective for Social Anxiety in Youth

A telehealth intervention that delivered cognitive behavioral therapy via the internet was effective for the treatment of social anxiety disorder in pediatric patients, according to results from a randomized clinical trial published online ahead of print in JAMA Psychiatry.

“Internet-delivered cognitive behavioral therapy has the potential to overcome common treatment barriers and increase the availability of evidence-based psychological treatments for this patient group,” researchers wrote.

The study included 103 children and adolescents, ages 10 through 17, in Sweden with a principal diagnosis of social anxiety disorder and their parents. Researchers randomized children to 10 weeks of internet-delivered cognitive behavioral therapy or internet-delivered supportive therapy that served as an active control. Both interventions included 10 online modules, five separate modules for parents, and three video sessions with the therapist.

Compared with supportive therapy, internet-delivered cognitive behavioral therapy was significantly more effective in reducing social anxiety and comorbid psychiatric symptoms as well as increasing levels of global functioning in youth, according to the study.

Internet-delivered cognitive behavioral therapy was superior to internet-delivered supportive therapy in both assessments by masked assessors and symptom ratings by participants and their parents.

Online Mindfulness-Based Cognitive Therapy Improves Residual Depressive Symptoms

A cost-effectiveness analysis also showed societal cost-savings with internet-delivered cognitive behavioral therapy compared with supportive therapy.

The main drivers of savings were lower medication costs and increased school productivity, researchers reported. From a health care perspective, internet-delivered cognitive behavioral therapy was more costly than the active comparator, however, mostly due to longer therapist support times.

The implementation of internet-delivered cognitive behavioral therapy could improve access to evidence-based treatment for social anxiety disorder in youth, researchers advised. The disorder is believed to affect 5% to 10% of children and adolescents.

“Offering treatment digitally means that children and parents don’t have to take time off school and work to travel to a health care facility," said study first author Martina Nordh, PhD, a psychologist and researcher at Karolinska Institutet, Stockholm, Sweden. “We also believe it may lower the threshold to seeking treatment, as young people with social anxiety disorder can find it too challenging to meet with unfamiliar people and to be in a new setting.”

—Jolynn Tumolo

References

Nordh M, Wahlund T, Jolstedt M, et al. Therapist-guided internet-delivered cognitive behavioral therapy vs internet-delivered supportive therapy for children and adolescents with social anxiety disorder: a randomized clinical trial. JAMA Psychiatry. 2021 May 12;[Epub ahead of print].

Online CBT effective for social anxiety disorder in young people [press release]. Stockholm, Sweden: Karolinska Institutet; May 18, 2021.

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