Online Therapy and Anxiety Disorder
According to the World Health Organization, the ratio of anxiety disorder to global population is approximately 3.6% as of 2015. It is more common in women than in men. The total estimated number of people suffering from anxiety disorders worldwide is 264 million (World Health Organization, 2017). When we look at the basic features of anxiety disorders, excessive and persistent fear, avoidance of perceived threats and panic attacks may also include mental disorders.
Social Anxiety Disorder
Social Anxiety Disorder (Social Phobia) is a topic under the title of DSM-5 anxiety disorders. It is characterized by a fear or anxiety that occurs in one or more social situations in which one can be assessed by others. Social interactions have almost always aroused fear or anxiety in social situations such as observation by others and taking action before others (DSM-5, 2014).
When we look at internet-based CBT applications for social anxiety disorder, a meta-analysis study examined the effectiveness of technology-assisted psychological interventions in social anxiety disorder. 37 randomized controlled trials. Patients who recive Online CBT had significantly less social anxiety symptoms when evaluated and reported to effectively reduce symptoms. When the follow-up evaluations after therapy , we can see positive effects of Online CBT continued in the long term.
In a study to test treatment efficacy in a particular culture. (Romania), 70 participants were randomly assigned to a 9-week therapist-assisted internet-based CBT or control group.
There was a significant difference between the two groups. Therapist-supported Online CBT program was more effective. Also in the clinical interviews after the intervention: 34.2% of the treatment group improved and 36.8% maintained some social anxiety symptoms.
Agoraphobia and Panic Atack
Panic Disorder In terms of DSM-5 diagnostic criteria, it is cases with recurrent unexpected panic attacks; peaking within minutes and accompanied by intense fear and internal distress.
Panic attacks; include:
- sense of drowning,
- chest pain,
- fear of losing control,
- fear of death
Agoraphobia, which is frequently accompanied by panic disorder, is the state of intense anxiety and fear, which can be difficult to escape, such as using public transport, being in open or closed spaces, crowded places, being outside the house alone.
The effectiveness of transdiagnostic internet-based CBT protocol on major depression, generalized anxiety disorder, panic disorder and social phobia has been examined. Seventy-seven patients were randomly assign to treatment program of 10 weeks. The program consisted of online training lessons and homework throughout tools such as email or phone call from a weekly clinical psychologist, access to the online discussion forum, and automated e-mails. 82% of the participants completed 8 weeks of the program.
Therapist-supported cognitive behavior therapy program is effective in the treatment of ; major depression, generalized anxiety disorder, panic disorder and social phobia.
General Anxiety Disorder
A prospective assessment of Online CBT therapies for anxiety and depression provides online health practice via the Internet. Also in the national online health practice between January and December 2013, all patients with assessment or included treatment . The patients completed the online treatment program by phone or email with weekly support from a therapist over an 8-week period. When a total of 1,471 people who participated and completed the online treatment identified as being identified with anxiety or depression, the effect size was found to be Cohen’s d = 1.66.
After treatment and at follow-up, the recovery rate changed from 46.7% to 51.1%, and deterioration from 1.9% to 3.8%. The results show that this online therapy is an innovative way to provide accessible, cost-effective, effective and acceptable mental health services to many people who cannot receive psychological care, considering that it also saves time for the therapist.
According to the post-treatment evaluation, the severity of the symptoms of all anxiety disorders significantly reduce. Also generalized anxiety disorder, OCD, PTSD and social anxiety disorder therapy programs increase the quality of life; There was a significant decrease in general psychological distress levels for social anxiety disorder and panic disorder.
According to DSM-5 Specific Phobia is intense fear or anxiety of a specific object or situation. For example animals, height, air travel etc (DSM-5, 2014. You can find some of the studies on internet-based CBT programs for specific phobia down below.
In one study, Online CBT and Exposure therapy is compared in people with spider fear. A group followed the 5-week program module offered over the Internet. Due to results there were no significant difference between the groups after treatment and long-term follow-up. However, the effect size after treatment was significant at d = 1.84 and 2.58 in the internet and live exposure groups, respectively. In addition, 46.2% of the internet group and 85.7% of the in vivo exposure group had behavioral changes after treatment for avoidance and fear responses.