Internet-delivered CBT for Adolescents With GAD

Not Applicable

Completed

Brief Summary: This multiple baseline evaluation aims to test the feasibility and preliminary effectiveness of Internet-delivered cognitive behavioral therapy (ICBT) for adolescents with Generalized Anxiety Disorder (GAD).

Detailed Description: This pilot study aims to test Internet-delivered Cognitive Behavioral Therapy (ICBT) for adolescents with Generalized Anxiety Disorder (GAD)

The study has a single case research design (multiple baseline) and will include 12 participants with GAD according to a semi structured diagnostic interview.

Participants will be randomized to either two, six or ten weeks baseline measurements prior to starting treatment, and will thus work as their own controls.

Primary outcome measures will be collected at 10 weeks after treatment start. Follow-up assessments will be made three month after treatment.

Recruitment & Eligibility

Inclusion Criteria

A score on the Penn State Worry Questionnaire for Children (PSWQ-C) of > 30
Fulfilling DSM-5 criteria for Generalized Anxiety Disorder
No other disorder or symptoms present in need of more urgent treatment
Aged between 13 and 17 years
Ability to read and write in Swedish
A parent or caregiver that is able to participate in the treatment
Participants on psychotropic medication must have been on a stable dose for the last 6 weeks prior to baseline assessment
No other ongoing psychological treatment for any disorder

Exclusion Criteria

The presence of symptoms suggestive of a current diagnosis of Autistic Spectrum Disorder, Schizophrenia, Bipolar Disorder, Anorexia Nervosa, Bulimia, or Substance Use Disorder
Present risk of suicide
Present occurrence of domestic violence
Completed CBT for any anxiety disorder within the last 6 months (defined as at least 5 sessions of CBT including in vivo exposure sessions)

Arm && Interventions

Group	Intervention	Description
Internet-delivered CBT	Internet-Delivered Cognitive Behavioral Therapy	Internet-delivered Cognitive Behavioral Therapy (ICBT) for GAD, 10 weeks. Patients and their parents work with separate programs via the Internet. Both have contact with a therapist. Participants practice awareness of worry through daily worry monitoring. They identify their own behaviors that reinforce worry, i.e. control and avoidance behaviors. The program gives a rationale for behavior change, which is then implemented. Participants practice problem solving and exposure to uncertainty inducing situations and thoughts. Parents receive support and psycho education about worry. They practice alternative parental behaviors, which decrease focus on worry while validating the child's feelings. Treatment contains planning for maintenance of treatment gains for both patients and parents.

Primary Outcome Measures

Name	Time	Method
Brief Penn State Worry Questionnaire for Children	10 weeks after baseline	Self-assessment of excessive worry for individual analysis in multiple baseline evaluation
Penn State Worry Questionnaire for Children	10, 14 and 22 weeks after baseline	Child and parent version, lower values indicating decrease in worry. Assessments used in group statistical analysis of clinical outcome

Secondary Outcome Measures

Name	Time	Method
Children's Global Assessment Scale	10, 14 and 22 weeks after baseline	Clinician rated global functioning, higher values indicate higher functioning
Brief Intolerance of Uncertainty Scale	10, 14 and 22 weeks after baseline	Child version, lower values indicating decrease in intolerance of uncertainty
Brief Cognitive Avoidance Questionnaire	10, 14 and 22 weeks after baseline	Child version, lower values indicating decrease in cognitive avoidance
Negative Problem Orientation Questionnaire, abbreviated	10, 14 and 22 weeks after baseline	Child version, lower values indicating decrease in negative problem orientation
Revised Children's Anxiety and Depression Scale	10, 14 and 22 weeks after baseline	Child and parent versions, lower values indicating decrease in anxiety and depression
Education, Work and Social Adjustment Scale	10 and 22 weeks after baseline	Child and parent versions, , lower values indicating decreased impairment due to worry
Clinical Global Impression - Improvement	10, 14 and 22 weeks after baseline	Clinician rated, higher values indicate larger improvement after treatment
Anxiety Disorder Interview Schedule for the Diagnostic and Statistical Manual -IV	10, 14 and 22 weeks after baseline	Diagnostic interview
Clinician Severity Rating	10, 14 and 22 weeks after baseline	Clinician rated severity with lower values indicating lower level of severity of a disorder