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Computerized CBT (Think, Feel, Do) for Depression and Anxiety in Children and Adolescents: Outcomes and Feedback from a Pilot Randomized Controlled Trial

  • Paul Stallard (a1), Thomas Richardson (a1), Sophie Velleman (a1) and Megan Attwood (a1)
Abstract

Background: Research has demonstrated the effectiveness of computerized cognitive behaviour therapy (cCBT) for depression and anxiety in adults, but there has been little work with children and adolescents. Aims: To describe the development of a cCBT intervention (Think, Feel, Do) for young people, and preliminary outcomes and feedback from a pilot randomized controlled trial. Method: Twenty participants aged 11 to 16 with depression or anxiety were randomized to receive cCBT immediately or after a delay. Standardized measures were used to assess self-reported anxiety, depression, self-esteem and cognitions, as well as parent rated strengths and difficulties. A feedback form was also completed to assess young people's views of the programme. Results: A total of 15 participants completed the pre and post assessments in the trial, and 17 provided feedback on the intervention. Paired samples t-tests demonstrated significant improvements on 3 subscales in the control condition, compared to 7 subscales in the cCBT condition. Feedback showed moderate to high satisfaction for participants. Conclusions: This study provides encouraging preliminary results for the effectiveness and acceptability of cCBT with this age group.

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Corresponding author
Reprint requests to Paul Stallard, Mental Health Research and Development Unit (MHRDU), School for Health, University of Bath, Claverton Down, Bath BA2 7AY, UK. E-mail: p.stallard@bath.ac.uk
References
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Abeles P., Verduyn C., Robinson A., Smith P., Yule W. and Proudfoot J. (2009). Computerized CBT for adolescent depression (stressbusters) and its initial evaluation through an extended case series. Behavioural and Cognitive Psychotherapy, 37, 151165.
Andersson G., Bergstrom J., Hollandare F., Carlbring P., Kaldo V. and Ekselius L. (2005). Internet-based self-help for depression: randomized controlled trial. British Journal of Psychiatry, 18, 456461.
Barak A., Hen L., Boniel-Nissim M. and Shapira N. (2008). A comprehensive review and a meta-analysis of the effectiveness of internet-based psychotherapeutic interventions. Journal of Technology in Human Services, 26, 109160.
Beattie A., Shaw A., Kaur S. and Kessler D. (2009). Primary-care patients’ expectations and experiences of online cognitive behavioural therapy for depression: a qualitative study. Health Expectations, 12, 4559.
Bergstrom J., Andersson G., Karlsson A., Andreewitch S., Ruck C., Carlbring P. and Lindefors N. (2008). An open study of the effectiveness of Internet treatment for panic disorder delivered in a psychiatric setting. Nordic Journal of Psychiatry, 63, 4450.
Birleson P. (1980). The validity of depressive disorder in childhood and the development of a self-rating scale; a research report. Journal of Child Psychology and Psychiatry, 22, 7388.
Cartwright-Hatton S., Roberts C., Chitsabesan P., Fothergill C. and Harrington R. (2004). Systematic review of the efficacy of cognitive behaviour therapies for childhood and adolescent anxiety disorders. British Journal of Clinical Psychology, 43, 421–236.
Costello E. J., Mustillo S., Erkanli A., Keller G. and Angold A. (2003). Prevalence and development of psychiatric disorders in childhood and adolescence. Archives of General Psychiatry, 60, 837844.
Craske M. G., Rose R. D., Lang A., Welch S. S., Campbell-Sills L., Sullivan G., Sherbourne C., Bystrisky A., Stein M. and Roy-Byrne P. P. (2009). Computer-assisted delivery of cognitive behavioral therapy for anxiety disorders in primary care settings. Depression and Anxiety, 26, 235242.
Cuijpers P., Marks I. M., Van Straten A., Cavanagh K., Gega L. and Andersson G. (2009). Computer-aided psychotherapy for anxiety disorders: a meta-analytic review. Cognitive Behaviour Therapy, 38, 6682.
Cunningham M. J., Muthrich V. M., Rapee R. M., Lyneham H. J., Schniering C. A. and Hudson J. L. (2009). The Cool Teens CD-Rom for anxiety disorders in adolescents: a pilot case series. European Journal of Child and Adolescent Psychiatry, 18, 125129.
Ford T., Goodman R. and Meltzer H. (2003). The British Child and Adolescent Mental Health survey 1999: the prevalence of DSM-IV disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 12031211.
Gerrits R. S. R., Van Der Zanden R. A. P., Visscher R. F. M. and Onijn B. P. (2007). Master your mood online: a preventative chat group intervention for adolescents. Australian e-journal for the advancement of mental health, 6 (3).
Goodman R. (1997). The Strengths and Difficulties Questionnaire: a research note. Journal of Child Psychology and Psychiatry, 38, 581586.
Goodman R. (2001). Psychometric properties of the Strengths and Difficulties Questionnaire (SDQ). Journal of the American Academy of Child and Adolescent Psychiatry, 40, 13371345.
Graham C., Franses A., Kenwright M. and Marks I. (2000). Psychotherapy by computer: a postal survey of responders to a teletext article. Psychiatric Bulletin, 24, 331332.
Griffiths K. M. and Christensen H. (2007). Internet-based mental health programs: a powerful tool in the rural medical kit. Australian Journal of Rural Health, 15, 8187.
Hicks C. L., Von Baeyer C. L. and McGrath P. J. (2006). Online psychological treatment of pediatric recurrent pain: a randomized evaluation. Journal of Pediatric Psychology, 31, 724736.
Ishikawa S-I., Okajima I., Matsuoka H. and Sakano Y. (2007). Cognitive behavioural therapy for anxiety disorders in children and adolescents: a meta-analysis. Child and Adolescent Mental Health, 12, 164172.
Kessler D., Lewis G., Kaur S., Wiles N., King M., Weich S., Sharp D. J., Araya R., Hollinghurst S. and Peters T. J. (2009). Therapist-delivered internet psychotherapy for depression in primary care: a randomized controlled trial. The Lancet, 374, 628634.
Klein J. B., Jacobs R. H. and Reinecke M. A. (2007). Cognitive-behavioral therapy for adolescent depression: a meta-analytic investigation of changes in effect-size estimates. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 14031413.
Learmonth D., Trosh J., Rai S., Sewell J. and Cavanagh K. (2008). The role of computer-aided psychotherapy within an NHS CBT specialist service. Counselling and Psychotherapy Research, 8, 117123
March S., Spence S. H. and Donovan C. L. (2009). The efficacy of an internet-based cognitive-behavioural therapy intervention for child anxiety disorders. Journal of Pediatric Psychology, 34, 474487.
Muris P., Merckelbach H., Schmidt H., Gadet B. and Bogie N. (2001). Anxiety and depression as correlates of self-reported behavioural inhibition in normal adolescents. Behaviour Research and Therapy, 39, 10511061.
National Institute of Clinical Excellence (2005a). Obsessive Compulsive Disorder: core interventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorder. London: NICE.
National Institute of Clinical Excellence (2005b). Post-traumatic stress disorder (PTSD): the management of PTSD in adults and children in primary and secondary care. London: NICE.
National Institute of Clinical Excellence (2005c). Depression in Children and Young People. London: NICE.
National Institute of Clinical Excellence (2008). Computerized Cognitive Behaviour Therapy for Depression and Anxiety: review of technology appraisal 51. London: NICE.
O'Kearney R., Gibson M., Christensen H. and Griffiths K. M. (2006). Effects of a cognitive-behavioural internet program on depression, vulnerability to depression and stigma in adolescent males: a school-based controlled trial. Cognitive Behaviour Therapy, 35, 4354.
Reger M. A. and Gahm G. A. (2009). A meta-analysis of the effects of internet and computer-based cognitive behavioural treatments for anxiety. Journal of Clinical Psychology, 65, 5375.
Richardson T., Stallard P. and Velleman S. (2010). Computerized cognitive behavioural therapy for the prevention and treatment of depression and anxiety in children and adolescents: a systematic review. Clinical Child and Family Psychology Review, 13, 275290.
Rosenberg M. (1965). Society and the Adolescent Self-image. Princeton, NJ: Princeton University Press.
Spek V., Cuijpers P., Nyklicek I., Riper H., Keyzer J. and Pop V. (2007). Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis. Psychological Medicine, 37, 319328.
Spence S. H. (1998). A measure of anxiety symptoms among children. Behaviour Research and Therapy, 36, 545566.
Spence S. H., Barrett P. M. and Turner C. M. (2003). Psychometric properties of the Spence Children's Anxiety Scale with young adolescents. Journal of Anxiety Disorders, 17, 605625.
Spence S. H., Holmes J. M., March S. and Lipp T. V. (2006). The feasibility and outcome of clinic plus internet delivery of cognitive-behaviour therapy. Journal of Consulting and Clinical Psychology, 74, 614621.
Stallard P. (2004). Cognitive behaviour therapy with prepubertal children. In Graham P. (Ed.), Cognitive Behaviour Therapy for Children and Families (2nd edn, pp. 121135). Cambridge: Cambridge University Press.
Stallard P. and Rayner H. (2005). The development and preliminary evaluation of a Schema Questionnaire for Children (SQC). Behavioural and Cognitive Psychotherapy, 33, 217224.
Stallard P., Richardson T. and Velleman S. (2010). Clinicians’ attitudes towards the use of computerized cognitive behaviour therapy (cCBT) with children and adolescents. Behavioural and Cognitive Psychotherapy, 38, 545560.
Stallard P., Udwin O., Goddard M. and Hibbert S. (2007). The availability of cognitive behaviour therapy within specialist Child and Adolescent Mental Health Services (CAMHS): a national survey. Behavioural and Cognitive Psychotherapy, 35, 501505.
Stallard P., Velleman S. and Richardson T. (2010). Computer use and attitudes towards computerised therapy amongst young people and parents attending Child and Adolescent Mental Health Services. Child and Adolescent Mental Health, 15, 8084.
Titov N., Andrews G., Schwencke G., Drobny J. and Einstein D. (2008). Shyness 1: distance treatment of social phobia over the Internet. Australian and New Zealand Journal of Psychiatry, 42, 585594.
Van Voorhees B. W., Fogel J., Reinecke M. A., Gladstone T., Stuart S., Gollan J., et al. (2009). Randomized clinical trial of an internet-based depression prevention program for adolescents (Project CATCH-IT) in primary care: 12 week outcomes. Journal of Developmental and Behavioral Pediatrics, 30, 2337.
Waller R. and Gilbody S. (2009). Barriers to the uptake of computerized cognitive behavioural therapy: a systematic review of the quantitative and qualitative evidence, Psychological Medicine, 39, 705712.
Warmerdam L., van Straten A., Jongsma J., Twisk J. and Cuijpers P. (2010). Online cognitive behavioral therapy and problem-solving therapy for depressive symptoms: exploring mechanisms of change. Journal of Behaviour Therapy and Experimental Psychiatry, 41, 6470.
Whitfield G., Hinshelwood R., Pashely A., Campsie L. and Williams W. (2006). The impact of a novel computerized CBT CD Rom (Overcoming Depression) offered to patients referred to clinical psychology. Behavioural and Cognitive Psychotherapy, 34, 111.
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Behavioural and Cognitive Psychotherapy
  • ISSN: 1352-4658
  • EISSN: 1469-1833
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