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Online CBT in the Treatment of Child and Adolescent Anxiety Disorders: Issues in the Development of BRAVE–ONLINE and Two Case Illustrations

Published online by Cambridge University Press:  01 July 2008

Susan H. Spence ,
Caroline L. Donovan ,
Sonja March ,
Amanda Gamble ,
Renee Anderson ,
Samantha Prosser ,
Amy Kercher  and
Justin Kenardy
Susan H. Spence*
Affiliation:
Griffith University, Australia
Caroline L. Donovan
Affiliation:
Griffith University, Australia
Sonja March
Affiliation:
University of Queensland, Australia
Amanda Gamble
Affiliation:
Macquarie University, Australia
Renee Anderson
Affiliation:
University of Queensland, Australia
Samantha Prosser
Affiliation:
University of Queensland, Australia
Amy Kercher
Affiliation:
Macquarie University, Australia
Justin Kenardy
Affiliation:
University of Queensland, Australia
*
Reprint requests to Susan Spence, Griffith University, Gold Coast Campus, Queensland 4222, Australia. E-mail: s.spence@griffith.edu.au
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Abstract

This paper describes the rationale for and development of an online cognitive-behavioural treatment for child and adolescent anxiety (BRAVE–ONLINE). It highlights the challenges involved in adapting a clinic-based intervention for delivery using the internet, with separate sessions for parents and their children (or adolescents). We outline strategies to ensure that young people remain engaged in online therapy, and describe techniques designed to optimize the alliance between clients and the online therapist. Two case studies are presented that illustrate the practical and technical aspects of implementing the intervention, and demonstrate the feasibility of achieving successful outcomes using online delivery of CBT for child and adolescent anxiety. However, firm conclusions regarding the efficacy of this approach cannot be drawn until the results of randomized controlled trials are available. The paper identifies directions for future research.

Keywords

Anxietycognitive behaviour therapyinternetonlinecomputer

Information

Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 36 , Issue 4: Anxiety of Childhood and Adolescence , July 2008 , pp. 411 - 430
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2008

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References

Achenbach, T. M. and Rescorla, L. A. (2001). Manual for the ASEBA School-Age Forms and Profiles. Burlington, VT: University of Vermont, Research Centre for Children, Youth and Families.Google Scholar
Bandura, A. (1977). Social Learning Theory. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
Barrett, P. M. (1998). Evaluation of cognitive-behavioral group treatments for childhood anxiety disorders. Journal of Clinical Child Psychology, 27, 459–468.Google ScholarPubMed
Booth, M. L., Bernard, D., Quine, S., Kang, M. S., Usherwood, T., Alperstein, G. and Bennett, D. L. (2004). Access to health care among Australian adolescents: young people's perspectives and their sociodemographic distribution. Journal of Adolescent Health, 34, 97–103.CrossRefGoogle ScholarPubMed
Borkovec, T. D. and Nau, S. D. (1972). Credibility of analogue therapy rationales. Journal of Behavior Therapy and Experimental Psychiatry, 3, 257–260.CrossRefGoogle Scholar
Cornwall, E., Spence, S. H. and Schotte, D. (1996). The effectiveness of emotive imagery in the treatment of darkness phobia in children. Behaviour Change, 13, 223–229.CrossRefGoogle Scholar
Dadds, M. R., Davey, G. C. L. and Field, A. P. (2001). Developmental aspects of conditioning processes in anxiety disorders. In Vasey, M. W. and Dadds, M. R. (Eds.), The Developmental Psychopathology of Anxiety. Oxford: Oxford University Press.Google Scholar
Dewis, L. M., Kirkby, K. C., Martin, F., Daniels, B. A., Gilroy, L. J. and Menzies, R. G. (2001). Computer-aided vicarious exposure versus live graded exposure for spider phobia in children. Journal of Behavior Therapy and Experimental Psychiatry, 32, 17–27.CrossRefGoogle ScholarPubMed
Essau, C. A., Conradt, J. and Petermann, F. (2000). Frequency, comorbidity, and psychosocial impairment of anxiety disorders in German adolescents. Journal of Anxiety Disorders, 14, 263–279.CrossRefGoogle ScholarPubMed
Fung, D. S. S., Manassis, K., Kenny, A. and Fiksenbaum, L. (2002). Web-based CBT for selective mutism. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 112–113.CrossRefGoogle ScholarPubMed
Griffiths, K. M. and Christensen, H. (2006). Review of randomised controlled trials of internet interventions for mental disorders and related conditions. Clinical Psychologist, 10, 16–29.CrossRefGoogle Scholar
Howgego, I. M., Yellowlees, P., Owen, C., Meldrum, L. and Dark, F. (2003). The therapeutic alliance: the key to effective patient outcome? A descriptive review of the evidence in community mental health case management. Australian and New Zealand Journal of Psychiatry, 37, 169–183.CrossRefGoogle ScholarPubMed
Hudson, J. L. (2005). Efficacy of cognitive-behavioural therapy for children and adolescents with anxiety disorders. Behaviour Change, 22, 55–70.CrossRefGoogle Scholar
Iverson, G. L. (2001). Interpreting change on the WAIS-III/WMS-III in clinical samples. Archives of Clinical Neuropsychology, 16, 183–191.CrossRefGoogle ScholarPubMed
Jacobson, N. S. and Truax, P. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19.CrossRefGoogle ScholarPubMed
Kaltenthaler, E., Brazier, J., De Nigris, E., Tumur, I., Ferriter, M., Berverley, C., Parry, G., Rooney, G. and Sutcliffe, P. (2006). Computerised cognitive behaviour therapy for depression and anxiety update: a systematic review and economic evaluation. Health Technology Assessment, 10, 1–186.CrossRefGoogle ScholarPubMed
Kenardy, J. A. and Adams, C. (1993). Computers in cognitive-behaviour therapy. Australian Psychologist, 28, 189–194.Google Scholar
Kenardy, J. A., Dow, M. G. T., Johnston, D. W., Newman, M. G., Thomson, A. and Taylor, C. B. (2003). A comparison of delivery methods of cognitive-behavioral therapy for panic disorder: an international multicenter trial. Journal of Consulting and Clinical Psychology, 71, 1068–1075.CrossRefGoogle ScholarPubMed
Kendall, P. C. (1994). Treating anxiety disorders in children: results of a randomized clinical trial. Journal of Consulting and Clinical Psychology, 62, 100–110.CrossRefGoogle ScholarPubMed
Lyneham, H. J. and Rapee, R. M. (2005). Agreement between telephone and in-person delivery of a structured interview for anxiety disorders in children. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 274–282.CrossRefGoogle ScholarPubMed
Martin, D. J., Garske, J. P. and Davis, M. K. (2000). Relation of the therapeutic alliance with outcome and other variables: a meta-analytic review. Journal of Consulting and Clinical Psychology, 68, 438–450.Google ScholarPubMed
Muris, P., Schmidt, H. and Merckelbach, H. (2000). Correlations among two self-report questionnaires for measuring DSM-defined anxiety disorder symptoms in children: the Screen for Child Anxiety Related Emotional Disorders and the Spence Children's Anxiety Scale. Personality and Individual Differences, 28, 333–346.CrossRefGoogle Scholar
Nauta, M. H., Scholing, A., Rapee, R. M., Abbott, M., Spence, S. H. and Waters, A. (2004). A parent-report measure of children's anxiety: Psychometric properties and comparison with child-report in a clinic and normal sample. Behaviour Research and Therapy, 42, 813–839.CrossRefGoogle Scholar
Nelissen, I., Muris, P. and Merckelbach, H. (1995). Computerized exposure and in vivo exposure treatments of spider fear in children: two case reports. Journal of Behavior Therapy and Experimental Psychiatry, 26, 153–156.CrossRefGoogle ScholarPubMed
Ollendick, T. H., King, N. J. and Muris, P. (2002). Fears and phobias in children: phenomenology, epidemiology, and aetiology. Child and Adolescent Mental Health, 7, 98–106.CrossRefGoogle Scholar
Rapee, R. M. and Spence, S. H. (2004). The etiology of social phobia: empirical evidence and an initial model. Clinical Psychology Review. Special Social Phobia and Social Anxiety, 24, 737–767.Google Scholar
Rapee, R. M., Wignall, A., Hudson, J. L. and Schniering, C. A. (2000). Treating Anxious Children and Adolescents: an evidence-based approach. Oakland, CA: Harbinger Publications.Google Scholar
Schaffer, D., Gould, M. S., Brasic, J., Ambrosini, P., Fisher, D., Bird, H. and Aluwahlia, S. (1983). A Children's Global Assessment Scale (CGAS). Archives of General Psychiatry, 40, 1228–1231.Google Scholar
Silverman, W. K. (1994). Structured diagnostic interviews. In Ollendick, T. H. and King, N. J. (Eds.), International Handbook of Phobic and Anxiety Disorders in Children and Adolescents. issues in clinical child psychology (pp. 293–315). New York: Plenum Press.Google Scholar
Silverman, W. K. and Albano, A. M. (1996). Anxiety Disorders Interview schedule for DSM-IV – Child Version: Parent Interview Schedule. San Antonio: The Psychological Corporation – Harcourt, Brace and Company.Google Scholar
Silverman, W. K. and Treffers, P. D. A. (2001). Anxiety Disorders in Children and Adolescents: research, assessment and intervention. New York: Cambridge University Press.Google Scholar
Spek, V., Cuijpers, P., NyklÃcek, 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, 319–328.CrossRefGoogle ScholarPubMed
Spence, S. H. (1998). A measure of anxiety symptoms among children. Behaviour Research and Therapy, 36, 545–566.CrossRefGoogle ScholarPubMed
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, 605–625.CrossRefGoogle ScholarPubMed
Spence, S. H., Donovan, C. and Brechman-Toussaint, M. (2000). The treatment of childhood social phobia: the effectiveness of a social skills training-based, cognitive-behavioural intervention, with and without parental involvement. Journal of Child Psychology and Psychiatry, 41, 713–726.Google ScholarPubMed
Spence, S. H., Holmes, J. M., Donovan, C. L. and Kenardy, J. (2006). BRAVE for Teenagers – ONLINE: an internet based program for adolescents with anxiety. Brisbane, Australia: School of Psychology, University of Queensland.Google Scholar
Spence, S. H., Holmes, J. M., March, S. and Lipp, O. V. (2006). The feasibility and outcome of clinic plus internet delivery of cognitive-behavior therapy for childhood anxiety. Journal of Consulting and Clinical Psychology, 74, 614–621.CrossRefGoogle ScholarPubMed
Spence, S. H., March, S. and Holmes, J. M. (2005). BRAVE for Children – ONLINE: an internet based program for children with anxiety. Brisbane, Australia: School of Psychology, University of Queensland.Google Scholar
Tracey, T. J. and Kokotovic, A. M. (1989). Factor structure of the Working Alliance Inventory. Psychological Assessment, 1, 207–210.CrossRefGoogle Scholar
Vasey, M. W. and Dadds, M. R. (2001). The Developmental Psychopathology of Anxiety. London: Oxford University Press.CrossRefGoogle Scholar
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