Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-24T09:04:19.590Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  28 January 2011

Paul Stallard ,
Thomas Richardson ,
Sophie Velleman  and
Megan Attwood
Paul Stallard*
Affiliation:
University of Bath, UK
Thomas Richardson
Affiliation:
University of Bath, UK
Sophie Velleman
Affiliation:
University of Bath, UK
Megan Attwood
Affiliation:
University of Bath, UK
*
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: [email protected]
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

ChildrenadolescentsCBTcomputerdepressionanxiety
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 39 , Issue 3 , May 2011 , pp. 273 - 284
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

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, 151–165.CrossRefGoogle ScholarPubMed
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, 456–461.CrossRefGoogle Scholar
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, 109–160.CrossRefGoogle Scholar
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, 45–59.CrossRefGoogle ScholarPubMed
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, 44–50.CrossRefGoogle Scholar
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, 73–88.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
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, 837–844.CrossRefGoogle ScholarPubMed
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, 235–242.CrossRefGoogle ScholarPubMed
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, 66–82.CrossRefGoogle ScholarPubMed
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, 125–129.CrossRefGoogle ScholarPubMed
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, 1203–1211.CrossRefGoogle ScholarPubMed
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).CrossRefGoogle Scholar
Goodman, R. (1997). The Strengths and Difficulties Questionnaire: a research note. Journal of Child Psychology and Psychiatry, 38, 581–586.CrossRefGoogle ScholarPubMed
Goodman, R. (2001). Psychometric properties of the Strengths and Difficulties Questionnaire (SDQ). Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1337–1345.CrossRefGoogle Scholar
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, 331–332.CrossRefGoogle Scholar
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, 81–87.CrossRefGoogle ScholarPubMed
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, 724–736.CrossRefGoogle Scholar
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, 164–172.CrossRefGoogle ScholarPubMed
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, 628–634.CrossRefGoogle Scholar
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, 1403–1413.CrossRefGoogle ScholarPubMed
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, 117–123CrossRefGoogle Scholar
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, 474–487.CrossRefGoogle ScholarPubMed
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, 1051–1061.CrossRefGoogle ScholarPubMed
National Institute of Clinical Excellence (2005a). Obsessive Compulsive Disorder: core interventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorder. London: NICE.Google Scholar
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.Google Scholar
National Institute of Clinical Excellence (2005c). Depression in Children and Young People. London: NICE.Google Scholar
National Institute of Clinical Excellence (2008). Computerized Cognitive Behaviour Therapy for Depression and Anxiety: review of technology appraisal 51. London: NICE.Google Scholar
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, 43–54.CrossRefGoogle ScholarPubMed
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, 53–75.CrossRefGoogle ScholarPubMed
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, 275–290.CrossRefGoogle ScholarPubMed
Rosenberg, M. (1965). Society and the Adolescent Self-image. Princeton, NJ: Princeton University Press.CrossRefGoogle Scholar
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, 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., 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, 614–621.CrossRefGoogle Scholar
Stallard, P. (2004). Cognitive behaviour therapy with prepubertal children. In Graham, P. (Ed.), Cognitive Behaviour Therapy for Children and Families (2nd edn, pp. 121–135). Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Stallard, P. and Rayner, H. (2005). The development and preliminary evaluation of a Schema Questionnaire for Children (SQC). Behavioural and Cognitive Psychotherapy, 33, 217–224.CrossRefGoogle Scholar
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, 545–560.CrossRefGoogle ScholarPubMed
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, 501–505.CrossRefGoogle Scholar
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, 80–84.CrossRefGoogle ScholarPubMed
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, 585–594.CrossRefGoogle Scholar
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, 23–37.CrossRefGoogle ScholarPubMed
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, 705–712.CrossRefGoogle Scholar
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, 64–70.CrossRefGoogle ScholarPubMed
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, 1–11.CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.