Evaluation of internet-based, cognitive behaviour therapy for the treatment of anxiety disorders in adolescents

焦虑症影响约5-10%的青少年，如果不及时治疗，焦虑症会带来一系列不良后果。大多数患有焦虑症的年轻人既不寻求也不接受治疗。这可能部分是由于到精神健康诊所就诊的耻辱感和参加治疗的后勤问题。一项挑战是确定如何使有需要的青少年，特别是农村和偏远地区的青少年更容易获得治疗。与最初的想法相反，有证据表明，互联网可以用来为包括焦虑症在内的一系列心理健康问题提供有效的心理治疗。到目前为止，这项研究主要集中在成年人身上，但青少年可能处于特别有利的地位，从这些形式的治疗中受益，因为他们是有经验的互联网资源用户。本研究探讨了基于网络的认知行为疗法（CBT）在青少年焦虑症治疗中的有效性。最近，我们对焦虑儿童进行了CBT试验，结合了诊所和网络治疗，一半的治疗在诊所进行，一半在网络上进行。试点数据显示，诊所+网络治疗显著减少了焦虑，几乎与全面的临床治疗一样有效。拟议的研究建立在我们的试点工作的基础上，通过评估更广泛的基于互联网的治疗的有效性，在这种治疗中，所有的疗程都是使用互联网完成的，并且年龄较大。该研究还检查了预测哪些年轻人对干预反应最积极的因素，以便将治疗与未来最有可能从中受益的人相匹配。其目的是为患有焦虑症的青少年开发一种有效的基于互联网的治疗方法，这种方法易于获得，适合在农村和偏远人口中使用，只需要最少的面对面治疗师接触。

Anxiety disorders affect around 5-10% of adolescents and are associated with a range of adverse consequences if left untreated. The majority of young people with anxiety disorders do not seek nor receive treatment. This may be due partly to the perceived stigma of attending a mental health clinic and logistic problems of attending therapy. A challenge is to identify ways in which treatment can be made more accessible to adolescents in need, particularly those in rural and remote areas. Contrary to original beliefs, evidence shows that the internet can be used to deliver effective psychological therapies for a range of mental health problems, including anxiety disorders. So far this research has focused on adults, but adolescents may be in a particularly strong position to benefit from these forms of therapy, being experienced users of internet resources. This research investigates the effectiveness of internet-based cognitive-behaviour therapy (CBT) in the treatment for anxiety disorders in adolescents. Recently we have piloted CBT for anxious children that combines clinic and internet therapy, with half the therapy sessions in the clinic and half over the internet. Pilot data show that clinic + internet therapy produced significant reductions in anxiety and is almost as effective full clinic-based therapy. The proposed research builds on our pilot work by evaluating the effectiveness of a more extensive internet-based therapy in which all sessions are completed using the internet and with an older age group. The research also examines the factors that predict which young people will respond most positively to the intervention so that the treatment can be matched to those most likely to benefit from it in the future. The aim is to develop an effective internet-based treatment for adolescents with anxiety disorders that is easily accessed and suitable for use in rural and remote populations, requiring minimal face-to-face therapist contact.