Internet-delivered exposure therapy versus internet-delivered cognitive behavioral therapy for panic disorder: A pilot randomized controlled trial

Eileen P Stech; Aileen Z Chen; Maria J Sharrock; Ashlee B Grierson; Emily L Upton; Alison E J Mahoney; Jessica R Grisham; Jill M Newby

doi:10.1016/j.janxdis.2021.102382

Internet-delivered exposure therapy versus internet-delivered cognitive behavioral therapy for panic disorder: A pilot randomized controlled trial

J Anxiety Disord. 2021 Apr:79:102382. doi: 10.1016/j.janxdis.2021.102382. Epub 2021 Mar 10.

Authors

Eileen P Stech¹, Aileen Z Chen², Maria J Sharrock², Ashlee B Grierson², Emily L Upton³, Alison E J Mahoney², Jessica R Grisham³, Jill M Newby⁴

Affiliations

¹ School of Psychology, University of New South Wales Sydney, NSW 2052, Australia; Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, Sydney, NSW 2010, Australia. Electronic address: eileen.stech@unsw.edu.au.
² School of Psychiatry, University of New South Wales Sydney, NSW 2052, Australia; Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, Sydney, NSW 2010, Australia.
³ School of Psychology, University of New South Wales Sydney, NSW 2052, Australia.
⁴ School of Psychology, University of New South Wales Sydney, NSW 2052, Australia; Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, Sydney, NSW 2010, Australia; Black Dog Institute, University of New South Wales Sydney, NSW 2052, Australia.

PMID: 33774558
DOI: 10.1016/j.janxdis.2021.102382

Abstract

Aim: To compare the efficacy and acceptability of internet-delivered exposure therapy for panic disorder, to multi-component internet-delivered cognitive behavioral therapy (iCBT) that included controlled breathing, cognitive restructuring and exposure.

Methods: Participants with panic disorder, with or without agoraphobia, were randomized to internet-delivered exposure therapy (n = 35) or iCBT (n = 34). Both programs were clinician guided, with six lessons delivered over eight weeks. Outcomes included panic disorder and agoraphobia symptom severity, as well as depression symptom severity, functional impairment and days out of role.

Results: Participants in both conditions displayed a large reduction in panic disorder symptom severity (ds >1.30) from pre- to post-treatment. Participants in both conditions displayed medium to large reduction in agoraphobia and depression symptom severity, functional impairment and days out of role. Effects were maintained at three- and six-month follow-up. There was no significant difference between the interventions in clinical outcomes, adherence or treatment satisfaction.

Conclusions: Internet-delivered exposure therapy appeared to be as acceptable and efficacious as more established iCBT, despite including less strategies. However, a fully powered replication is now needed to compare the two approaches.

Keywords: Agoraphobia; Cognitive behavioral therapy; Exposure therapy; Internet-delivered CBT; Panic disorder.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Cognitive Behavioral Therapy*
Humans
Implosive Therapy*
Internet
Panic Disorder* / therapy
Pilot Projects
Treatment Outcome