The acceptability of a therapist-assisted internet-delivered cognitive behaviour therapy program for the treatment of anxiety disorders in adolescents: a qualitative study

Katy Smart; Lydia Smith; Kate Harvey; Polly Waite

doi:10.1007/s00787-021-01903-6

The acceptability of a therapist-assisted internet-delivered cognitive behaviour therapy program for the treatment of anxiety disorders in adolescents: a qualitative study

Katy Smart
, Lydia Smith
, Kate Harvey
, Polly Waite

School of Nursing, Midwifery and Health

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

31 Downloads (Pure)

Abstract

Computerized treatments have been shown to be effective in young people with anxiety disorders. However, there has been limited investigation into the experiences of adolescents in undertaking this treatment. This qualitative study explored adolescents’ experiences of being treated for an anxiety disorder, using an online intervention with therapist support, as part of a randomised controlled trial. Individual semi-structured interviews were conducted with thirteen adolescents aged between 13 and 17 years, who had received the online intervention. Data were analysed using reflexive thematic analysis. Two cross-cutting themes were identified: (i) Usability of the program, and (ii) Putting techniques into practice. Although the convenience of online sessions was recognised as positive, many of the adolescents expressed a preference for face-to-face sessions. The length of sessions and the large amount of reading involved was highlighted by most participants. The transdiagnostic nature of the content meant some elements of the programme were seen as less relevant. While many participants appreciated the ‘fun’ aspect of the program, others felt that certain aspects of the program were not suitable for their age group. Exposure, psychoeducation and cognitive restructuring were generally received positively, whereas responses to the use of relaxation and rewards were much more mixed. Our findings highlight the potential utility for online treatments delivered with therapist support. However, they also highlight how issues with both the format and treatment components can impact the acceptability of a program. As such, further work is warranted to improve the acceptability of online treatments for adolescents with anxiety disorders.

Original language	English
Pages (from-to)	661-673
Number of pages	13
Journal	European Child and Adolescent Psychiatry
Volume	32
Early online date	8 Nov 2021
DOIs	https://doi.org/10.1007/s00787-021-01903-6
Publication status	Published - Apr 2023

Bibliographical note

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated
otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Funding

P.W. was supported by a Medical Research Council (MRC) Clinical Research Training Fellowship (G1002011) for this research, and is currently supported by an NIHR Postdoctoral Research Fellowship (PDF-2016-09-092). The study was supported by the National Institute for Health Research (NIHR) Clinical Research Network. The views expressed in this publication are those of the authors and not necessarily those of the NIHR, NHS or the UK Department of Health and Social\u00A0Care. The NIHR had no involvement in any aspect of this paper. The authors would like to thank the adolescents and their families who took part in this research for their help, as well as Professor Sue Spence, Dr Sonja March and colleagues for making the BRAVE for Teenagers-ONLINE program available for this study. The authors would also like to thank staff from BHFT CAMHS Anxiety & Depression Pathway and the\u00A0AnDY Research Unit\u00A0who supported this research. Research materials can be accessed by contacting the corresponding author. The authors have declared that they have no competing or potential conflicts of interest. PW was supported by a Medical Research Council (MRC) Clinical Research Training Fellowship (G1002011) for this research and is currently supported by an NIHR Postdoctoral Research Fellowship (PDF-2016-09-092). The study was supported by the National Institute for Health Research (NIHR) Clinical Research Network. The views expressed in this publication are those of the authors and not necessarily those of the NIHR, NHS or the UK Department of Health and Social Care. The NIHR had no involvement in any aspect of this paper. KS and LS undertook this research as part of their MSc at the University of Reading.

Funders	Funder number
National Institute for Health and Care Research
Medical Research Council	G1002011

Keywords

Cognitive behavioural therapy
Online
Internet
Adolescent
Anxiety disorders
Qualitative

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10.1007/s00787-021-01903-6Licence: CC BY

PublishedFinal published version, 920 KBLicence: CC BY

Cite this

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title = "The acceptability of a therapist-assisted internet-delivered cognitive behaviour therapy program for the treatment of anxiety disorders in adolescents: a qualitative study",

abstract = "Computerized treatments have been shown to be effective in young people with anxiety disorders. However, there has been limited investigation into the experiences of adolescents in undertaking this treatment. This qualitative study explored adolescents{\textquoteright} experiences of being treated for an anxiety disorder, using an online intervention with therapist support, as part of a randomised controlled trial. Individual semi-structured interviews were conducted with thirteen adolescents aged between 13 and 17 years, who had received the online intervention. Data were analysed using reflexive thematic analysis. Two cross-cutting themes were identified: (i) Usability of the program, and (ii) Putting techniques into practice. Although the convenience of online sessions was recognised as positive, many of the adolescents expressed a preference for face-to-face sessions. The length of sessions and the large amount of reading involved was highlighted by most participants. The transdiagnostic nature of the content meant some elements of the programme were seen as less relevant. While many participants appreciated the {\textquoteleft}fun{\textquoteright} aspect of the program, others felt that certain aspects of the program were not suitable for their age group. Exposure, psychoeducation and cognitive restructuring were generally received positively, whereas responses to the use of relaxation and rewards were much more mixed. Our findings highlight the potential utility for online treatments delivered with therapist support. However, they also highlight how issues with both the format and treatment components can impact the acceptability of a program. As such, further work is warranted to improve the acceptability of online treatments for adolescents with anxiety disorders.",

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JO - European Child and Adolescent Psychiatry

JF - European Child and Adolescent Psychiatry

ER -

The acceptability of a therapist-assisted internet-delivered cognitive behaviour therapy program for the treatment of anxiety disorders in adolescents: a qualitative study

Abstract

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