Delivering solid treatments on shaky ground: Feasibility study of an online therapy for child anxiety in the aftermath of a natural disaster

摘要

Objective: To assess feasibility of online cognitive behaviour therapy (CBT) for children and adolescents with anxiety in the aftermath of a natural disaster. Method: 42 children and adolescents with clinical anxiety referred from primary care were invited to complete an internet CBT program (BRAVE-ONLINE). Outcome measures and assessment timelines were chosen to allow a comparison of the results with the program developers' randomised controlled trials. Results: At 6-month post intervention, more than half (55) of the 33 participants assessed, no longer met criteria for their primary anxiety disorder. The mean number of anxiety diagnoses dropped from 2.76 (SD=0.85) at baseline to 1.06 (SD=1.25) at follow-up (z=-4.51, p.001). Participants' anxiety and mood symptoms reduced and health-related quality of life improved significantly by follow-up. Satisfaction ratings were moderate to high. On average, by 6-month follow-up, children and adolescents had completed 6 of 10 sessions and parents had completed 5/6 (child parent program) and 3/5 sessions (adolescent parent program). Conclusions: Following a natural disaster (the Canterbury earthquakes), children and adolescents showed clinically significant improvement in anxiety and mood when they used BRAVE-ONLINE. This approach was both feasible and acceptable to families and offered a solution when mental health services were under pressure.