A Preliminary Outcomes of Internet-based Cognitive Behavioral Skill Training for Youth at-risk of Anxiety: A Feasibility Study
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Abstract
ABSTRACT
Objective: To examine the feasibility and efficacy of Internet-based Cognitive Behavioral Skill training for youth at-risk of anxiety disorders.
Method: This was a pilot study. Adolescents aged 12-15 years old were enrolled to participate in online cognitive behavioral skills training conducted between May 1st to November 30th, 2021. The Screen for Child Anxiety Related Disorders, Thai-version (SCARED) were used for assessing the degree of anxiety symptoms at baseline and 8 weeks after intervention. Feasibility of the intervention were assessed by a questionnaire developed by the authors.
Result: There were 8 participants (mean age 13.25 years) completed 2 sessions of the Internet-based intervention. SCARED score were decreased 62.5 percents (n=5) in child self-report and 75 percents (n=6) in parent report, particularly in those with high degree of anxiety at baseline ( 40). However, the result was inconclusive for those with moderate symptoms of anxiety (baseline score 25-35). More than half of participants reported high to highest satisfactory with the program.
Conclusion: Internet-based cognitive behavioral skill training for youth at risk of anxiety is an
acceptable preliminary intervention. Provided physical distancing with lower utilization of
resource, it could be a viable option to provide effective telepsychiatric-intervention for at-risk
youth during this covid-19 pandemic situation.
Keyword: anxiety, child and adolescence, Cognitive Behavioral Therapy, CBT, telepsychiatry
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References
Martin A, Bloch M, Volkmar F. Lewis’s Child and Adolescent Psychiatry: A Comprehensive Textbook. 5th ed. China: Wolters Kluwer; 2018.
Polanczyk G, Salum G, Sugaya L, Caye A, Rohde L. Annual Research Review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry 2015; 56(3): 345-65.
Biswas T, Scott J, Munir K, Renzaho A, Rawal L, Baxter J, et al. Global variation in the prevalence of suicidal ideation, anxiety and their correlates among adolescents: A population based study of 82 countries. EClinical Medicine 2020; 24: 100395.
Ekasawin S, Phothisut C, Chomchuen R. The prevalence of psychiatric disorders in Thai students aged 13-17 year. J Ment Health Thai 2016; 24(3): 141-53.
Centers for Disease Control and Prevention [Internet]. Atlanta: Government agency. Data and Statistics on Children’s Mental Health; 2019 [updated 2022 Mar 4; cited 2021 Jan 19]; [about 6 screens]. Available from: https://www.cdc.gov/childrensmentalhealth/data.html
Burstein M, Beesdo-Baum K, He J, Merikangas K. Threshold and subthreshold generalized anxiety disorder among US adolescents: prevalence, sociodemographic, and clinical characteristics. Psychol Med 2014; 44(11): 2351-62.
Cartwright-Hatton S, McNicol K, Doubleday E. Anxiety in a neglected population: Prevalence of anxiety disorders in preadolescent children. Clin Psychol Rev 2006; 26(7): 817-33.
Walter H, Bukstein O, Abright A, Keable H, Ramtekkar U, Ripperger-Suhler J, et al. Clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders. J Am Acad Child Adolesc Psychiatry 2020; 59(10): 1107-24.
Bittner A, Egger H, Erkanli A, Jane Costello E, Foley D, Angold A. What do childhood anxiety disorders predict?. J Child Psychol Psychiatry 2007; 48(12): 1174-83.
Ohira I, Urao Y, Sato Y, Ohtani T, Shimizu E. A pilot and feasibility study of a cognitive behavioural therapy-based anxiety prevention programme for junior high school students in Japan: a quasi-experimental study. Child Adoles Psychiatry Ment Health 2019; 13(1): 1-12.
Urao Y, Yoshida M, Koshiba T, Sato Y, Ishikawa SI, Shimizu E. Effectiveness of a cognitive behavioural therapy-based anxiety prevention programme at an elementary school in Japan: a quasi-experimental study. Child Adolesc Psychiatry Ment Health 2018;12: 3.
Cochrane Library [Internet]. London: The Organization; 2015. Cognitive behavioural therapy for anxiety disorders in children and adolescents; 2015 [updated 2020 Nov 16; cited 2020 Dec 14]; [about 2 screens]. Available from: https://www.cochranelibrary.com/cdsr/doi/10. 1002/14651858.CD004690.pub4/full.
Chavira D, Stein M, Bailey K, Stein M. Child anxiety in primary care: Prevalent but untreated. Depress Anxiety 2004; 20(4): 155-64.
Essau CA, Conradt J, Petermann F. Frequency, comorbidity, and psychosocial impairment of anxiety disorders in German adolescents. J Anxiety Disord. 2000; 14(3): 263-79.
Cavanagh K. Geographic Inequity in the availability of cognitive behavioural therapy in England and Wales: a 10-Year update. Behav Cogn Psychother. 2014; 42(4): 497-501.
Booth M, Bernard D, Quine S, Kang M, Usherwood T, Alpersyein G, et al. Access to health care among Australian adolescents young people’s perspectives and their sociodemographic distribution. J Adolesc Health. 2004; 34(1): 97-103.
Anderson P, Jacobs C, Rothbaum BO. Computer-supported cognitive behavioral treatment of anxiety disorders. J Clin Psychol. 2004; 60(3): 253-67.
Newman MG, Consoli A, Taylor CB. Computers in assessment and cognitive behavioral treatment of clinical disorders: Anxiety as a case in point. Behavior Therapy 1997; 28(2): 211-35.
Marks IM, Cavanagh K, Gega L. Computer-aided psychotherapy: revolution or bubble?. Br J Psychiatry 2007; 191(6): 471-3.
Vigerland S, Lenhard F, Bonnert M, Lalouni M, Hedman E, Ahlen J, et al. Internet-delivered cognitive behavior therapy for children and adolescents: A systematic review and meta-analysis. Clin Psychol Rev 2016; 50: 1-10.
Ularntinon S, Nithiuthai J. Identifying youth with anxiety disorders in pediatric primary care: a preliminary study from Thailand [resident research]. Bangkok: Queen Sirikit National Institute of Child Health; 2016.
Tangjittiporn T, Sottimanon A, Ularntinon S. Psychometric properties of the screen for child anxiety related disorders Thai version. Pediatr Int [Internet]. 2021 [cited 2021 Dec 20]. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/ped.15093.
ศิริรัตน์ อุฬารตินนท์. วิดีโอศึกษาความรู้เพิ่มเติม เรื่อง ลิลลี่ขี้กลัว [Internet]. Thaiteentraining.com. 2017 [cited 14 December 2020]. Available from: http://www.thaiteentraining.com/index.php?module=vdos&action=view&id=MzE3ZTQwMzQ3ZTQwZTQ=4.
Compton S, Walkup J, Albano A, Piacentini J, Birmaher B, Sherrill J, et al. Child/adolescent anxiety multimodal study (CAMS): rationale, design, and methods. Child Adoles Psychiatry Ment Health 2010; 4: 1.
ศิริรัตน์ อุฬารตินนท์. ลิลลี่ขี้กลัว. พิมพ์ครั้งที่ 3. กรุงเทพ: สำนักพิมพ์คิดเทอเรซี่; 2561.
Calear AL, Christensen H, Brewer J, Mackinnon A, Griffiths KM. A pilot randomized control- ed trial of the e-couch anxiety and worry program in schools. Internet Interv 2016;6: 1-5.
Spence SH, Donovan CL, March S, Gamble A, Anderson RE, Prosser S et al. A randomized controlled trial of online versus clinic-based CBT for adolescent anxiety. J Consul Clin Psychol. 2011; 79(5): 629-42.
O’Connor K, Bagnell A, McGrath P, Wozney L, Radomski A, Rosychuk RJ et al. An internet-based cognitive behavioral program for adolescents with anxiety: Pilot randomized controlled trial. JMIR Ment Health 2020 ;7(7):e13356.
Cunningham MJ, Wuthrich VM, Rapee RM, Lyneham HJ, Schniering CA, Hudson JL. The Cool Teens CD-ROM for anxiety disorders in adolescents. Eur Child Adolesc Psychiatry 2009;18(2): 125-9.
Donovan CL, March S. Online CBT for preschool anxiety disorders: a randomised control trial. Behav Res Ther 2014; 58: 24-35.
Nahum D, Alfonso C, Sönmez E. Advances in Psychiatry [Internet]. New York City: Springer International Publishing AG;2018. [cited 2021 Mar 9]. Available from: https://sci-hub.se/10. 1007/978-3-319-70554-5_29.