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Therapist-assisted, internet-based treatment for panic disorder: can general practitioners achieve comparable patient outcomes to psychologists

Shandley, Kerrie, Austin, David William, Klein, Britt, Pier, Ciaran, Schattner, Peter, Pierce, David and Wade, Victoria 2008, Therapist-assisted, internet-based treatment for panic disorder: can general practitioners achieve comparable patient outcomes to psychologists, Journal of medical internet research, vol. 10, no. 2, pp. 14-39, doi: 10.2196/jmir.1033.

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Title Therapist-assisted, internet-based treatment for panic disorder: can general practitioners achieve comparable patient outcomes to psychologists
Author(s) Shandley, Kerrie
Austin, David WilliamORCID iD for Austin, David William orcid.org/0000-0002-1296-3555
Klein, Britt
Pier, Ciaran
Schattner, Peter
Pierce, David
Wade, Victoria
Journal name Journal of medical internet research
Volume number 10
Issue number 2
Start page 14
End page 39
Total pages 26
Publisher Journal of Medical Internet Research
Place of publication Toronto, Canada
Publication date 2008
ISSN 1439-4456
1438-8871
Keyword(s) panic disorder
anxiety
Internet
mental health
general practice
cognitive behavioral therapy
email
Summary Background: Mental illness is an escalating concern worldwide. The management of disorders such as anxiety and depression largely falls to family doctors or general practitioners (GPs). However, GPs are often too time constrained and may lack the necessary training to adequately manage the needs of such patients. Evidence-based Internet interventions represent a potentially valuable resource to reduce the burden of care and the cost of managing mental health disorders within primary care settings and, at the same time, improve patient outcomes.
Objective: The present study sought to extend the efficacy of a therapist-assisted Internet treatment program for panic disorder, Panic Online, by determining whether comparable outcomes could be achieved and maintained when Panic Online was supported by either GPs or psychologists.
Methods: Via a natural groups design, 96 people with a primary diagnosis of panic disorder (with or without agoraphobia) completed the Panic Online program over 12 weeks with the therapeutic assistance of their GP (n = 53), who had received specialist training in cognitive behavioral therapy, or a clinical psychologist (n = 43). Participants completed a clinical diagnostic telephone interview, conducted by a psychologist, and a set of online questionnaires to assess panic-related symptoms at three time periods (pretreatment, posttreatment, and 6 month follow-up).
Results: Both treatments led to clinically significant improvements on measures of panic and panic-related symptomatology from pretreatment to posttreatment. Both groups were shown to significantly improve over time. Improvements for both groups were maintained at follow-up; however, the groups did differ significantly on two quality of life domains: physical (F1,82 = 9.13, P = .00) and environmental (F1,82 = 4.41, P = .04). The attrition rate was significantly higher among those being treated by their GP (χ21 = 4.40, P = .02, N = 96).
Conclusions: This study provides evidence that Internet-based interventions are an effective adjunct to existing mental health care systems. Consequently, this may facilitate and enhance the delivery of evidence-based mental health treatments to increasingly large segments of the population via primary care systems and through suitably trained health professionals.
Language eng
DOI 10.2196/jmir.1033
Field of Research 170106 Health
Socio Economic Objective 920209 Mental Health Services
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2008, Journal of Medical Internet Research
Persistent URL http://hdl.handle.net/10536/DRO/DU:30017773

Document type: Journal Article
Collection: School of Psychology
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Created: Fri, 14 Aug 2009, 13:57:01 EST

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