Cognitive behaviour therapy via the internet effective treatment according to new study

A new study from Karolinska Institutet shows that exposure-based cognitive behaviour therapy via the internet is a more effective treatment for health anxiety than an active psychological treatment with relaxation and stress management. The results are presented in the British Journal of Psychiatry.

Health anxiety involves a strong, persistent and excessive fear of succumbing to serious illness. The condition can cause great suffering to the patient and often occurs among patients within primary care. A previous study showed that health anxiety can be treated with what is known as exposure-based cognitive behaviour therapy via the Internet, where the patient gradually exposes themselves to situations that may trigger health anxiety.

For the first time, researchers at the Department of Clinical Neuroscience at Karolinska Institutet have now compared the exposure-based Internet treatment with active psychological treatment based on relaxation and stress management. Both treatments were 12 weeks long and the 158 participants took part in the treatment via the Internet and had access to therapists primarily via e-mail.

Results show that the participants judged the treatments to be equally credible. Both the treatments clearly reduced the patients' health anxiety, but the exposure-based treatment reduced health anxiety to a greater extent than the treatment based on relaxation and stress management.

The results imply a new understanding of what is important in the treatment of health anxiety. The study also has clinical significance as Internet-based therapy can increase access to evidence-based psychological treatment for health anxiety.

“More people can be treated since the treatment time per patient is significantly lower than for traditional treatment. Internet treatment is independent of physical distance and, in time, this means that treatment can be administered to people who live in rural areas or in places where there is no outpatient psychiatry with access to psychologists with CBT expertise,” says PhD and licensed psychologist Erik Hedman, who led the study.

The study has been financed with funds from ALF and from Karolinska Institutet.

Publication

Internet-delivered exposure-based cognitive-behavioural therapy and behavioural stress management for severe health anxiety: randomised controlled trial
Erik Hedman, Erland Axelsson, Anders Görling, Carina Ritzman, Markus Ronnheden, Samir El Alaoui, Erik Andersson, Mats Lekander and Brjánn Ljótsson
British Journal of Psychiatry, online ahead of print August 7, 2014, doi:10.1192/bjp.bp.113.140913