The uptake and outcomes of Internet-based cognitive behavioural therapy for health anxiety symptoms during the COVID-19 pandemic

Maria J Sharrock; Alison E J Mahoney; Hila Haskelberg; Michael Millard; Jill M Newby

doi:10.1016/j.janxdis.2021.102494

The uptake and outcomes of Internet-based cognitive behavioural therapy for health anxiety symptoms during the COVID-19 pandemic

J Anxiety Disord. 2021 Dec:84:102494. doi: 10.1016/j.janxdis.2021.102494. Epub 2021 Oct 30.

Authors

Maria J Sharrock¹, Alison E J Mahoney², Hila Haskelberg³, Michael Millard⁴, Jill M Newby⁵

Affiliations

¹ Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales at St Vincent's Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales 2010, Australia. Electronic address: maria.sharrock@svha.org.au.
² Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales at St Vincent's Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales 2010, Australia; School of Psychiatry, University of New South Wales, Sydney, New South Wales 2052, Australia. Electronic address: alison.mahoney@svha.org.au.
³ Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales at St Vincent's Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales 2010, Australia. Electronic address: hila.haskelberg@svha.org.au.
⁴ Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales at St Vincent's Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales 2010, Australia; School of Psychiatry, University of New South Wales, Sydney, New South Wales 2052, Australia. Electronic address: michael.millard@svha.org.au.
⁵ School of Psychology, Faculty of Science, University of New South Wales, Sydney, New South Wales, 2052, Australia; Black Dog Institute, Hospital Road, Randwick, New South Wales 2031, Australia. Electronic address: j.newby@unsw.edu.au.

Abstract

Background: Internet cognitive behavioural therapy (iCBT) for health anxiety has demonstrated efficacy but has not been evaluated during the COVID-19 pandemic. This study presents the first evaluation of the uptake and outcomes of iCBT for health anxiety during the COVID-19 pandemic.

Methods: THIS WAY UP is an Australian digital mental health service which delivers iCBT interventions to community members. We compared the uptake of THIS WAY UP's iCBT course for health anxiety in an Australian adult sample who started the course before the pandemic (12th September 2019-11 th March 2020) to during the pandemic (12th March to 11th June 2020). The course was accessible to Australian adults over 18 years old, with no inclusion criteria. Outcomes included course registrations and commencements, lesson and course completion, and self-reported health anxiety (Short Health Anxiety Inventory), depression (Patient Health Questionnaire 9-item) and distress (Kessler-10).

Results: From March to June 2020, we observed significant increases in course registrations (N = 238 vs N = 1057); and course commencements (N = 126 vs. N = 778). Large, significant improvements in health anxiety (g = 0.89), and distress (K10: g = 0.91), and medium improvements in depression (g = 0.55) were found. Course completion during COVID was 30.5%.

Conclusions: iCBT improved health anxiety during the COVID-19 pandemic, and provides scalable intervention that can address increased demands for mental health services in the community.

Keywords: COVID-19; Effectiveness; Health anxiety; Internet intervention; iCBT.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Anxiety / therapy
Australia
COVID-19*
Cognitive Behavioral Therapy*
Humans
Internet
Pandemics
SARS-CoV-2
Treatment Outcome