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

Abstract

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.

Keywords: anxiety; cognitive behaviour therapy; computerised cognitive behaviour therapy; natural disaster; technology in psychotherapy research & training.