A pilot study of self-guided internet-delivered cognitive behavioural therapy for anxiety and depression among Arabs

Abstract

This pilot study examined the efficacy and acceptability of a self-guided and culturally modified internet-delivered Cognitive Behaviour Therapy (iCBT) treatment for Arab people, aged 18 and over, with symptoms of depression and anxiety. Thirty-six participants from seven countries, with at least mild symptoms of depression (Patient Health Questionnaire 9-item; PHQ-9; total scores ≥ 5) or anxiety (Generalised Anxiety Disorder 7-item; GAD-7; total scores ≥ 5) accessed the online Arabic Wellbeing Course, which consisted of five online lessons delivered over eight weeks and presented in the English language. Standard measures of depression, anxiety, distress and disability were administered at pre-treatment, post-treatment and 3-month follow-up. Thirty-six percent of participants completed the five lessons over eight weeks, with 61% and 36% providing post-treatment and 3-month follow-up data respectively. Participants reported significant improvements (within-group Cohen's d; avg. reduction) in depression (ds ≥ 1.20; avg. reduction ≥ 46%), anxiety (ds ≥ 1.15; avg. reduction ≥ 45%), disability (ds ≥ 0.81; avg. reduction ≥ 35%) and psychological distress (ds ≥ 0.91; avg. reduction ≥ 24%) immediately post-treatment, which were sustained at or further improved to 3-month follow-up. Participants rated the Arabic Wellbeing Course as acceptable. Notwithstanding the absence of a control group, low follow-up questionnaire completion rates and the Course not being translated in Arabic, these results are encouraging and contribute to a growing body of literature indicating that, with minor modifications, internet-delivered interventions have the potential of increasing access to treatment for immigrant groups.

Keywords: Anxiety; Arabs; Depression; Internet-delivered treatment; Transdiagnostic.

Fig. 1

Participant flow.