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The Emerging Role of Technology in Cognitive–Behavioral Therapy for Anxious Youth: A Review

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Abstract

Research documents the application of cognitive–behavioral therapy (CBT) with technology either as therapeutic adjuncts or stand-alone interventions. The literature evaluating the feasibility and efficacy of using technology with CBT for youth experiencing internalizing disorders is small though steadily emerging. Technological approaches offer cost-effective and efficient service to an increased number of anxious youth for whom a CBT treatment would be otherwise unavailable. The present article aims to review the use of two broad types of technology in CBT for anxious children and adolescents: computer- and internet-based CBT and mobile mental health applications (i.e., mobile phone, smartphone, and tablet technology). Within each section, we provide an overview of the advantages and general principles of each type of technology, and review evidence for the use of each type of technology along with examples of current applications. Finally, we discuss ethical issues, barriers, and future directions for the use of technology in facilitating dissemination of effective treatments.

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References

  • Aguilera, A., & Muench, F. (2012). There’s an App for that: Information technology applications for cognitive–behavioral practice. The Behavior Therapist, 35(4), 65–72.

    Google Scholar 

  • Aguilera, A., & Muñoz, R. F. (2011). Text messaging as an adjunct to CBT in low-income populations: A usability and feasibility pilot study. Professional Psychology: Research and Practice, 42, 472–478. doi:10.1037/a0025499.

    Google Scholar 

  • American Psychological Association. (2003). Ethical principles of psychologists and code of conduct. Retrieved on 13 Aug 2013 from http://www.apa.org/ethics/code/principles.pdf.

  • Anderson, P. L., Zimand, E., Hodges, L. F., & Rothbaum, B. O. (2005). Cognitive behavioral therapy for public-speaking anxiety using virtual reality for exposure. Depression and Anxiety, 22(3), 156–158. doi:10.1002/da.20090.

    Article  PubMed  Google Scholar 

  • Andrews, G., Cuijpers, P., Craske, M. G., McEvoy, P., & Titov, N. (2010). Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: A meta-analysis. PLoS ONE, 5(10), e13196. doi:10.1371/journal.pone.0013196.

    Article  PubMed Central  PubMed  Google Scholar 

  • Association of Behavioral and Cognitive Therapies. (2013). About psychological treatment: What to expect from Cognitive Behavioral Therapies. Retrieved on 13 Aug 2013 from http://www.abct.org/Public/?m=mPublic&fa=CBT_Treatment.

  • Boschen, M. J. (2009a). Mobile telephones and psychotherapy: I capability and applicability. The Behavior Therapist, 32, 168–175.

    Google Scholar 

  • Boschen, M. J. (2009b). Mobile telephones and psychotherapy: II. A review of empirical research. The Behavior Therapist, 32, 175–181.

    Google Scholar 

  • Bouchard, S., Payeur, R., Rivard, V., Allard, M., Paquin, B., Renaud, P., et al. (2000). Cognitive behavior therapy for panic disorder with agoraphobia in videoconference: Preliminary results. Cyberpsychology, Behavior, and Social Networking, 3(6), 999–1007.

    Article  Google Scholar 

  • Cartwright-Hatton, S., Roberts, C., Chitsabesan, P., Fothergill, C., & Harrington, R. (2004). Systematic review of the efficacy of cognitive behavior therapies for childhood adolescent anxiety disorders. British Journal of Clinical Psychology, 43, 421–436.

    Article  PubMed  Google Scholar 

  • Chavira, D., Stein, M., Bailey, K., & Stein, M. (2005). Child anxiety in primary care: Prevalent but untreated. Depression and Anxiety, 20, 155–164. doi:10.1097/DBP.0b013e3181836a5b.

    Article  Google Scholar 

  • Craske, M. G., Rose, R. D., Lane, A., Shaw Welch, S., Campbell-Sills, L., Sullivan, G., et al. (2009). Computer-assisted delivery of cognitive behavioral therapy for anxiety disorders in primary-care settings. Depression and Anxiety, 26, 235–242. doi:10.1002/da.20542.

    Article  PubMed Central  PubMed  Google Scholar 

  • Cunningham, M. J., Rapee, R. M., & Lyneham, H. J. (2006). The cool teens CD-ROM: A self-help program for adolescents with anxiety. Youth Studies Australia, 25, 50–56.

    Google Scholar 

  • Cunningham, M. J., Wuthrich, V. M., Rapee, R. M., Lyneham, H. J., Schniering, C. A., & Hudson, J. L. (2009). The cool teens CD-ROM for anxiety disorders in adolescents: A pilot case series. European Child and Adolescent Psychiatry, 18(2), 125–129. doi:10.1007/s00787-008-0703-y.

    Article  PubMed  Google Scholar 

  • Elkins, R., McHugh, K., Santucci, L., & Barlow, D. (2011). Improving the transportability of CBT for internalizing disorders in children. Clinical Child and Family Psychology Review, 14, 161–173. doi:10.1007/s10567-011-0085-4.

    Article  PubMed  Google Scholar 

  • Essau, C., Conradt, J., & Petermann, F. (1999). Frequency and comorbidity of social phobia and social fears in adolescents. Behavior Research and Therapy, 37, 831–843.

    Article  Google Scholar 

  • Greist, J. H., Osgood-Hynes, D. J., Baer, L., & Marks, I. M. (2000). Technology-based advances in the management of depression: Focus on the COPE™ program. Disease Management and Health Outcomes, 7, 193–200.

    Article  Google Scholar 

  • Heimberg, R. G., & Coles, M. E. (1999). Reflections on innovations in cognitive-behavioral treatments of anxiety disorders. Special series: Innovations in cognitive-behavioral treatments of anxiety disorders. Cognitive and Behavioral Practice, 6, 258–263.

    Google Scholar 

  • Jerome, L., & Zaylor, C. (2000). Cyberspace: Creating the therapeutic environment for telehealth applications. Professional Psychology: Research and Practice, 31, 478–483.

    Google Scholar 

  • Kaltenthaler, E., Parry, G., Beverley, C., & Ferriter, M. (2008). Computerised cognitive–behavioural therapy for depression: Systematic review. The British Journal of Psychiatry, 193, 181–184. doi:10.1192/bjp.bp.106.025981.

    Article  PubMed  Google Scholar 

  • Kazdin, A. (2011). Evidence-based treatment research: Advances, limitations, and next steps. American Psychologist, 66, 685–698.

    Article  PubMed  Google Scholar 

  • Kazdin, A. E., & Blase, S. L. (2011). Rebooting psychotherapy research and practice to reduce the burden of mental illness. Perspectives on Psychological Science, 6, 21–37. doi:10.1177/1745691610393527.

    Article  Google Scholar 

  • Kendall, P. C., Khanna, M., Edson, A., Cummings, C., & Harris, M. S. (2011). Computers and psychosocial treatment for child anxiety: Recent advances and ongoing efforts. Depression and Anxiety, 28, 58–66. doi:10.1002/da.20757.

    Article  PubMed  Google Scholar 

  • Khanna, M. S., & Kendall, P. C. (2008). Computer assisted CBT for child anxiety: Development of the coping cat CD Rom. Cognitive Behavioral Practice, 15, 159–165.

    Article  Google Scholar 

  • Khanna, M. S., & Kendall, P. C. (2010). Computer-assisted cognitive–behavioral therapy for child anxiety: Results of a randomized clinical trial. Journal of Consulting and Clinical Psychology, 78(5), 737–745. doi:10.1037/a0019739.

    Article  PubMed  Google Scholar 

  • Koocher, G. P., & Morray, E. (2000). Regulation of telepsychology: A survey of state attorneys general. Professional Psychology: Research and Practice, 31(5), 503–508. doi:10.1037/0735-7028.31.5.503.

    Google Scholar 

  • Laszlo, J. V., Esterman, G., & Zabko, S. (1999). Therapy over the internet? Theory, research and finances. Cyber Psychology and Behavior, 2, 293–307.

    Article  Google Scholar 

  • Lenhart, A., Ling, R., Campbell, S., & Purcell, K. (2010). Teens and mobile phones. Pew Internet & American Life Project. Retrieved on 13 Aug 2013 from http://www.pewInternet.org/Reports/2010/Teens-and-Mobile-Phones.aspx.

  • Luxton, D., McCann, R., Bush, N., Mishkind, M., & Reger, G. (2011). mHealth for mental health: Integrating smartphone technology in behavioral healthcare. Professional Psychology Research and Practice, 42, 502–512.

    Article  Google Scholar 

  • Ly, K., Carlbring, P., & Andersson, G. (2012). Behavioral activation-based guided self-help treatment administered through a smartphone application: Study protocol for a randomized controlled trial. Trials, 13, 62–68. doi:10.1186/1745-6215-13-62.

    Article  PubMed Central  PubMed  Google Scholar 

  • Madden, M., Lenhart, A., Duggan, M., Cortesi, S., & Gasser, U. (2013). Teens and technology, 2013. Pew Internet & American Life Project. Retrieved on 2 Aug 2013 from http://www.pewInternet.org/Reports/2013/Teens-and-Tech/Summary-of-Findings.aspx.

  • Maheu, M. M., & Gordon, B. L. (2000). Counseling and therapy on the internet. Professional Psychology: Research and Practice, 31(5), 484–489. doi:10.1037/a0029458.

    Google Scholar 

  • March, S., Spence, S. H., & Donovan, C. L. (2009). The efficacy of an internet-based cognitive behavioral therapy intervention for child anxiety disorders. Journal of Pediatric Psychology, 34, 474–487. doi:10.1093/jpepsy/jsn099.

    Article  PubMed  Google Scholar 

  • Merikingas, K., He, J. P., Brody, D., Fisher, P., Bourdon, K., & Koretz, D. (2010). Prevalence and treatment of mental disorders in the 2001–2004 NHANES. Pediatrics, 125, 75–81.

    Article  Google Scholar 

  • Michie, S., Abraham, C., Whittington, C., McAteer, J., & Gupta, S. (2009). Effective techniques in healthy eating and physical activity interventions: A meta-regression. Health Psychology, 28, 690–701. doi:10.1037/a0016136.

    Article  PubMed  Google Scholar 

  • Morris, M. E., Kathawala, Q., Leen, T. K., Gorenstein, E. E., Guilak, F., Labhard, M., et al. (2010). Mobile therapy: Case study evaluations of a cell phone application for emotional self-awareness. Journal of Medical Internet Research, 12, e10. doi:10.2196/jmir.1371.

    Article  PubMed Central  PubMed  Google Scholar 

  • Newman, M. G., Kenardy, J., Herman, S., & Taylor, C. B. (1997). Comparison of palmtop-computer-assisted brief cognitive–behavioral treatment to cognitive–behavioral treatment for panic disorder. Journal of Consulting and Clinical Psychology, 65(1), 178–183. doi:10.1037/0022-006X.65.1.178.

    Article  PubMed  Google Scholar 

  • Nickelson, D. W. (1996). Behavioral telehealth: Emerging practice, research and policy opportunities. Behavioral Sciences and the Law, 14, 443–457. doi:10.1002/(SICI)1099-0798.

    Article  Google Scholar 

  • Ollendick, T., & King, N. (1998). Empirically supported treatments for children with phobic and anxiety disorders: Current status. Journal of Clinical Child Psychology, 27(2), 156–167.

    Article  PubMed  Google Scholar 

  • Proudfoot, J., Parker, G., Pavlovic, D. H., Manicavasagar, V., Adler, E., & Whitton, A. (2010). Community attitudes to the appropriation of mobile phones for monitoring and managing depression, anxiety, and stress. Journal of Medical Internet Research, 12(5), e64. doi:10.2196/jmir.1475.

    Article  PubMed Central  PubMed  Google Scholar 

  • Proudfoot, J., Ryden, C., Everitt, B., Shapiro, D. A., Goldberg, D., Mann, A., et al. (2004). Clinical efficacy of computerised cognitive–behavioural therapy for anxiety and depression in primary care: Randomized controlled trial. British Journal of Psychiatry, 185, 46–54. doi:10.1192/bjp.185.1.46.

    Article  PubMed  Google Scholar 

  • Riley, W. T., Rivera, D. E., Atienza, A. A., Nilsen, W., Allison, S. M., & Mermelstein, R. (2011). Health behavior models in the age of mobile interventions: Are our theories up to the task? Translational Behavioral Medicine, 1, 53–71. doi:10.1007/s13142-011-0021-7.

    Article  PubMed Central  PubMed  Google Scholar 

  • Shiffman, S., Stone, A. A., & Hufford, M. R. (2008). Ecological momentary assessment. Annual Review of Clinical Psychology, 4, 1–32. doi:10.1146/annurev.clinpsy.3.022806.091415.

    Article  PubMed  Google Scholar 

  • Smith, S. G., Rothbaum, B. O., & Hodges, L. (1999). Treatment of fear of flying using virtual reality exposure therapy: A single case study. The Behavior Therapist, 22, 154–158, 160.

    Google Scholar 

  • Spek, V., Cuijpers, P., Nyklíček, I., Riper, H., Keyzer, J., & Pop, V. (2007). Internet-based cognitive behavior therapy for mood and anxiety disorders: A meta-analysis. Psychological Medicine, 37, 319–328. doi:10.1017/S0033291706008944.

    Article  PubMed  Google Scholar 

  • Spence, S. H., Donovan, C. L., March, S., Gamble, A., Anderson, R., Prosser, S., et al. (2008). Online CBT in the treatment of child and adolescent anxiety disorders: Issues in the development of BRAVE-ONLINE and two case illustrations. Behavioural and Cognitive Psychotherapy, 36(4), 411–430.

    Article  Google Scholar 

  • Spence, S. H., Donovan, C. L., March, S., Gamble, A., Anderson, R., Prosser, S., et al. (2011). A randomized controlled trial of online versus clinic-based CBT for adolescent anxiety. Journal of Consulting and Clinical Psychology, 79, 629–642. doi:10.1037/a0024512.

    Article  PubMed  Google Scholar 

  • Spence, S. H., Holmes, J. M., March, S., & Lipp, O. V. (2006). The feasibility and outcome of clinic plus Internet delivery of cognitive–behavior therapy for childhood anxiety. Journal of Consulting and Clinical Psychology, 74(3), 614–621. doi:10.1037/0022-006X.74.3.614.

    Article  PubMed  Google Scholar 

  • Stallard, P., Richardson, T., & Velleman, S. (2010). Clinicians’ attitudes towards the use of computerized cognitive behaviour therapy (cCBT) with children and adolescents. Behavioural and Cognitive Psychotherapy, 38(5), 545–560. doi:10.1017/S135246581000086X.

    Article  PubMed  Google Scholar 

  • Subrahmanyam, K., & Lin, G. (2007). Adolescents on the net: Internet use and well-being. Adolescence, 42(168), 659–667.

    PubMed  Google Scholar 

  • VandenBos, G. R., & Williams, S. (2000). The internet versus the telephone: What is tele-health, anyway? Professional Psychology: Research and Practice, 31, 490–492.

    Google Scholar 

  • Wuthrich, V. W., Rapee, R. M., Cunningham, M. J., Lyneham, H. J., Hudson, J. L., & Schniering, C. (2012). A randomized controlled trial of the cool teens CD-ROM computerized program for adolescent anxiety. Journal of the Academy of Child and Adolescent Psychiatry, 51, 261–270. doi:10.1016/j.jaac.2011.12.002.

    Article  Google Scholar 

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Authors and Affiliations

  1. Early Life Stress and Pediatric Anxiety Program, Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, 401 Quarry Rd., Stanford, CA, 94305, USA

    Rebecca Rialon Berry

  2. School of Public Health, Georgia State University, Atlanta, GA, USA

    Betty Lai

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  1. Rebecca Rialon Berry
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  2. Betty Lai
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Correspondence to Rebecca Rialon Berry.

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Berry, R.R., Lai, B. The Emerging Role of Technology in Cognitive–Behavioral Therapy for Anxious Youth: A Review. J Rat-Emo Cognitive-Behav Ther 32, 57–66 (2014). https://doi.org/10.1007/s10942-014-0184-5

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