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A comparison of internet-based versus face-to-face cognitive behavioral therapy
Saul, Jay E. A comparison of internet-based versus face-to-face cognitive behavioral therapy for snake phobia. [Dissertation Abstract] Dissertation Abstracts International: Section B: The Sciences and Engineering. Vol 67(10-B), 2007, pp. 6077.
Year of Publication 2007 Technology-based interventions have been shown to be effective with a wide range of health problems. However, many of these treatments have yet to be tested against traditional techniques. The purpose of this study was to examine how treatment over the internet compared to treatment in a traditional setting for snake phobics. Forty-five individuals unable to get within 10 feet of a live corn snake were randomly assigned to an internet-based CBT condition, a face-to-face CBT condition, or a wait-list control condition. Each active treatment included identical components of psychoeducation, cognitive restructuring, hierarchy creation, imaginal exposure, and relapse prevention. The difference between the active treatments was in method of treatment delivery. Individuals in the internet condition participated through synchronous chat programs while face-to-face sessions took place in a mental health clinic. It was hypothesized that those in active treatment conditions would improve over time, unlike individuals in the wait-list control group. It was also expected that the two CBT groups would not differ at any assessment point. The dependent measures used were a Behavioral Avoidance Test (BAT) and a Subjective Units of Distress score (SUDS) taken immediately after the BAT. A Repeated Measures Analysis of Variance (ANOVA) revealed significant improvements on the BAT by individuals in all three conditions. However, those in the CBT conditions were able to get significantly closer to the snake than those in the control condition at both post-treatment and follow-up. While there was a significant main effect for time on the SUDS scores, there were no significant treatment differences. Participants in the internet-based CBT and wait-list control groups improved their SUDS scores significantly from pre-treatment through follow-up. While the face-to-face CBT group did not improve on the SUDS over time, there were no significant differences between the conditions at any of the assessment points. Because the CBT conditions did not differ at any point on either of the dependent measures, the delivery methods appear to have equal efficacy. This supports the belief that a cognitive-behavioral treatment approach is effective regardless of whether it is conducted with individuals in an office or online. (PsycINFO Database Record (c) 2008 APA, all rights reserved) |