Article Review: Treatment of Panic Disorder: Live Therapy VS. Self-Help Via the Internet

This article, Treatment of panic disorder: live therapy vs. self-help via the Internet Per Carlbring, Elisabeth Nilsson-Ihrfelt, Johan Waara, et al. Behaviour Research and Therapy, Volume 43, Issue 10 October 2005, pages 1321-1333, was based on a study which was performed to determine if there was a difference between treating panic disorder with ten weekly individual sessions with a cognitive behavior therapist and treating it with ten on-line modules through a self-help program. In order to select the group of participants, each person who expressed interest had to complete a computerized interview based on the Montgomery Asberg Depression Rating Scale as well as many other questions gathered from other panic disorder interview. Once the participants were narrowed down, they then conducted personal one on one interviews to cut the group down to 49 participants who were then randomly divided into the two groups.

The internet based group received all the manuals through e-mail and had access to a web page which contained all the information. After they completed one module, they then took a quiz and couldn't move on till they answered all the questions correctly. Homework assignments were sent to their therapist through e-mail and for each module, each participant also needed to post a message on a message board for others to view and respond to.

The participants who received live therapy went to sessions which were one on one with their therapist and lasting somewhere between 45 and 60 minutes each week for ten weeks. They received homework assignments in between sessions which were comprised of the same modules the internet based group were reading. Each session was tape recorded and the participants were urged to listen to it after their time with the therapist to ingrain what had been discussed.

Both groups were assessed on many different levels, everyone being measured through the same process for accurate comparison. The Agoraphobic Cognitions Questionnaire was used to assess cognition, physiological sensations were measured by the Body Sensations Questionnaire, agoraphobia was reassured with the mobility inventory, the Beck anxiety inventory was used to assess anxiety, the Beck depression inventory was used to measure levels of depression, and the patients quality of life were assessed by the quality of life inventory.

It was shown that the internet self-help groups could be just as effective as those sessions which were conducted one on one, as long as there was some e-mail contact with a therapist. One month after treatment it was measured that 80% of the internet group and 67% of the live group no longer met the requirements to be diagnosed with panic disorder. One year after the treatment was finished these numbers changed to 92% of the internet group and 88% of the live group no longer were classified with panic disorder.

I found this article to be interesting and informative, and it actually proved my hypothesis wrong. I had thought the participants who received the one on one therapy would have shown a higher success rate because they were dealing with a trained therapist in a one on one session where they could speak freely and receive feedback immediately. Looking at the results of this study, I do see some positive points of the internet based group compared to the live group such as the fact that they could move at their own pace and read the modules on their own time that fit into their schedule. It is also easier for some people to work on their own, having support only in the background, but not having to be face to face which could cause more anxiety than working through a computer screen.

I think this was a good study to perform and it now makes me wonder what other types of disorders could be effectively treated using online self-help programs. These programs could make it easier for people since they would work it into their schedule whenever they had the time and would also most likely be less expensive than one on one therapy.