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Effectiveness and cost-effectiveness of web-based treatment for phobic outpatients on a waiting list for psychotherapy protocol of a randomised controlled trial.doc

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Effectiveness and cost-effectiveness of web-based treatment for phobic outpatients on a waiting list for psychotherapy protocol of a randomised controlled trial

Koketal.BMCPsychiatry2012,12:131 /1471-244X/12/131 STUDY PROTOCOL OpenAccess Effectivenessandcost-effectivenessofweb-based treatmentforphobicoutpatientsonawaitinglist forpsychotherapy:protocolofarandomised controlledtrial RobinNKok1*,AnnemiekevanStraten1,AartjanBeekman2,JudithBosmans3,ManjadeNeef4andPimCuijpers1 Abstract Background:Phobicdisordersarehighlyprevalentandconstituteaconsiderableburdenforpatientsandsociety. Aspatientswaitforface-to-facepsychotherapyforphobicdisordersinoutpatientclinics,thistimecanbeusedfor guidedself-helpinterventions.Theaimofthisstudyistoinvestigateafiveweekinternet-basedguidedself-help programmeofexposuretherapyintermsofclinicaleffectivenessandimpactonspeedofrecoveryinpsychiatric outpatients,aswellasthecost-effectivenessofthispre-treatmentwaitinglistintervention. Methods/design:Arandomisedcontrolledtrialwillbeconductedamong244Dutchadultpatientsrecruitedfrom waitinglistsofoutpatientclinicsforface-to-facepsychotherapyforphobicdisorders.Patientssufferingfromatleast oneDSM-IVclassifiedphobicdisorder(socialphobia,agoraphobiaorspecificphobia)arerandomlyallocated(ata 1:1ratio)toeitherafive-weekinternet-basedguidedself-helpprogramfollowedbyface-to-facepsychotherapy,or acontrolgroupfollowedbyface-to-facepsychotherapy.Waitingliststatusanddurationareunchangedandactual needforfurthertreatmentisevaluatedpriortoface-to-facepsychotherapy.Clinicalandeconomicself-assessment measurementstakeplaceatbaseline,post-test(fiveweeksafterbaseline)andat3,6,9and12monthsafter baseline. Discussion:Offeringpre-treatmentinternet-basedguidedself-helpefficientlyusestimeotherwiselostonawaiting listandmayincreasepatientsatisfaction.Patientsareexpectedtoneedfewerface-to-facesessions,reducingtotal treatmentcostandincreasingspeedofrecovery.Internet-deliveredtreatmentforphobiasmaybeavaluable additiontopsychotherapyasdemandforoutpatienttreatmentincreaseswhilebudgetsdecrease. Trialregistration:NetherlandsTrialRegisterNTR2233 Keywords:Phobias,Phobicdisorders,Web-basedintervent