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Logo of bmcpsycBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Psychiatry
 
BMC Psychiatry. 2012; 12: 131.
Published online 2012 August 31. doi:  10.1186/1471-244X-12-131
PMCID: PMC3507751
Effectiveness and cost-effectiveness of web-based treatment for phobic outpatients on a waiting list for psychotherapy: protocol of a randomised controlled trial
Robin N Kok,corresponding author1 Annemieke van Straten,1 Aartjan Beekman,2 Judith Bosmans,3 Manja de Neef,4 and Pim Cuijpers1
1Department of Clinical Psychology and the EMGO institute for Health and Care Research, Faculty of Psychology and Education, VU University Amsterdam, Van der Boechorststraat 1, 1081, BT, Amsterdam, The Netherlands
2Department of Psychiatry and the EMGO institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007, MB, Amsterdam, The Netherlands
3Department of Health Sciences and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, 1081, HV, Amsterdam, The Netherlands
4Dutch Association of Cognitive Behaviour Therapy, Utrecht, The Netherlands
corresponding authorCorresponding author.
Robin N Kok: r.n.kok/at/vu.nl; Annemieke van Straten: a.van.straten/at/vu.nl; Aartjan Beekman: a.beekman/at/ggzingeest.nl; Judith Bosmans: j.e.bosmans/at/vu.nl; Manja de Neef: m_de_neef/at/hotmail.com; Pim Cuijpers: p.cuijpers/at/vu.nl
Received May 23, 2012; Accepted August 22, 2012.
Abstract
Background
Phobic disorders are highly prevalent and constitute a considerable burden for patients and society. As patients wait for face-to-face psychotherapy for phobic disorders in outpatient clinics, this time can be used for guided self-help interventions. The aim of this study is to investigate a five week internet-based guided self-help programme of exposure therapy in terms of clinical effectiveness and impact on speed of recovery in psychiatric outpatients, as well as the cost-effectiveness of this pre-treatment waiting list intervention.
Methods/design
A randomised controlled trial will be conducted among 244 Dutch adult patients recruited from waiting lists of outpatient clinics for face-to-face psychotherapy for phobic disorders. Patients suffering from at least one DSM-IV classified phobic disorder (social phobia, agoraphobia or specific phobia) are randomly allocated (at a 1:1 ratio) to either a five-week internet-based guided self-help program followed by face-to-face psychotherapy, or a control group followed by face-to-face psychotherapy. Waiting list status and duration are unchanged and actual need for further treatment is evaluated prior to face-to-face psychotherapy. Clinical and economic self-assessment measurements take place at baseline, post-test (five weeks after baseline) and at 3, 6, 9 and 12 months after baseline.
Discussion
Offering pre-treatment internet-based guided self-help efficiently uses time otherwise lost on a waiting list and may increase patient satisfaction. Patients are expected to need fewer face-to-face sessions, reducing total treatment cost and increasing speed of recovery. Internet-delivered treatment for phobias may be a valuable addition to psychotherapy as demand for outpatient treatment increases while budgets decrease.
Trial registration
Netherlands Trial Register NTR2233
Keywords: Phobias, Phobic disorders, Web-based intervention, Internet therapy, Randomised controlled trial, Cost-effectiveness, Outpatients
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