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Cuijpers pointed to the fact that anxiety disorders are highly prevalent, and are associated with a marked impairment in quality of life and a huge economic cost to society. In the Netherlands, for example, anxiety disorders account for the second highest disease burden after heart disease. This means that, as a group, anxiety disorders such as generalised anxiety disorder (GAD), social anxiety disorder (SAD) and obsessive-compulsive disorder (OCD) are more prevalent than depression in this country.
"Unfortunately, a considerable number of people who struggle with anxiety do not seek or receive adequate treatment. Self-help interventions have been proposed to constitute a relatively cheap, effective, efficient and low-threshold intervention," Cuijpers, who is head of the Department of Clinical Psychology at the university, noted.
How it works
A technique in which patients use an internet website to work through exercises and assignments aimed at treating their anxiety was proposed. Guidance by a professional counsellor, either face-to-face or via telephone or e-mail, can then be added to help the patient in making the most of this treatment process. If self help isn't effective, psychotherapy and medication could follow.
According to Cuijpers, a 2006 meta-analytic study of self-help interventions for anxiety disorders clearly indicated that guided self-help can be just as effective as individual and group treatment – with the added advantages that it requires less treatment time, briefer waiting lists, and no appointments with therapists.
Cuijpers said that guided self-help could be particularly useful in patients with milder disorders – particularly in those that wouldn't otherwise have seeked treatment. It has been shown that only 26.5% of people with mild anxiety disorders seek help and that 90% of people who suffer from anxiety disorders have a mild to moderate form of the condition.
"It's important to develop treatments that are easily available to many people. I think that internet interventions can help in this way."
The downsides
Cuijpers also pointed to the downsides. These include the fact that self-help through the internet won't be acceptable to all, that counsellors who communicate via the phone or e-mail won't be able to pick up subtle non-verbal and verbal signals, that the internet isn't accessible to all, and that it won't be an option for "technophobic" patients.
Research shows, however, that unguided self-help (in other words, where there isn't a facilitator) isn't as effective as individual or group treatment for anxiety disorders.
- (Carine van Rooyen, Health24, March 2008)
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