In a new study, researchers compared two ways of delivering cognitive behavioral therapy, CBT, to treat people with health anxiety, a condition that may increase in the wake of COVID-19.
Out of about 200 study participants, half received CBT over the internet, and half were treated with conventional face-to-face CBT.
The results show that internet-delivered treatment had comparable effects, and could serve as an alternative to physical meetings in helping people who are worried about their health.
The research was conducted by a team at Karolinska Institutet in Sweden.
Health anxiety also referred to as hypochondriasis, is characterized by excessive and persistent fear or worry about serious illness.
It often leads to big suffering and functional impairment. About 3.5% of the general population and up to 20% of patients in medical clinics are estimated to suffer from the condition, which causes great strain on the health care system.
In face-to-face CBT, which typically involves weekly sessions with a mental health clinician, about two-thirds of patients respond to treatment.
However, given the prevalence of health anxiety and the scarcity of mental health professionals, the need for treatment far exceeds the availability of evidence-based face-to-face therapy.
The researchers, therefore, wanted to examine the effect of an internet-based treatment where the patient has access to information online and communicates regularly with a therapist through an email-like system.
The patient also engages in behavioral changes in their day-to-day life, just as in the case of face-to-face CBT.
In the study, 204 adults with health anxiety were randomized to receive either face-to-face or internet CBT for a period of 12 weeks.
The participants were asked to rate their level of health anxiety each week using a standardized questionnaire commonly referred to as the Health Anxiety Inventory.
According to the researchers, internet CBT had effects largely on par with face-to-face treatment.
This was despite the fact that the average internet-therapist spent only 10 minutes per patient per week compared with about 45 minutes in the other group.
One significant advantage is that the therapist can help more patients at the same time, but also that the treatment can be delivered regardless of the patient’s geographical location, including people living in rural areas.
The fact that people can access the content and communicate with their therapists at any time of the day also means that people who struggle to take time off from work can take part in treatment.
Another positive aspect of online CBT is that patients who are reluctant to seek psychological treatment due to perceived stigma may be more inclined to seek help.
One author of the study is Erik Hedman-Lagerlöf, a professor of psychology and researcher at the Department of Clinical Neuroscience, Karolinska Institutet.
The study is published in JAMA Psychiatry.
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