Efficacy of Online CBT for GAD Compared to Pharmaceutical Interventions
Generalized Anxiety Disorder
About this trial
This is an interventional treatment trial for Generalized Anxiety Disorder focused on measuring Generalized Anxiety Disorder, Online Psychotherapy, Cognitive Behavioural Therapy
Eligibility Criteria
Inclusion Criteria:
- 18 years of age or older
- Have consistent and reliable access to the internet
- Be diagnosed with GAD according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V) by a clinician
- Meet the criteria for GAD according to the GAD-7 Screener (GAD-7)
- Be competent to consent to participate
- Speak and read English
Exclusion Criteria:
- Patients will be deemed ineligible for participation in the study if they are in acute distress.
Sites / Locations
- Hotel Dieu Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Experimental
e-CBT
Pharmacotherapy
e-CBT + Pharmacotherapy
Weekly sessions of e-CBT through OPTT will consist of approximately 30 slides. Each session is expected to last approximately 50 minutes. The content and format of each weekly online session were designed to mirror live CBT. The slides will highlight a different topic each week and include general information, an overview of skills and homework on that topic. The homework included in each session will be submitted through OPTT and reviewed by the clinicians with personalized feedback provided by clinicians within three days of submission. Weekly homework submission for feedback will be mandatory before being eligible for the next session. Biweekly GAD-7, DASS-42 and Q-LES-SF questionnaires will be completed through OPTT. A second STAI will be completed in the final week of e-CBT treatment.
Biweekly meeting with psychiatrist with GAD-7, DASS-42 and Q-LES-SF. Pharmacotherapy class decided according to protocol developed in accordance with Canada's best practice guidelines for GAD treatment. At second appointment, medication will be maintained and optimized, regardless of response. At third appointment, optimized if partial response or switched according to protocol if no response. Partial response is improvement of 20% or more in GAD-7. If switched, 6-week protocol will recommence with new medication. At fourth appointment, dosage optimized if responding well to medication and improvement greater than 50% within primary arm, or 20% if secondary arm, patient will remain on said medication for remainder of 12-week study. If not improving more than 20%, medication switched according to protocol and 6-week protocol will recommence. If primary arm and 20-50% improvement after six weeks on new medication, augmented with olanzapine, risperidone or benzodiazepines.
Participants will commence both treatments described above simultaneously.