Skip to main content

Treatment of Anxiety Disorders in the Digital Age

  • Chapter
  • First Online:
Clinical Handbook of Anxiety Disorders

Part of the book series: Current Clinical Psychiatry ((CCPSY))

Abstract

Anxiety disorders are highly pervasive and debilitating. Despite the prevalence of these disorders, many people with anxiety disorders are unable to access care, and even fewer have access to evidence-based treatments. Online (or Internet-mediated) interventions may be effective in reducing barriers to care for people with anxiety. Internet-mediated mental health interventions have become increasingly utilized and studied in parallel with advancements in technology. With foundations in evidence-based therapy methods, such treatments have been adapted for a variety of disorders, including anxiety disorders. Results from a variety of studies suggest promising but mixed findings on feasibility, efficacy, and treatment engagement. There remain several important challenges to and considerations for the use of digital tools to treat anxiety disorders, including treatment dropout, negative attitudes toward Internet-mediated technologies, low technological literacy, and lack of access to technology.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Kessler RC, Petukhova M, Sampson NA, Zaslavsky AM, Wittchen H-U. Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. Int J Methods Psychiatr Res. 2012;21:169–84.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Wang PS, Lane M, Olfson M, Pincus HA, Wells KB, Kessler RC. Twelve-month use of mental health services in the United States: results from the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:629–40.

    Article  PubMed  Google Scholar 

  3. Young AS, Klap R, Sherbourne CD, Wells KB. The quality of care for depressive and anxiety disorders in the United States. Arch Gen Psychiatry. 2001;58:55–61.

    Article  CAS  PubMed  Google Scholar 

  4. Essau CA. Frequency and patterns of mental health services utilization among adolescents with anxiety and depressive disorders. Depress Anxiety. 2005;22:130–7.

    Article  PubMed  Google Scholar 

  5. Chartier-Otis M, Perreault M, Bélanger C. Determinants of barriers to treatment for anxiety disorders. Psychiatry Q. 2010;81:127–38.

    Article  Google Scholar 

  6. Coles ME, Coleman SL. Barriers to treatment seeking for anxiety disorders: initial data on the role of mental health literacy. Depress Anxiety. 2010;27:63–71.

    Article  PubMed  Google Scholar 

  7. Goetter EM, Frumkin MR, Palitz SA, Swee MB, Baker AW, Bui E, Simon NM. Barriers to mental health treatment among individuals with social anxiety disorder and generalized anxiety disorder. Psychol Serv. 2018; https://doi.org/10.1037/ser0000254.

  8. Lambert JD, Greaves CJ, Farrand P, Price L, Haase AM, Taylor AH. Web-based intervention using behavioral activation and physical activity for adults with depression (the eMotion study): pilot randomized controlled trial. J Med Internet Res. 2018;20:e10112.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Fletcher K, Foley F, Thomas N, et al. Web-based intervention to improve quality of life in late stage bipolar disorder (ORBIT): randomised controlled trial protocol. BMC Psychiatry. 2018;18:221.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Bell IH, Fielding-Smith SF, Hayward M, Rossell SL, Lim MH, Farhall J, Thomas N. Smartphone-based ecological momentary assessment and intervention in a blended coping-focused therapy for distressing voices: development and case illustration. Internet Interv. 2018;14:18–25.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Bucci S, Barrowclough C, Ainsworth J, Machin M, Morris R, Berry K, Emsley R, Lewis S, Edge D, Buchan I. Actissist: proof-of-concept trial of a theory-driven digital intervention for psychosis. Schizophr Bull. 2018;44(5):1070–80. https://doi.org/10.1093/schbul/sby032.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Garcia-Palacios A, Botella C, Hoffman H, Fabregat S. Comparing acceptance and refusal rates of virtual reality exposure vs. in vivo exposure by patients with specific phobias. Cyberpsychol Behav. 2007;10:722–4.

    Article  CAS  PubMed  Google Scholar 

  13. Wallin E, Maathz P, Parling T, Hursti T. Self-stigma and the intention to seek psychological help online compared to face-to-face. J Clin Psychol. 2018;74:1207–18.

    Article  PubMed  Google Scholar 

  14. Darkins AW, Cary MA. Telemedicine and telehealth: principles, policies, performances and pitfalls. New York: Springer; 2000.

    Google Scholar 

  15. Gros DF, Morland LA, Greene CJ, Acierno R, Strachan M, Egede LE, Tuerk PW, Myrick H, Frueh BC. Delivery of evidence-based psychotherapy via video telehealth. J Psychopathol Behav Assess. 2013;35:506–21.

    Article  Google Scholar 

  16. Lovell K, Fullalove L, Garvey R, Brooker C. Telephone treatment of obsessive-compulsive disorder. Behav Cogn Psychother. 2000;28:87–91.

    Article  Google Scholar 

  17. Krijn M, Emmelkamp PMG, Olafsson RP, Biemond R. Virtual reality exposure therapy of anxiety disorders: a review. Clin Psychol Rev. 2004;24:259–81.

    Article  CAS  PubMed  Google Scholar 

  18. Andrews G, Cuijpers P, Craske MG, McEvoy P, Titov N. Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: a meta-analysis. PLoS ONE. 2010;5:e13196. https://doi.org/10.1371/journal.pone.0013196.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Firth J, Torous J, Carney R, Newby J, Cosco TD, Christensen H, Sarris J. Digital Technologies in the Treatment of anxiety: recent innovations and future directions. Curr Psychiatry Rep. 2018;20:44.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Titov N, Dear BF, Staples LG, et al. MindSpot clinic: an accessible, efficient, and effective online treatment service for anxiety and depression. Psychiatr Serv. 2015;66:1043–50.

    Article  PubMed  Google Scholar 

  21. Klein B, Meyer D, Austin DW, Kyrios M. Anxiety online—a virtual clinic: preliminary outcomes following completion of five fully automated treatment programs for anxiety disorders and symptoms. J Med Internet Res. 2011;13:e89. https://doi.org/10.2196/jmir.1918.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Kaltenthaler E, Sutcliffe P, Parry G, Beverley C, Rees A, Ferriter M. The acceptability to patients of computerized cognitive behaviour therapy for depression: a systematic review. Psychol Med. 2008;38:1521–30.

    Article  CAS  PubMed  Google Scholar 

  23. Davies EB, Morriss R, Glazebrook C. Computer-delivered and web-based interventions to improve depression, anxiety, and psychological well-being of university students: a systematic review and meta-analysis. J Med Internet Res. 2014;16:e130.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Mathiasen K, Riper H, Andersen TE, Roessler KK. Guided internet-based cognitive behavioral therapy for adult depression and anxiety in routine secondary care: observational study. J Med Internet Res. 2018;20:e10927.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Carlbring P, Maurin L, Törngren C, Linna E, Eriksson T, Sparthan E, Strååt M, Marquez von Hage C, Bergman-Nordgren L, Andersson G. Individually-tailored, internet-based treatment for anxiety disorders: a randomized controlled trial. Behav Res Ther. 2011;49:18–24.

    Article  PubMed  Google Scholar 

  26. Titov N, Andrews G, Schwencke G, Robinson E, Peters L, Spence J. Randomized controlled trial of internet cognitive Behavioural treatment for social phobia with and without motivational enhancement strategies. Aust N Z J Psychiatry. 2010;44:938–45.

    Article  PubMed  Google Scholar 

  27. Hoffmann D, Rask CU, Hedman-Lagerlöf E, Ljótsson B, Frostholm L. Development and feasibility testing of internet-delivered acceptance and commitment therapy for severe health anxiety: pilot study. JMIR Ment Health. 2018;5:e28.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Viskovich S, Pakenham KI. Pilot evaluation of a web-based acceptance and commitment therapy program to promote mental health skills in university students. J Clin Psychol. 2018;74:2047. https://doi.org/10.1002/jclp.22656.

    Article  PubMed  Google Scholar 

  29. Boettcher J, Åström V, Påhlsson D, Schenström O, Andersson G, Carlbring P. Internet-based mindfulness treatment for anxiety disorders: a randomized controlled trial. Behav Ther. 2014;45:241–53.

    Article  PubMed  Google Scholar 

  30. Benton SA, Heesacker M, Snowden SJ, Lee G. Therapist-assisted, online (TAO) intervention for anxiety in college students: TAO outperformed treatment as usual. Prof Psychol Res Pract. 2016;47:363–71.

    Article  Google Scholar 

  31. Tulbure BT, Rusu A, Sava FA, Sălăgean N, Farchione TJ. A web-based transdiagnostic intervention for affective and mood disorders: randomized controlled trial. JMIR Ment Health. 2018;5:e36.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Dear BF, Titov N, Schwencke G, Andrews G, Johnston L, Craske MG, McEvoy P. An open trial of a brief transdiagnostic internet treatment for anxiety and depression. Behav Res Ther. 2011;49:830–7.

    Article  PubMed  Google Scholar 

  33. Spence SH, Donovan CL, March S, Kenardy JA, Hearn CS. Generic versus disorder specific cognitive behavior therapy for social anxiety disorder in youth: a randomized controlled trial using internet delivery. Behav Res Ther. 2017;90:41–57.

    Article  PubMed  Google Scholar 

  34. Berger T, Urech A, Krieger T, Stolz T, Schulz A, Vincent A, Moser CT, Moritz S, Meyer B. Effects of a transdiagnostic unguided internet intervention (‘velibra’) for anxiety disorders in primary care: results of a randomized controlled trial. Psychol Med Camb. 2017;47:67–80.

    Article  CAS  Google Scholar 

  35. Durland L, Interian A, Pretzer-Aboff I, Dobkin RD. Effect of telehealth-to-home interventions on quality of life for individuals with depressive and anxiety disorders. Smart Homecare Technol TeleHealth. 2014;2:105–19.

    Google Scholar 

  36. Whitten P, Buis L. Private payer reimbursement for telemedicine services in the United States. Telemed J E Health. 2007;13:15–24.

    Article  PubMed  Google Scholar 

  37. Bouchard S, Payeur R, Rivard V, Allard M, Paquin B, Renaud P, Goyer L. Cognitive behavior therapy for panic disorder with agoraphobia in videoconference: preliminary results. Cyberpsychol Behav. 2000;3:999–1007.

    Article  Google Scholar 

  38. Bouchard S, Paquin B, Payeur R, Allard M, Rivard V, Fournier T, Renaud P, Lapierre J. Delivering cognitive-behavior therapy for panic disorder with agoraphobia in videoconference. Telemed J E Health. 2004;10:13–25.

    Article  PubMed  Google Scholar 

  39. Yuen EK, Herbert JD, Forman EM, Goetter EM, Juarascio AS, Rabin S, Goodwin C, Bouchard S. Acceptance based behavior therapy for social anxiety disorder through videoconferencing. J Anxiety Disord. 2013;27:389–97.

    Article  PubMed  Google Scholar 

  40. Yuen E, Goetter EM, Stasio M, Mansour B, Forte S, Zulaica K, Watkins J. A pilot of acceptance and commitment therapy for public speaking anxiety delivered with group videoconferencing and virtual reality exposure. J Contextual Behav Sci. 2019;12:47–54.

    Article  Google Scholar 

  41. Himle JA, Fischer DJ, Muroff JR, Van Etten ML, Lokers LM, Abelson JL, Hanna GL. Videoconferencing-based cognitive-behavioral therapy for obsessive-compulsive disorder. Behav Res Ther. 2006;44:1821–9.

    Article  PubMed  Google Scholar 

  42. Vogel PA, Launes G, Moen EM, Solem S, Hansen B, Håland AT, Himle JA. Videoconference- and cell phone-based cognitive-behavioral therapy of obsessive-compulsive disorder: a case series. J Anxiety Disord. 2012;26:158–64.

    Article  PubMed  Google Scholar 

  43. Himle MB, Freitag M, Walther M, Franklin SA, Ely L, Woods DW. A randomized pilot trial comparing videoconference versus face-to-face delivery of behavior therapy for childhood tic disorders. Behav Res Ther. 2012;50:565–70.

    Article  PubMed  Google Scholar 

  44. Tuerk PW, Fortney J, Bosworth HB, Wakefield B, Ruggiero KJ, Acierno R, Frueh BC. Toward the development of national telehealth services: the role of veterans health administration and future directions for research. Telemed J E-Health. 2009;16:115–7.

    Article  Google Scholar 

  45. Shore P, Goranson A, Ward MF, Lu MW. Meeting veterans where they’re @: a VA Home-Based Telemental Health (HBTMH) pilot program. Int J Psychiatry Med. 2014;48:5–17.

    Article  PubMed  Google Scholar 

  46. Tuerk PW, Yoder M, Ruggiero KJ, Gros DF, Acierno R. A pilot study of prolonged exposure therapy for posttraumatic stress disorder delivered via telehealth technology. J Trauma Stress. 2010;23:116–23.

    PubMed  PubMed Central  Google Scholar 

  47. Bolton AJ, Dorstyn DS. Telepsychology for Posttraumatic Stress Disorder: A systematic review. J Telemed Telecare. 2015;21:254–67.

    Article  CAS  PubMed  Google Scholar 

  48. Morland LA, Mackintosh M-A, Greene CJ, Rosen CS, Chard KM, Resick P, Frueh BC. Cognitive processing therapy for posttraumatic stress disorder delivered to rural veterans via telemental health: a randomized noninferiority clinical trial. J Clin Psychiatry. 2014;75:470–6.

    Article  PubMed  Google Scholar 

  49. Rothbaum BO, Hodges LF, Kooper R, Opdyke D, Williford JS, North M. Effectiveness of computer-generated (virtual reality) graded exposure in the treatment of acrophobia. Am J Psychiatry. 1995;152:626–8.

    Article  CAS  PubMed  Google Scholar 

  50. Emmelkamp PMG, Bruynzeel M, Drost L, van der Mast CAPG. Virtual reality treatment in acrophobia: a comparison with exposure in vivo. Cyberpsychol Behav. 2001;4:335–9.

    Article  CAS  PubMed  Google Scholar 

  51. Morina N, Ijntema H, Meyerbröker K, Emmelkamp PMG. Can virtual reality exposure therapy gains be generalized to real-life? A meta-analysis of studies applying behavioral assessments. Behav Res Ther. 2015;74:18–24.

    Article  PubMed  Google Scholar 

  52. Anderson PL, Zimand E, Hodges LF, Rothbaum BO. Cognitive behavioral therapy for public-speaking anxiety using virtual reality for exposure. Depress Anxiety. 2005;22:156–8.

    Article  PubMed  Google Scholar 

  53. Gonçalves R, Pedrozo AL, Coutinho ESF, Figueira I, Ventura P. Efficacy of virtual reality exposure therapy in the treatment of PTSD: a systematic review. PLoS One. 2012;7:e48469.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  54. Rothbaum BO, Anderson P, Zimand E, Hodges L, Lang D, Wilson J. Virtual reality exposure therapy and standard (in vivo) exposure therapy in the treatment of fear of flying. Behav Ther. 2006;37:80–90.

    Article  PubMed  Google Scholar 

  55. Bouchard S, Dumoulin S, Robillard G, Guitard T, Klinger É, Forget H, Loranger C, Roucaut FX. Virtual reality compared with in vivo exposure in the treatment of social anxiety disorder: a three-arm randomised controlled trial. Br J Psychiatry. 2017;210:276–83.

    Article  PubMed  Google Scholar 

  56. Kramer TL, Pyne JM, Kimbrell TA, Savary PE, Smith JL, Jegley SM. Clinician perceptions of virtual reality to assess and treat returning veterans. Psychiatr Serv. 2010;61:1153–6.

    Article  PubMed  Google Scholar 

  57. Segal R, Bhatia M, Drapeau M. Therapists’ perception of benefits and costs of using virtual reality treatments. Cyberpsychol Behav Soc Netw. 2011;14:29–34.

    Article  PubMed  Google Scholar 

  58. McCann RA, Armstrong CM, Skopp NA, Edwards-Stewart A, Smolenski DJ, June JD, Metzger-Abamukong M, Reger GM. Virtual reality exposure therapy for the treatment of anxiety disorders: an evaluation of research quality. J Anxiety Disord. 2014;28:625–31.

    Article  PubMed  Google Scholar 

  59. Page S, Coxon M. Virtual reality exposure therapy for anxiety disorders: small samples and no controls? Front Psychol. 2016;7 https://doi.org/10.3389/fpsyg.2016.00326.

  60. Kamkuimo Kengne SA, Fossaert M, Girard B, Menelas B-AJ. Action-centered exposure therapy (ACET): a new approach to the use of virtual reality to the Care of People with post-traumatic stress disorder. Behav Sci. 2018;8:76.

    Article  PubMed Central  Google Scholar 

  61. Matthews AJ, Maunder R, Scanlan JD, Kirkby KC. Online computer-aided vicarious exposure for OCD symptoms: a pilot study. J Behav Ther Exp Psychiatry. 2017;54:25–34.

    Article  PubMed  Google Scholar 

  62. Yuen EK, Herbert JD, Forman EM, Goetter EM, Comer R, Bradley J-C. Treatment of social anxiety disorder using online virtual environments in second life. Behav Ther. 2013;44:51–61.

    Article  PubMed  Google Scholar 

  63. Pramana G, Parmanto B, Lomas J, Lindhiem O, Kendall PC, Silk J. Using mobile health gamification to facilitate cognitive behavioral therapy skills practice in child anxiety treatment: open clinical trial. JMIR Serious Games. 2018;6:e9.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Price M, Yuen EK, Goetter EM, Herbert JD, Forman EM, Acierno R, Ruggiero KJ. mHealth: a mechanism to deliver more accessible, more effective mental health care. Clin Psychol Psychother. 2014;21:427–36.

    Article  PubMed  Google Scholar 

  65. Stolz T, Schulz A, Krieger T, Vincent A, Urech A, Moser C, Westermann S, Berger T. A mobile app for social anxiety disorder: a three-arm randomized controlled trial comparing mobile and PC-based guided self-help interventions. J Consult Clin Psychol. 2018;86:493–504.

    Article  PubMed  Google Scholar 

  66. Weisel KK, Zarski A-C, Berger T, Schaub MP, Krieger T, Moser CT, Berking M, Ebert DD. Transdiagnostic tailored internet- and Mobile-based guided treatment for major depressive disorder and comorbid anxiety: study protocol of a randomized controlled trial. Front Psych. 2018;9:274.

    Article  Google Scholar 

  67. Bui E, Blackburn AM, Brenner LH, Laifer LM, Park ER, Fricchione GL, Sylvia LG. Military and veteran caregivers’ perspectives of stressors and a mind-body program. Issues Ment Health Nurs. 2018;39:850–7.

    Article  PubMed  Google Scholar 

  68. Harrer M, Adam SH, Fleischmann RJ, et al. Effectiveness of an internet- and app-based intervention for college students with elevated stress: randomized controlled trial. J Med Internet Res. 2018;20:e136.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Economides M, Martman J, Bell MJ, Sanderson B. Improvements in stress, affect, and irritability following brief use of a mindfulness-based smartphone app: a randomized controlled trial. Mindfulness. 2018;9:1584–93.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Cox CE, Hough CL, Jones DM, et al. Effects of mindfulness training programmes delivered by a self-directed mobile app and by telephone compared with an education programme for survivors of critical illness: a pilot randomised clinical trial. Thorax. 2018;74:33. https://doi.org/10.1136/thoraxjnl-2017-211264.

    Article  PubMed  Google Scholar 

  71. Parker L, Bero L, Gillies D, Raven M, Mintzes B, Jureidini J, Grundy Q. Mental health messages in prominent mental health apps. Ann Fam Med. 2018;16:338–42.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Hadjistavropoulos HD, Faller YN, Klatt A, Nugent MN, Dear BF, Titov N. Patient perspectives on strengths and challenges of therapist-assisted internet-delivered cognitive behaviour therapy: using the patient voice to improve care. Community Ment Health J. 2018;54:944. https://doi.org/10.1007/s10597-018-0286-0.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Goetter EM, Blackburn AM, Bui E, Laifer LM, Simon NM. Veterans’ prospective attitudes about mental health treatment using telehealth. J Psychosoc Nurs Ment Health Serv. 2019;59(9):38–43.

    Article  PubMed  Google Scholar 

  74. Musiat P, Goldstone P, Tarrier N. Understanding the acceptability of e-mental health – attitudes and expectations towards computerised self-help treatments for mental health problems. BMC Psychiatry. 2014;14:109.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Fleischmann RJ, Harrer M, Zarski A-C, Baumeister H, Lehr D, Ebert DD. Patients’ experiences in a guided internet- and app-based stress intervention for college students: a qualitative study. Internet Interv. 2018;12:130–40.

    Article  CAS  PubMed  Google Scholar 

  76. Knowles SE, Toms G, Sanders C, et al. Qualitative meta-synthesis of user experience of computerised therapy for depression and anxiety. PLoS One. 2014;9 https://doi.org/10.1371/journal.pone.0084323.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  77. Apolinário-Hagen J, Fritsche L, Bierhals C, Salewski C. Improving attitudes toward e-mental health services in the general population via psychoeducational information material: a randomized controlled trial. Internet Interv. 2018;12:141–9.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Perle JG, Langsam LC, Randel A, Lutchman S, Levine AB, Odland AP, Nierenberg B, Marker CD. Attitudes toward psychological telehealth: current and future clinical psychologists’ opinions of internet-based interventions. J Clin Psychol. 2013;69:100–13.

    Article  PubMed  Google Scholar 

  79. Chavira DA, Bustos CE, Garcia MS, Ng B, Camacho A. Delivering CBT to rural Latino children with anxiety disorders: a qualitative study. Community Ment Health J. 2017;53:53–61.

    Article  PubMed  Google Scholar 

  80. Pihlaja S, Stenberg J-H, Joutsenniemi K, Mehik H, Ritola V, Joffe G. Therapeutic alliance in guided internet therapy programs for depression and anxiety disorders – a systematic review. Internet Interv. 2018;11:1–10.

    Article  PubMed  Google Scholar 

  81. Geramita EM, Herbeck Belnap B, Abebe KZ, Rothenberger SD, Rotondi AJ, Rollman BL. The association between increased levels of patient engagement with an internet support group and improved mental health outcomes at 6-month follow-up: post-hoc analyses from a randomized controlled trial. J Med Internet Res. 2018;20:e10402.

    Article  PubMed  PubMed Central  Google Scholar 

  82. Goetter EM, Herbert JD, Forman EM, Yuen EK, Gershkovich M, Glassman LH, Rabin SJ, Goldstein SP. Delivering exposure and ritual prevention for obsessive–compulsive disorder via videoconference: clinical considerations and recommendations. J Obsessive Compuls Relat Disord. 2013;2:137–45.

    Article  Google Scholar 

  83. Yuen EK, Goetter EM, Herbert JD, Forman EM. Challenges and opportunities in internet-mediated telemental health. Prof Psychol Res Pract. 2012;43:1–8.

    Article  Google Scholar 

  84. Ashford MT, Olander EK, Rowe H, Fisher JR, Ayers S. Feasibility and acceptability of a web-based treatment with telephone support for postpartum women with anxiety: randomized controlled trial. JMIR Ment Health. 2018;5:e19.

    Article  PubMed  PubMed Central  Google Scholar 

  85. March S, Spence SH, Donovan CL, Kenardy JA. Large-scale dissemination of internet-based cognitive behavioral therapy for youth anxiety: feasibility and acceptability study. J Med Internet Res. 2018;20:e234.

    Article  PubMed  PubMed Central  Google Scholar 

  86. AM AL-A, Klein B, Meyer D. Posttreatment attrition and its predictors, attrition Bias, and treatment efficacy of the anxiety online programs. J Med Internet Res. 2014;16 https://doi.org/10.2196/jmir.3513.

    Article  PubMed  PubMed Central  Google Scholar 

  87. de la Torre-Díez I, López-Coronado M, Vaca C, Aguado JS, de Castro C. Cost-utility and cost-effectiveness studies of telemedicine, electronic, and Mobile health systems in the literature: a systematic review. Telemed J E Health. 2014;21:81–5.

    Article  PubMed  Google Scholar 

  88. Mistry H. Systematic review of studies of the cost-effectiveness of telemedicine and telecare. Changes in the economic evidence over twenty years. J Telemed Telecare. 2012;18:1–6.

    Article  PubMed  Google Scholar 

  89. Whitten PS, Mair FS, Haycox A, May CR, Williams TL, Hellmich S. Systematic review of cost effectiveness studies of telemedicine interventions. BMJ. 2002;324:1434–7.

    Article  PubMed  PubMed Central  Google Scholar 

  90. Crow SJ, Mitchell JE, Crosby RD, Swanson SA, Wonderlich S, Lancanster K. The cost effectiveness of cognitive behavioral therapy for bulimia nervosa delivered via telemedicine versus face-to-face. Behav Res Ther. 2009;47:451–3.

    Article  PubMed  PubMed Central  Google Scholar 

  91. Morland LA, Raab M, Mackintosh M-A, Rosen CS, Dismuke CE, Greene CJ, Frueh BC. Telemedicine: a cost-reducing means of delivering psychotherapy to rural combat veterans with PTSD. Telemed J E Health. 2013;19:754–9.

    Article  PubMed  PubMed Central  Google Scholar 

  92. Schneider BC, Schröder J, Berger T, et al. Bridging the “digital divide”: a comparison of use and effectiveness of an online intervention for depression between baby boomers and millennials. J Affect Disord. 2018;236:243–51.

    Article  PubMed  Google Scholar 

  93. Vaportzis E, Giatsi Clausen M, Gow AJ. Older adults perceptions of technology and barriers to interacting with tablet computers: a focus group study. Front Psychol. 2017;8 https://doi.org/10.3389/fpsyg.2017.01687.

  94. Herbert JD, Goetter EM, Forman EM, Yuen EK, Erford BM, Milillo JJ, Goldstein SP. Crossing the line: interstate delivery of remote psychological services. Behav Ther. 2012;35:145–52.

    Google Scholar 

  95. George BP, Scoglio NJ, Reminick JI, Rajan B, Beck CA, Seidmann A, Biglan KM, Dorsey ER. Telemedicine in leading US neurology departments. Neurohospitalist. 2012;2:123–8.

    Article  PubMed  PubMed Central  Google Scholar 

  96. Mehrotra A, Jena AB, Busch AB, Souza J, Uscher-Pines L, Landon BE. Utilization of telemedicine among rural Medicare beneficiaries. JAMA. 2016;315:2015–6.

    Article  PubMed  PubMed Central  Google Scholar 

  97. Gros DF, Veronee K, Strachan M, Ruggiero KJ, Acierno R. Managing suicidality in home-based telehealth. J Telemed Telecare. 2011;17:332–5.

    Article  PubMed  Google Scholar 

  98. Godleski L, Nieves JE, Darkins A, Lehmann L. VA telemental health: suicide assessment. Behav Sci Law. 2008;26:271–86.

    Article  PubMed  Google Scholar 

  99. Dorstyn DS, Saniotis A, Sobhanian F. A systematic review of telecounselling and its effectiveness in managing depression amongst minority ethnic communities. J Telemed Telecare. 2013;19:338–46.

    Article  PubMed  Google Scholar 

  100. Williams MT, Domanico J, Marques L, Leblanc NJ, Turkheimer E. Barriers to treatment among African Americans with obsessive-compulsive disorder. J Anxiety Disord. 2012;26:555–63.

    Article  PubMed  PubMed Central  Google Scholar 

  101. Memon A, Taylor K, Mohebati LM, Sundin J, Cooper M, Scanlon T, de Visser R. Perceived barriers to accessing mental health services among black and minority ethnic (BME) communities: a qualitative study in Southeast England. BMJ Open. 2016;6:e012337.

    Article  PubMed  PubMed Central  Google Scholar 

  102. Gary FA. Stigma: barrier to mental health care among ethnic minorities. Issues Ment Health Nurs. 2005;26:979–99.

    Article  PubMed  Google Scholar 

  103. Pew Research Center. Demographics of internet and home broadband usage in the United States; 2018. https://www.pewinternet.org/fact-sheet/internet-broadband/.

  104. Pew Research Center. Demographics of mobile device ownership and adoption in the United States. https://www.pewinternet.org/fact-sheet/mobile/.

  105. Pew Research Center, Parker K, Horowitz JM, Brown A, Fry R, Cohn D, Igielnik R. Similarities and differences between urban, suburban and rural communities in America; 2018. https://www.pewsocialtrends.org/2018/05/22/what-unites-and-divides-urban-suburban-and-rural-communities/.

  106. Hennemann S, Farnsteiner S, Sander L. Internet- and mobile-based aftercare and relapse prevention in mental disorders: a systematic review and recommendations for future research. Internet Interv. 2018;14:1–17.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Elizabeth M. Goetter .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Blackburn, A.M., Goetter, E.M. (2020). Treatment of Anxiety Disorders in the Digital Age. In: Bui, E., Charney, M., Baker, A. (eds) Clinical Handbook of Anxiety Disorders. Current Clinical Psychiatry. Humana, Cham. https://doi.org/10.1007/978-3-030-30687-8_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-30687-8_16

  • Published:

  • Publisher Name: Humana, Cham

  • Print ISBN: 978-3-030-30686-1

  • Online ISBN: 978-3-030-30687-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics