A randomized controlled trial examining the efficacy of an internet-based cognitive behavioral therapy program for adolescents with anxiety disorders

Autoři: Silke Stjerneklar aff001;  Esben Hougaard aff001;  Lauren F. McLellan aff002;  Mikael Thastum aff001
Působiště autorů: Department of Psychology and Behavioral Sciences, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark aff001;  Centre for Emotional Health, Department of Psychology, Macquarie University, New South Wales, North Ryde, Australia aff002
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: 10.1371/journal.pone.0222485



Anxiety disorders are highly prevalent in adolescence, but access to health care services is limited and only few receive professional help. Internet-based cognitive behavioral therapy (ICBT) has been proposed to increase accessibility and reduce costs of treatment.


The study evaluated the efficacy of a Danish version of the guided ICBT program ChilledOut Online, developed at the Centre for Emotional Health, Macquarie University, Australia.


At the Centre for Psychological Treatment of Children and Adolescents, Aarhus University, Denmark, a randomized controlled trial was conducted with 70 adolescents (13–17 years) with anxiety disorders according to DSM-IV. Participants were randomly assigned to a 14-weeks therapist-guided ICBT or to a waitlist condition. Outcomes were evaluated post-treatment and at 3- and 12-month follow-up.


At post-treatment, the ICBT group significantly outperformed the waitlist condition with moderate to large between-group effect sizes on diagnostic severity and anxiety symptoms rated by clinicians, and by adolescents and their parents. Forty percent of adolescents in ICBT were free of their primary diagnosis compared to 16% in the waitlist condition. Treatment gains were maintained at 3- and 12-month follow-up.


Results of the study provide support for the efficacy of guided ICBT for adolescents with anxiety disorders.

Trial registration

ClinicalTrials.gov: NCT02535403.

Klíčová slova:

People and places – Population groupings – Age groups – Children – Adolescents – Families – Fathers – Biology and life sciences – Psychology – Emotions – Anxiety – Social sciences – Medicine and health sciences – Mental health and psychiatry – Neuropsychiatric disorders – Anxiety disorders – Neuroses – Diagnostic medicine – Research and analysis methods – Research design – Survey research – Questionnaires


1. Costello EJ, Egger HL, Copeland W, Erkanli A, Angold A. The developmental epidemiology of anxiety disorders: Phenomenology, prevalence, and comorbidity. In: Silverman WK FA, editor. Anxiety disorders in children and adolescents. 2. ed. Cambridge: Cambridge University Press; 2011. p. 56–75.

2. Polanczyk GV, Salum GA, Sugaya LS, Caye A, Rohde LA. Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. Journal of child psychology and psychiatry, and allied disciplines. 2015;56(3):345–65. Epub 2015/02/05. doi: 10.1111/jcpp.12381 25649325.

3. Merikangas KR, He JP, Burstein M, Swanson SA, Avenevoli S, Cui L, et al. Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication—Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry. 2010;49(10):980–9. Epub 2010/09/22. doi: 10.1016/j.jaac.2010.05.017 20855043; PubMed Central PMCID: PMC2946114.

4. Beesdo-Baum K, Knappe S. Developmental epidemiology of anxiety disorders. Child Adolesc Psychiatr Clin N Am. 2012;21(3):457–78. Epub 2012/07/18. doi: 10.1016/j.chc.2012.05.001 22800989.

5. Kessler RC, Avenevoli S, Costello EJ, Georgiades K, Green JG, Gruber MJ, et al. Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry. 2012;69(4):372–80. doi: 10.1001/archgenpsychiatry.2011.160 22147808; 2012-09587-005.

6. 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. International Journal of Methods in Psychiatric Research. 2012;21(3):169–84. doi: 10.1002/mpr.1359 22865617

7. James AC, James G, Cowdrey FA, Soler A, Choke A. Cognitive behavioural therapy for anxiety disorders in children and adolescents. The Cochrane database of systematic reviews. 2013;(6):Cd004690. Epub 2013/06/05. doi: 10.1002/14651858.CD004690.pub3 23733328.

8. Merikangas KR, He J-P, Brody D, Fisher PW, Bourdon K, Koretz DS. Prevalence and treatment of mental disorders among US children in the 2001–2004 NHANES. Pediatrics. 2010;125(1):75–81. doi: 10.1542/peds.2008-2598 20008426; 2010-17117-014.

9. Wang PS, Aguilar-Gaxiola S, Alonso J, Angermeyer MC, Borges G, Bromet EJ, et al. Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys. The Lancet. 2007;370(9590):841–50. http://dx.doi.org/10.1016/S0140-6736(07)61414-7. 621878556; 2007-13901-003.

10. Shafran R, Clark DM, Fairburn CG, Arntz A, Barlow DH, Ehlers A, et al. Mind the gap: Improving the dissemination of CBT. Behav Res Ther. 2009;47(11):902–9. Epub 2009/08/12. doi: 10.1016/j.brat.2009.07.003 19664756.

11. Stallard P, Udwin O, Goddard M, Hibbert S. The Availability of Cognitive Behaviour Therapy Within Specialist Child and Adolescent Mental Health Services (CAMHS): A National Survey. Behavioural and Cognitive Psychotherapy. 2007;35(4):501–5. Epub 2007/05/31. doi: 10.1017/S1352465807003724

12. Gulliver A, Griffiths KM, Christensen H. Perceived barriers and facilitators to mental health help-seeking in young people: A systematic review. BMC psychiatry. 2010;10. doi: 10.1186/1471-244X-10-10 860176004; 2011-02872-001.

13. Adolescents Tillett J. and Informed Consent: Ethical and Legal Issues. The Journal of Perinatal & Neonatal Nursing. 2005;19(2):112–21. 621153809; 2006-03909-002.

14. Zachrisson HD, Rodje K, Mykletun A. Utilization of health services in relation to mental health problems in adolescents: a population based survey. BMC public health. 2006;6:34. Epub 2006/02/17. doi: 10.1186/1471-2458-6-34 16480522; PubMed Central PMCID: PMC1386725.

15. Reavley NJ, Cvetkovski S, Jorm AF, Lubman DI. Help-Seeking for Substance Use, Anxiety and Affective Disorders Among Young People: Results from the 2007 Australian National Survey of Mental Health and Wellbeing. Australian & New Zealand Journal of Psychiatry. 2010;44(8):729–35. doi: 10.3109/00048671003705458 20636194

16. Nearchou FA, Bird N, Costello A, Duggan S, Gilroy J, Long R, et al. Personal and perceived public mental-health stigma as predictors of help-seeking intentions in adolescents. J Adolesc. 2018;66:83–90. Epub 2018/05/26. doi: 10.1016/j.adolescence.2018.05.003 29800758.

17. Rickwood DJ, Deane FP, Wilson CJ. When and how do young people seek professional help for mental health problems? The Medical journal of Australia. 2007;187(7 Suppl):S35–9. Epub 2007/11/28. 17908023.

18. Wilson CJ, Bushnell JA, Caputi P. Early access and help seeking: practice implications and new initiatives. Early intervention in psychiatry. 2011;5 Suppl 1:34–9. Epub 2011/01/19. doi: 10.1111/j.1751-7893.2010.00238.x 21208389.

19. Elliott BA, Larson JT. Adolescents in mid-sized and rural communities: Foregone care, perceived barriers, and risk factors. Journal of Adolescent Health. 2004;35(4):303–9. doi: 10.1016/j.jadohealth.2003.09.015 15450544; 2004-19430-007.

20. Andersson G, Titov N. Advantages and limitations of Internet-based interventions for common mental disorders. World Psychiatry. 2014;13(1):4–11. Epub 2014/02/06. doi: 10.1002/wps.20083 24497236; PubMed Central PMCID: PMC3918007.

21. Barak A, Klein B, Proudfoot JG. Defining internet-supported therapeutic interventions. Annals of behavioral medicine: a publication of the Society of Behavioral Medicine. 2009;38(1):4–17. Epub 2009/09/30. doi: 10.1007/s12160-009-9130-7 19787305.

22. Andersson G. Internet-Delivered Psychological Treatments. Annu Rev Clin Psychol. 2016;12:157–79. Epub 2015/12/15. doi: 10.1146/annurev-clinpsy-021815-093006 26652054.

23. Johansson R, Andersson G. Internet-based psychological treatments for depression. Expert Review of Neurotherapeutics. 2012;12(7):861–70. doi: 10.1586/ern.12.63 22853793

24. Kleiboer A, Donker T, Seekles W, van Straten A, Riper H, Cuijpers P. A randomized controlled trial on the role of support in Internet-based problem solving therapy for depression and anxiety. Behav Res Ther. 2015;72:63–71. Epub 2015/07/21. doi: 10.1016/j.brat.2015.06.013 26188373.

25. Baumeister H, Reichler L, Munzinger M, Lin J. The impact of guidance on Internet-based mental health interventions—A systematic review. Internet Interventions. 2014;1(4):205–15. http://dx.doi.org/10.1016/j.invent.2014.08.003.

26. Griffiths KM, Christensen H. Review of randomised controlled trials of internet interventions for mental disorders and related conditions. Clinical Psychologist. 2006;10(1):16–29. http://dx.doi.org.ez.statsbiblioteket.dk:2048/10.1080/13284200500378696.

27. Christensen H, Batterham P, Calear A. Online interventions for anxiety disorders. Current opinion in psychiatry. 2014;27(1):7–13. doi: 10.1097/YCO.0000000000000019 24257123; 2013-43204-002.

28. Hedman E, Ljotsson B, Lindefors N. Cognitive behavior therapy via the Internet: a systematic review of applications, clinical efficacy and cost-effectiveness. Expert review of pharmacoeconomics & outcomes research. 2012;12(6):745–64. Epub 2012/12/21. doi: 10.1586/erp.12.67 23252357.

29. Richards D, Richardson T, Timulak L, McElvaney J. The efficacy of internet-delivered treatment for generalized anxiety disorder: A systematic review and meta-analysis. Internet Interventions. 2015;2(3):272–82. http://dx.doi.org/10.1016/j.invent.2015.07.003.

30. Spek V, Cuijpers P, Nyklíček I, Riper H, Keyzer J, Pop V. Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: A meta-analysis. Psychological Medicine. 2007;37(3):319–28. doi: 10.1017/S0033291706008944 17112400; 2007-03729-002.

31. Cunningham MJ, Wuthrich VM, Rapee RM, Lyneham HJ, Schniering CA, Hudson JL. The Cool Teens CD-ROM for anxiety disorders in adolescents: a pilot case series. Eur Child Adolesc Psychiatry. 2009;18(2):125–9. Epub 2008/06/20. doi: 10.1007/s00787-008-0703-y 18563472.

32. Donker T, Blankers M, Hedman E, Ljotsson B, Petrie K, Christensen H. Economic evaluations of Internet interventions for mental health: a systematic review. Psychol Med. 2015:1–20. Epub 2015/08/04. doi: 10.1017/s0033291715001427 26235445.

33. Hedman E, Andersson E, Ljótsson B, Andersson G, Rück C, Lindefors N. Cost-effectiveness of Internet-based cognitive behavior therapy vs. cognitive behavioral group therapy for social anxiety disorder: Results from a randomized controlled trial. Behaviour Research and Therapy. 2011;49(11):729–36. doi: 10.1016/j.brat.2011.07.009 21851929

34. Lenhard F, Ssegonja R, Andersson E, Feldman I, Ruck C, Mataix-Cols D, et al. Cost-effectiveness of therapist-guided internet-delivered cognitive behaviour therapy for paediatric obsessive-compulsive disorder: results from a randomised controlled trial. BMJ open. 2017;7(5):e015246. Epub 2017/05/19. doi: 10.1136/bmjopen-2016-015246 28515196.

35. Ho J, Corden ME, Caccamo L, Tomasino KN, Duffecy J, Begale M, et al. Design and evaluation of a peer network to support adherence to a web-based intervention for adolescents. Internet Interventions. 2016;6:50–6. doi: 10.1016/j.invent.2016.09.005 27722095

36. Stallard P, Velleman S, Richardson T. Computer use and attitudes towards computerised therapy amongst young people and parents attending child and adolescent mental health services. Child and Adolescent Mental Health. 2010;15(2):80–4. http://dx.doi.org/10.1111/j.1475-3588.2009.00540.x. 622181267; 2010-06698-003.

37. Subrahmanyam K, Lin G. Adolescents on the net: Internet use and well-being. Adolescence. 2007;42(168):659–77. 18229503; 2007-19818-003.

38. Nicholas J, Oliver K, Lee K, O’Brien M. Help-seeking behaviour and the Internet: An investigation among Australian adolescents. Australian e-Journal for the Advancement of Mental Health. 2004;3(1):16–23. doi: 10.5172/jamh.3.1.16

39. Ebert DD, Zarski AC, Christensen H, Stikkelbroek Y, Cuijpers P, Berking M, et al. Internet and computer-based cognitive behavioral therapy for anxiety and depression in youth: a meta-analysis of randomized controlled outcome trials. PloS one. 2015;10(3):e0119895. Epub 2015/03/19. doi: 10.1371/journal.pone.0119895 25786025.

40. Pennant ME, Loucas CE, Whittington C, Creswell C, Fonagy P, Fuggle P, et al. Computerised therapies for anxiety and depression in children and young people: A systematic review and meta-analysis. Behaviour Research and Therapy. 2015;67:1–18. doi: 10.1016/j.brat.2015.01.009 25727678; 2015-12473-002.

41. Podina IR, Mogoase C, David D, Szentagotai A, Dobrean A. A Meta-Analysis on the Efficacy of Technology Mediated CBT for Anxious Children and Adolescents. Journal of Rational-Emotive & Cognitive-Behavior Therapy. 2016;34(1):31–50. doi: 10.1007/s10942-015-0228-5

42. Ye X, Bapuji SB, Winters SE, Struthers A, Raynard M, Metge C, et al. Effectiveness of internet-based interventions for children, youth, and young adults with anxiety and/or depression: a systematic review and meta-analysis. BMC health services research. 2014;14:313. Epub 2014/07/20. doi: 10.1186/1472-6963-14-313 25037951; PubMed Central PMCID: PMC4110069.

43. Hollis C, Falconer CJ, Martin JL, Whittington C, Stockton S, Glazebrook C, et al. Annual Research Review: Digital health interventions for children and young people with mental health problems—A systematic and meta‐review. Journal of Child Psychology and Psychiatry. 2017;58(4):474–503. doi: 10.1111/jcpp.12663 27943285; 2016-60086-001.

44. Tillfors M, Andersson G, Ekselius L, Furmark T, Lewenhaupt S, Karlsson A, et al. A randomized trial of internet-delivered treatment for social anxiety disorder in high school students. Cognitive Behaviour Therapy. 2011;40(2):147–57. doi: 10.1080/16506073.2011.555486 25155815; 2011-14818-007.

45. Spence SH, Donovan CL, March S, Gamble A, Anderson R, Prosser S, et al. Online CBT in the treatment of child and adolescent anxiety disorders: Issues in the development of BRAVE-ONLINE and two case illustrations. Behavioural and Cognitive Psychotherapy. 2008;36(4):411–30. http://dx.doi.org/10.1017/S135246580800444X. 621613258; 2008-15717-004.

46. Spence SH, Donovan CL, March S, Gamble A, Anderson RE, Prosser S, et al. A randomized controlled trial of online versus clinic-based CBT for adolescent anxiety. Journal of consulting and clinical psychology. 2011;79(5):629–42. doi: 10.1037/a0024512 21744945; 2011-14202-001.

47. Lenhard F, Vigerland S, Andersson E, Ruck C, Mataix-Cols D, Thulin U, et al. Internet-delivered cognitive behavior therapy for adolescents with obsessive-compulsive disorder: an open trial. PloS one. 2014;9(6):e100773. doi: 10.1371/journal.pone.0100773 24949622; PubMed Central PMCID: PMC4065049.

48. Lenhard F, Andersson E, Mataix-Cols D, Ruck C, Vigerland S, Hogstrom J, et al. Therapist-Guided, Internet-Delivered Cognitive-Behavioral Therapy for Adolescents With Obsessive-Compulsive Disorder: A Randomized Controlled Trial. Journal of the American Academy of Child and Adolescent Psychiatry. 2017;56(1):10–9.e2. Epub 2016/12/21. doi: 10.1016/j.jaac.2016.09.515 27993223.

49. Tillfors M, Carlbring P, Furmark T, Lewenhaupt S, Spak M, Eriksson A, et al. Treating university students with social phobia and public speaking fears: Internet delivered self-help with or without live group exposure sessions. Depression and Anxiety. 2008;25(8):708–17. doi: 10.1002/da.20416 18729147; 2008-13151-008.

50. Spence SH. A measure of anxiety symptoms among children. Behaviour Research and Therapy. 1998;36(5):545–66. doi: 10.1016/s0005-7967(98)00034-5 9648330; 1998-10708-006.

51. Scahill L, Riddle MA, McSwiggin-Hardin M, Ort SI, King RA, Goodman WK, et al. Children's Yale-Brown Obsessive Compulsive Scale: Reliability and validity. Journal of the American Academy of Child & Adolescent Psychiatry. 1997;36(6):844–52. http://dx.doi.org/10.1097/00004583-199706000-00023. 619078361; 1997-04647-022.

52. Lyneham HJ, McLellan LF, Cunningham M, Wuthrich V, Schniering C, Hudson JL, et al. ChilledOut Online Program. Sydney: Centre for Emotional Health, Macquarie University; 2014.

53. Rapee RM, Lyneham HJ, Schniering CA, Wuthrich V, Abbott MA, Hudson JL, et al. The cool kids child and adolescents anxiety program–therapist manual. Sydney, NSW: Centre for Emotional Health, Macquarie University; 2006.

54. Wuthrich VM, Cunningham MJ, Rapee RM. Cool Teens: A Computerized Intervention for Anxious Adolescents. The Wiley-Blackwell Handbook of The Treatment of Childhood and Adolescent Anxiety: John Wiley & Sons, Ltd.; 2013. p. 249–74.

55. Cunningham M. Overview of design approaches in the Cool Teens CD and other computer programs for adolescent anxiety. E-Journal of Applied Psychology. 2008;4(2):6–11. 851233202; 2010-10939-002.

56. Wuthrich VM, Rapee RM, Cunningham MJ, Lyneham HJ, Hudson JL, Schniering CA. A randomized controlled trial of the Cool Teens CD-ROM computerized program for adolescent anxiety. Journal of the American Academy of Child & Adolescent Psychiatry. 2012;51(3):261–70. http://dx.doi.org/10.1016/j.jaac.2011.12.002. 964197898; 2012-05353-009.

57. Stjerneklar S, Hougaard E, Nielsen AD, Gaardsvig MM, Thastum M. Internet-based cognitive behavioral therapy for adolescents with anxiety disorders: A feasibility study. Internet Interventions. 2018;11:30–40. doi: 10.1016/j.invent.2018.01.001 30135757

58. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. 4th ed. ed. Washington, DC: American Psychiatric Association; 1994.

59. Silverman WK, Albano AM. Anxiety Disorders Interview Schedule for Children for DSM–IV: Child and Parent Versions. San Antonio: TX: Psychological Corporation; 1996.

60. Silverman WK, Saavedra LM, Pina AA. Test-retest reliability of anxiety symptoms and diagnoses with anxiety disorders interview schedule for DSM-IV: Child and parent versions. Journal of the American Academy of Child & Adolescent Psychiatry. 2001;40(8):937–44. http://dx.doi.org/10.1097/00004583-200108000-00016. 619583840; 2001-01750-010.

61. Wood JJ, Piacentini JC, Bergman RL, McCracken J, Barrios V. Concurrent validity of the anxiety disorders section of the Anxiety Disorders Interview Schedule for DSM-IV: child and parent versions. Journal of clinical child and adolescent psychology: the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53. 2002;31(3):335–42. Epub 2002/08/02. doi: 10.1207/s15374424jccp3103_05 12149971.

62. Lyneham HJ, Rapee RM. Agreement Between Telephone and In-Person Delivery of a Structured Interview for Anxiety Disorders in Children. Journal of the American Academy of Child & Adolescent Psychiatry. 2005;44(3):274–82. http://dx.doi.org/10.1097/00004583-200503000-00012. 620692159; 2005-02313-012.

63. Arendt K, Hougaard E, Thastum M. Psychometric properties of the child and parent versions of Spence Children's Anxiety Scale in a Danish community and clinical sample. Journal of Anxiety Disorders. 2014;28(8):947–56. doi: 10.1016/j.janxdis.2014.09.021 25445085

64. Lyneham HJ, Sburlati ES, Abbott MJ, Rapee RM, Hudson JL, Tolin DF, et al. Psychometric properties of the Child Anxiety Life Interference Scale (CALIS). Journal of Anxiety Disorders. 2013;27(7):711–9. doi: 10.1016/j.janxdis.2013.09.008 24135256; 2013-41121-012.

65. Angold A, Costello EJ, Messer SC, Pickles A. Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. International Journal of Methods in Psychiatric Research. 1995;5(4):237–49. 618820158; 1996-02633-002.

66. Muris P. A brief questionnaire for measuring self-efficacy in youths. Journal of Psychopathology and Behavioral Assessment. 2001;23(3):145–9. http://dx.doi.org/10.1023/A:1010961119608. 619816969; 2002-10117-002.

67. Muris P. Relationships between self-efficacy and symptoms of anxiety disorders and depression in a normal adolescent sample. Personality and Individual Differences. 2002;32(2):337–48. http://dx.doi.org/10.1016/S0191-8869(01)00027-7. 619720149; 2002-00167-010.

68. Suldo SM, Shaffer EJ. Evaluation of the Self-Efficacy Questionnaire for Children in Two Samples of American Adolescents. Journal of Psychoeducational Assessment. 2007;25(4):341–55. doi: 10.1177/0734282907300636

69. Topp CW, Østergaard SD, Søndergaard S, Bech P. The WHO-5 Well-Being Index: A Systematic Review of the Literature. Psychotherapy and Psychosomatics. 2015;84(3):167–76. doi: 10.1159/000376585 25831962

70. Löwe B, Spitzer RL, Gräfe K, Kroenke K, Quenter A, Zipfel S, et al. Comparative validity of three screening questionnaires for DSM-IV depressive disorders and physicians’ diagnoses. Journal of affective disorders. 2004;78(2):131–40. doi: 10.1016/s0165-0327(02)00237-9 14706723

71. Brähler E, Mühlan H, Albani C, Schmidt S. Teststatistische Prüfung und Normierung der deutschen Versionen des EUROHIS-QOL Lebensqualität-Index und des WHO-5 Wohlbefindens-Index. Diagnostica. 2007;53(2):83–96. doi: 10.1026/0012-1924.53.2.83

72. Brown A, Ford T, Deighton J, Wolpert M. Satisfaction in Child and Adolescent Mental Health Services: Translating Users’ Feedback into Measurement. Administration and Policy in Mental Health and Mental Health Services Research. 2014;41(4):434–46. doi: 10.1007/s10488-012-0433-9 22829193

73. Attride-Stirling J. Development of methods to capture users’ views of CAMHS in clinical governance reviews. Cambridge, UK: Commission for Health Improvement; 2002.

74. Goodman R, Meltzer H, Bailey V. The strengths and difficulties questionnaire: A pilot study on the validity of the self-report version. European Child & Adolescent Psychiatry. 1998;7(3):125–30. doi: 10.1007/s007870050057

75. Goodman R. The Strengths and Difficulties Questionnaire: A Research Note. Journal of Child Psychology and Psychiatry. 1997;38(5):581–6. doi: 10.1111/j.1469-7610.1997.tb01545.x 9255702

76. Tracey TJ, Kokotovic AM. Factor structure of the Working Alliance Inventory. Psychological Assessment: A Journal of Consulting and Clinical Psychology. 1989;1(3):207–10. http://dx.doi.org/10.1037/1040-3590.1.3.207. 617705879; 1990-03343-001.

77. Melville KM, Casey LM, Kavanagh DJ. Dropout from Internet-based treatment for psychological disorders. The British journal of clinical psychology / the British Psychological Society. 2010;49(Pt 4):455–71. Epub 2009/10/06. doi: 10.1348/014466509x472138 19799804.

78. Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2 ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.

79. Chakraborty H, Gu H. A Mixed Model Approach for Intent-to-Treat Analysis in Longitudinal Clinical Trials with Missing Values. RTI Press publication No MR-0009-0903 [Internet]. 2009 31.01.2018. Available from: doi: 10.3768/rtipress.2009.mr.0009.0903 30896910

80. Jacobson NS, Truax P. Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of consulting and clinical psychology. 1991;59(1):12–9. doi: 10.1037//0022-006x.59.1.12 2002127; 1991-16094-001.

81. Heck RH, Thomas SL, Tabata LN. Multilevel and Longitudinal Modeling with IBM SPSS (Quantitative Methodology Series). 2 ed. New York and London: Routledge/Taylor & Francis; 2014.

82. Bisgaard MP, Poulin PD. Statistical Yearbook. 121th ed: Statistics Denmark; 2017 june 2017. 568 p.

83. Vigerland S, Ljótsson B, Thulin U, Öst L-G, Andersson G, Serlachius E. Internet-delivered cognitive behavioural therapy for children with anxiety disorders: A randomised controlled trial. Behaviour Research and Therapy. 2016;76:47–56. doi: 10.1016/j.brat.2015.11.006 26649465; 2015-59077-007.

84. 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. Epub 2016/12/19. doi: 10.1016/j.brat.2016.12.003 27988427.

85. Thirlwall K, Cooper PJ, Karalus J, Voysey M, Willetts L, Creswell C. Treatment of child anxiety disorders via guided parent-delivered cognitive-behavioural therapy: randomised controlled trial. The British journal of psychiatry: the journal of mental science. 2013;203(6):436–44. Epub 2013/08/24. doi: 10.1192/bjp.bp.113.126698 23969483.

86. March S, Spence SH, Donovan CL. The efficacy of an Internet-based cognitive-behavioral therapy intervention for child anxiety disorders. Journal of Pediatric Psychology. 2009;34(5):474–87. doi: 10.1093/jpepsy/jsn099 18794187; 2009-08292-004.

87. Arendt K, Thastum M, Hougaard E. Efficacy of a Danish version of the Cool Kids program: a randomized wait-list controlled trial. Acta Psychiatr Scand. 2015. doi: 10.1111/acps.12448 26016532.

88. Cuijpers P, Sijbrandij M, Koole S, Huibers M, Berking M, Andersson G. Psychological treatment of generalized anxiety disorder: a meta-analysis. Clin Psychol Rev. 2014;34(2):130–40. Epub 2014/02/04. doi: 10.1016/j.cpr.2014.01.002 24487344.

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