<p>The aim of this study was to evaluate if a population suffering from generalized anxiety disorder could benefit from an Internet based self-help treatment guided via email contact with a therapist. The treatment was based on established cognitive behavioral principles. It was hypothesized that significant improvements would be found as measured by eight self report questionnaires, absence of a clinical diagnoses and global clinical improvement. A total of 89 participants were included and 44 were randomized to a treatment condition and 45 were assigned to a waitlist control. The controls received similar treatment after the first post treatment assessment, conducted eight weeks after the beginning or treatment of the first group. The results showed statistically significant improvements for the treatment group. No changes were observed in the waiting-list control group, with the exception of a minor decrease in depression scores. Large effect sizes were found both within the treatment group and between the two groups in favor of the treatment. In conclusion, Internet treatment can be an efficacious format for treating generalized anxiety disorder.</p>

The aim of this study was to evaluate if a population suffering from generalized anxiety disorder could benefit from an Internet based self-help treatment guided via email contact with a therapist. The treatment was based on established cognitive behavioral principles. It was hypothesized that significant improvements would be found as measured by eight self report questionnaires, absence of a clinical diagnoses and global clinical improvement. A total of 89 participants were included and 44 were randomized to a treatment condition and 45 were assigned to a waitlist control. The controls received similar treatment after the first post treatment assessment, conducted eight weeks after the beginning or treatment of the first group. The results showed statistically significant improvements for the treatment group. No changes were observed in the waiting-list control group, with the exception of a minor decrease in depression scores. Large effect sizes were found both within the treatment group and between the two groups in favor of the treatment. In conclusion, Internet treatment can be an efficacious format for treating generalized anxiety disorder.

This thesis follows the research portfolio format and is carried out in part fulfilment of the academic component of the Doctorate in Clinical Psychology at the University of Edinburgh. An abstract provides an overview of the entire portfolio thesis. Chapter One contains a systematic review of published research exploring staff attitudes towards computerized cognitive behavior therapy (cCBT). Chapter Two is an empirical study examining a range of potential predictor variables on well-being outcomes from cCBT. Chapter one is prepared for Behavioural and Cognitive Psychotherapy, whereas chapter two is prepared for submission to the journal, Behaviour Research and Therapy. Both chapters follow the relevant author guidelines. Background: Evidence suggests that computerised cognitive behavioural therapy (cCBT) is both effective and efficacious in treating depression and anxiety. Numerous barriers to its implementation and uptake have been identified, however, including attitudinal variables and high patient attrition rates. Research examining predictors of response from cCBT have tended to adopt the pathological model of distress, focussing on symptom reduction rather than the promotion of well-being. Furthermore, exploration of possible predictors has tended to focus on a narrow range of factors (e.g. age, gender), neglecting key psychosocial variables (e.g. social identification, baseline distress) that could be exerting an effect. Aims: A systematic review examined staff attitudes towards cCBT for depression, anxiety, and comorbid depression and anxiety, focussing on three attitudinal domains: Perceived acceptability of cCBT; staff's self-reported intention to use cCBT in the future, and perceived advantages and disadvantages of cCBT for depression and/or anxiety. An experimental study was subsequently conducted, examining a range of potential predictors on well-being outcomes from a cCBT intervention utilising Beating the Blues. Method: A systematic search across five databases was conducted, followed by manual searches. Strict search criteria were applied, resulting in the identification of 15 studies. These were subjected to quality assessment, data extraction and synthesis. For the empirical study, data from 1354 participants was collected, with subgroup-analyses conducted on those completing measures of life and mental health satisfaction, functioning and well-being. Key potential predictors of interest were level of group identification, baseline distress, and socioeconomic deprivation. Results: Findings from the systematic review indicated that staff held relatively positive attitudes towards cCBT, with some ambivalence emerging in relation to perceived advantages and disadvantages of the intervention. The empirical study obtained significant effects of group identification on life and mental health satisfaction. A mediating impact of group identity on baseline distress emerged, whereas a moderating effect of baseline distress on deprivation was obtained for the functioning model. Discussion: The current findings demonstrated both positive and negative aspects of staff attitudes towards cCBT for depression and/or anxiety, whereas the empirical project established a clear link between social identification, baseline distress, and well-being. Results from both studies are discussed in terms of clinical implications relating to the uptake of cCBT.