title: The effectiveness of internet cognitive behavioural therapy for generalized anxiety disorder in clinical practice.
abstract: BACKGROUND
  Clinical trials have demonstrated the efficacy of internet cognitive behavioral therapy (iCBT) in the treatment of generalized anxiety disorder (GAD). The current study aims to determine whether these efficacy findings, established under controlled research conditions, translate into effectiveness in practice.
  
  
  METHODS
  The sample comprised 588 patients who completed at least one iCBT lesson for GAD through CRUfAD clinic (www.crufadclinic.org). This six-lesson course became available to primary care physicians to prescribe in 2009. Routine data collection included demographics, GAD symptomatology (GAD-7), psychological distress (K-10), and disability (WHODAS).
  
  
  RESULTS
  All six lessons were completed by 324/588 (55.1%) patients. When compared with completers, noncompleters tended to be younger and based in rural locations. Prior to discontinuing the course, noncompleters demonstrated statistically significant reductions in psychological distress. For those who completed the course, effect sizes on all outcome measures were medium to large and over 60% of moderate-to-severe GAD cases met criteria for remission upon treatment completion.
  
  
  CONCLUSIONS
  The current study indicates that computerized CBT for GAD is effective in generating positive, clinically significant outcomes among typical patients treated under the usual conditions in primary care. Future research should focus on reducing treatment discontinuation among younger people and those based in rural locations.
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia. louisem@unsw.edu.au
authors.forename: Louise
authors.initials: L
authors.lastname: Mewton
authors.forename: Nora
authors.initials: N
authors.lastname: Wong
authors.forename: Gavin
authors.initials: G
authors.lastname: Andrews
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome; D055815:Young Adult