Anxiety treatment pilot program reaches teens where they are-online

High satisfaction rates reported as researchers look to increase low completion rates.

An innovative program designed to reach anxiety-ridden teens where they're most likely to be-online-showed high satisfaction rates in a recently completed pilot study.

The Breathe Program is a self-led, online intervention that contains six cognitive behavioural therapy (CBT)-based modules presented through the use of interactive text, embedded videos and comic book style storyboards, and is geared to youth who have mild to moderate anxiety symptoms and who can't or wouldn't otherwise seek help because of barriers to treatment.

One in 10 youth experiences anxiety

"It's important that teens who have anxiety get help. Anxiety disorders diagnosed in childhood do not often resolve over time without intervention," said Ashley Radomski, a graduate researcher in the pediatrics mental health group at the University of Alberta, adding that about one in 10 youth experiences anxiety at a level that is diagnosable and requires treatment.

What teens have to say

"Watching the videos from real people who also suffer from anxiety was enjoyable because I felt I could relate to (most of) them."

"I think I subconsciously use (the skills I learned in the Breathe program) a lot, but the most helpful thing was to try and think realistically. It helps a lot because most of the things I get anxious about are highly unrealistic. I use that skill almost every time I get anxious."

"Facing my fears and organizing my thoughts was a challenge because sometimes I would have to dig deep to find answers."

"I like the information about conversation skills and body image. That was really interesting and kind of eye-opening."

"CBT teaches people to gradually face feared situations by applying skills and activities, such as self-talk or deep breathing, and to replace anxious thoughts with healthier ones. It's the recommended treatment for mild or moderate anxiety," she added.

Radomski is a member of the team working on scientifically proving the merits of the Breathe Program, a pan-Canadian program developed in 2013 by Amanda Newton, pediatrics associate professor at the U of A, along with Alexa Bagnell, pediatrics associate professor, and Patrick McGrath, pediatrics professor at Dalhousie University.

The next phase of the study is now underway: a full-scale randomized controlled trial that will evaluate the effectiveness of Breathe compared to a typical online resources.

In the meantime, Radomski is researching why two-thirds of the participants in the pilot study did not complete the online program-especially given the high satisfaction rating.

"It's common for an Internet-based interventions to report low completion rates," she said, adding that she's looking into user experience as well as design and delivery components in a separate research project with the goal of better understanding the factors affecting completion rates.

Getting youth the help they need

CBT is traditionally provided to youth by trained mental health professionals in person; however, there are barriers to accessing CBT, especially for teenagers, explained Radomski.

"Many youth may not be aware they need help, they may have concerns around stigma for mental health concerns or they may struggle with access to, costs of, or availability of care."

The trouble is that untreated anxiety can wreak future havoc on the health and well-being of teens who do not receive care.

"Early-onset [anxiety] disorders tend to follow a chronic course and can significantly interfere with interpersonal relationships, academic performance and daily functioning," said Radomski.

If teens don't get the treatment they need, disorders present significant future risk of adult anxiety disorders, educational underachievement, suicidality, depression, substance use and hospitalization, she added.

Youth between the ages of 13 and 19 who are interested in the Breathe program can see if they are eligible to participate in the full-scale study currently being conducted across Canada.

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