As noted in previous sections, there has been an expansion of research into e-health interventions, with growing evidence to support its use in managing and treating various disorders. A systematic review and meta-analysis examining e-health interventions for GAD found significant post-treatment improvements for generalised anxiety and pathological worry [735]. Indeed, the efficacy of e-health interventions was found to be equivalent to that of CBT interventions delivered face-to-face. The review further concluded that CBT- based interventions have a stronger evidence-base and greater efficacy compared to psychodynamic-based interventions.
Two other meta-analyses have examined the efficacy of internet-based approaches for anxiety [736, 737]. Spek and colleagues [736] evaluated internet-based CBT for anxiety and depressive disorders and found larger effect sizes for anxiety than depression interventions, which was suggested to be related to the amount of therapist support provided alongside the internet-based intervention. Cuijpers and colleagues [737] similarly demonstrated that computer-based psychotherapy was as effective for managing and treating anxiety disorders as face-to-face treatment, regardless of disorder type.
In relation to the management of phobia and panic disorder, the UK NICE Guidelines recommend FearFighter, a computer-based psychotherapy, as an evidence-based treatment for anxiety [444]. FearFighter is a CBT-based e-health intervention based on self-exposure therapy [738]. Research has found that the FearFighter program is as effective as face-to-face interventions in managing and treating panic and phobia [739].
To date, no e-health interventions have been developed for treating comorbid anxiety and AOD use. However, an Australian program called Anxiety Online does provide links to psychoeducation surrounding AOD use [740]. Anxiety Online comprises five e-therapy programs for GAD, SAD, panic disorder, PTSD, and OCD. Definitive evidence regarding the efficacy of this program is lacking; however, a naturalistic study found that the participation in Anxiety Online was associated with significant reductions in severity of all five disorders, and increased confidence in managing one’s own mental health care. Significant improvements in quality of life were also observed for the GAD, SAD, OCD, PTSD, and e-therapy programs, but not the panic disorder program. Overall, treatment satisfaction was good across all five e-therapy programs.