International Phase II clinical trial of CBTPsych: A standalone Internet social anxiety treatment for adults who stutter

• Preliminary trials showed encouraging results for CBTPsych, a standalone Internet anxiety treatment for those who stutter.
• However, it was unknown whether the site would be efficacious without any clinical contact at all.
• Results showed that this was in fact the case.

PurposeCBTPsych is an individualized, fully automated, standalone Internet treatment program that requires no clinical contact or support. It is designed specifically for those who stutter. Two preliminary trials demonstrated that it may be efficacious for treating the social anxiety commonly associated with stuttering. However, both trials involved pre- and post-treatment assessment at a speech clinic. This contact may have increased compliance, commitment and adherence with the program. The present study sought to establish the effectiveness of CBTPsych in a large international trial with no contact of any kind from researchers or clinicians.MethodParticipants were 267 adults with a reported history of stuttering who were given a maximum of 5 months access to CBTPsych. Pre- and post-treatment functioning was assessed within the online program with a range of psychometric measures.ResultsForty-nine participants (18.4%) completed all seven modules of CBTPsych and completed the post-treatment online assessments. That compliance rate was far superior to similar community trials of self-directed Internet mental health programs. Completion of the program was associated with large, statistically and clinically significant reductions for all measures. The reductions were similar to those obtained in earlier trials of CBTPsych, and those obtained in trials of in-clinic CBT with an expert clinician.ConclusionsCBTPsych is a promising individualized treatment for social anxiety for a proportion of adults who stutter, which requires no health care costs in terms of clinician contact or support.Educational objectivesThe reader will be able to: (a) discuss the reasons for investigating CBTPsych without any clinical contact; (b) describe the main components of the CBTPsych treatment; (c) summarize the results of this clinical trial; (d) describe how the results might affect clinical practice, if at all.