Self-help via the Internet : A new approach to psychological treatment

• Main Author: Ström, Lars
• Format: Doctoral Thesis
• Language: English
• Published: Uppsala universitet, Institutionen för psykologi 2003
• Subjects: Psychotherapy; Internet; treatment; sleep disorder; insomnia; stress management; stress; headache; drop-out; self-help; minimal therapist contact; Psykoterapi; Psychiatry; Psykiatri
• Online Access: http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3592; http://nbn-resolving.de/urn:isbn:91-554-5745-2

During the last 30 years, studies have shown self-help to be effective in a number of areas, and to produce equal or close to equal results compared to face-to-face therapy. The Internet can reach a large number of people at a low cost and add the possibility of two-way communication to self-help, thereby offering cost-effective psychological treatments. This thesis is based on four studies and aiming to investigate if self-help treatment conducted through Internet can reduce problems with insomnia, stress and headache and reach effect sizes comparable to previous minimal contact treatment studies. Other aims were to investigate cost-effectiveness, and to examine if adding regular telephone contact would reduce drop-out rates. Treatments involved psychological techniques previously proved to be effective for each problem. The first study showed a significant decrease in headache severity, and 50% of the participants in the treatment condition showed a clinically significant improvement. In Study II an Internet-based stress management program resulted in significant reductions of perceived stress, anxiety and depression. Improvements were found in both groups, with stronger effects in the self-help treatment group. Study III, a sleep management program, resulted in statistically significant improvements in the treatment group on all main variables, including total sleep time, total wake time in bed, and sleep efficiency. Some improvements were also found in the control group. Follow-up data indicated that improvements were sustained. Study IV did not confirm the hypothesis that the drop-out rates during headache treatment should decrease significantly if adding short and regular telephone contacts. Results from this thesis suggest that Internet is a medium well suited for therapy, with effect sizes comparable to face-to-face therapy, that using Internet as a medium for treatment can reduce costs while still maintaining similar results, and that adding a small amount of telephone contact does not decrease attrition.