onlineTalking therapies delivered via the Internet are more effective for treating severe anxiety than other web-based psychological treatments, according to a new study.

While previous studies have shown that internet-based cognitive behavioural therapy (CBT) is effective for treating severe anxiety, they have not been compared to other credible psychological treatments, such as behavioural stress management (BSM). Swedish researchers set out to examine which was the most effective form of internet-delivered stress management treatment – CBT or BSM. The results are published in the British Journal of Psychiatry.

In the study, 158 people with a diagnosis of severe anxiety were divided into two groups. The first group of 79 individuals received 12 weeks of CBT delivered via the internet, while the second group had 12 weeks of BSM web-based treatment.

The internet-delivered CBT included individuals being exposed to anxiety-related situations or events. In contrast, the internet-delivered BSM focused mainly on relaxation techniques.

Researchers found that both groups experienced overall reductions in stress but internet-delivered CBT led to larger reductions in anxiety compared to internet-delivered BSM.

Dr Erik Hedman, licensed psychologist, PhD, of the Department of Clinical Neuroscience at Karolinska Institutet in Stockholm, said: “Our study shows that CBT delivered via the internet can be an effective treatment for severe anxiety that results in treatment effects above and beyond those of an active, credible and effective internet-delivered psychological treatment based on relaxation and stress management.

“This study gives further support for using internet-delivered CBT as a means for increasing accessibility to effective psychological treatment for severe anxiety.”


Hedman E, Axelsson E, Görling A, Ritzman C, Ronnheden M, El Alaoui S, Andersson E, Lekander M, and Ljótsson B. (2014) Internet-delivered exposure-based cognitive–behavioural therapy and behavioural stress management for severe health anxiety: randomised controlled trial. British Journal of Psychiatry. ePub ahead of print 7 August 2014