Review of internet-based prevention and treatment programs for anxiety and depression in children and adolescents.

OBJECTIVE: To identify and describe current internet-based prevention and treatment programs for anxiety and depression in children and adolescents. DATA SOURCES: Systematic search of the Cochrane Library, PsycINFO and PubMed databases conducted in June 2009. STUDY SELECTION: Studies of internet-based programs that addressed anxiety or depression in children and adolescents. No restrictions were placed on study quality. DATA SYNTHESIS: Eight studies of four intervention programs were identified. Programs were delivered via schools, in primary care, through mental health clinics or open access websites. Two were treatment programs, three offered universal prevention, two were indicated prevention programs, and one was a selective prevention program. Study quality was mixed, with three randomised controlled trials in which participants were randomly allocated to the intervention or control condition, one randomised uncontrolled trial, two controlled trials in which participants were not randomly assigned to conditions, and two uncontrolled pre-post evaluations. Two studies targeted anxiety in children, while the remainder addressed depression, or anxiety and depression, in adolescents. All the interventions were based on cognitive behaviour therapy, and six of the eight studies reported post-intervention reductions in symptoms of anxiety and/or depression or improvements in diagnostic ratings. Three of these studies also reported improvements at follow-up.
CONCLUSION: Our findings provide early support for the effectiveness of internet-based programs for child and adolescent anxiety and depression. More extensive and rigorous research is needed to further establish the conditions through which effectiveness is enhanced, as well as to develop additional programs to address gaps in the field.