{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T22:14:32Z","timestamp":1777414472865,"version":"3.51.4"},"reference-count":48,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2019,7,24]],"date-time":"2019-07-24T00:00:00Z","timestamp":1563926400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Aust N Z J Psychiatry"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>This review examines the evidence from head-to-head randomised controlled trials addressing whether the efficacy of cognitive-behavioural therapy for anxiety disorders, obsessive-compulsive disorder and post-traumatic stress disorders in adults delivered by computer or online (computer- and Internet-delivered cognitive-behavioural therapy) is not inferior to in-person cognitive-behavioural therapy for reducing levels of symptoms and producing clinically significant gains at post-treatment and at follow-up. A supplementary aim is to examine the evidence for severity as a moderator of the relative efficacy of computer- and Internet-delivered cognitive-behavioural therapy and in-person cognitive-behavioural therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>PubMed, PsycINFO, Embase and Cochrane database of randomised trials were searched for randomised controlled trials of cognitive-behavioural therapy for these disorders with at least an in-person cognitive-behavioural therapy and Internet or computer cognitive-behavioural therapy arm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 14 randomised controlled trials (9 Internet, 5 computer) of cognitive-behavioural therapy for social anxiety disorder, panic disorder and specific phobia and 3 reports of effect moderators were included. One study showed a low risk of bias when assessed against risk of bias criteria for non-inferiority trials. The remaining studies were assessed as high or unclear risk of bias. One study found that Internet-delivered cognitive-behavioural therapy was superior and non-inferior at post-treatment and follow-up to group in-person cognitive-behavioural therapy for social anxiety disorder. One study of Internet-delivered cognitive-behavioural therapy for panic disorder showed non-inferiority to individual in-person cognitive-behavioural therapy for responder status at post-treatment and one of Internet cognitive-behavioural therapy for panic disorder for symptom severity at follow-up. Other comparisons (22 Internet, 13 computer) and for estimates pooled for Internet cognitive-behavioural therapy for social anxiety disorder, Internet cognitive-behavioural therapy for panic disorder and computer-delivered cognitive-behavioural therapy studies did not support non-inferiority. Evidence of effect moderation by severity and co-morbidity was mixed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>There is limited evidence from randomised controlled trials which supports claims that computer- or Internet-delivered cognitive-behavioural therapy for anxiety disorders is not inferior to in-person delivery. Randomised controlled trials properly designed to test non-inferiority are needed before conclusions about the relative benefits of in-person and Internet- and computer-delivered cognitive-behavioural therapy can be made.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Prospero:<\/jats:title>\n                    <jats:p>CRD420180961655-6<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0004867419864433","type":"journal-article","created":{"date-parts":[[2019,7,24]],"date-time":"2019-07-24T11:52:06Z","timestamp":1563969126000},"page":"851-865","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Are claims of non-inferiority of Internet and computer-based cognitive-behavioural therapy compared with in-person cognitive-behavioural therapy for adults with anxiety disorders supported by the evidence from head-to-head randomised controlled trials? A systematic review"],"prefix":"10.1177","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7839-7920","authenticated-orcid":false,"given":"Richard","family":"O\u2019Kearney","sequence":"first","affiliation":[{"name":"Research School of Psychology, The Australian National University, Canberra, ACT, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheri","family":"Kim","sequence":"additional","affiliation":[{"name":"Research School of Psychology, The Australian National University, Canberra, ACT, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachelle L","family":"Dawson","sequence":"additional","affiliation":[{"name":"Research School of Psychology, The Australian National University, Canberra, ACT, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison L","family":"Calear","sequence":"additional","affiliation":[{"name":"Research School of Population Health, The Australian National University, Canberra, ACT, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,7,24]]},"reference":[{"key":"bibr1-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.13280"},{"key":"bibr2-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.311.7003.485"},{"key":"bibr3-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2011.09.019"},{"key":"bibr4-0004867419864433","first-page":"1","volume":"155","author":"American Psychiatric Association (APA)","year":"2009","journal-title":"The American Journal of Psychiatry"},{"key":"bibr5-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"bibr6-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1016\/j.chb.2008.02.003"},{"key":"bibr7-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.74.4.677"},{"key":"bibr8-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20151"},{"key":"bibr9-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1177\/0004867418799453"},{"key":"bibr10-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2018.01.001"},{"key":"bibr11-0004867419864433","doi-asserted-by":"publisher","DOI":"10.3109\/00048674.2010.538840"},{"key":"bibr12-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0098118"},{"key":"bibr13-0004867419864433","volume-title":"Anxiety and Its Disorders: The Nature and Treatment of Anxiety and Panic","author":"Barlow DH","year":"2002","edition":"2"},{"key":"bibr14-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-10-54"},{"key":"bibr15-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1089\/cyber.2009.0224"},{"key":"bibr16-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1037\/0021-843X.110.1.49"},{"key":"bibr17-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1080\/16506073.2017.1401115"},{"key":"bibr18-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2004.10.002"},{"key":"bibr19-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1002\/da.22728"},{"key":"bibr20-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20346"},{"key":"bibr21-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2016.05.002"},{"key":"bibr22-0004867419864433","first-page":"234","volume":"151","author":"*Ghosh A","year":"1988","journal-title":"British Journal of Psychiatry"},{"key":"bibr23-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7894(00)80041-6"},{"key":"bibr24-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1002\/jts.20367"},{"key":"bibr25-0004867419864433","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-132-9-200005020-00006"},{"key":"bibr26-0004867419864433","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v63n0209"},{"key":"bibr27-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2015.06.002"},{"key":"bibr28-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1375\/bech.18.2.103"},{"key":"bibr29-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2012.01834.x"},{"key":"bibr30-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0018001"},{"key":"bibr31-0004867419864433","doi-asserted-by":"publisher","DOI":"10.1177\/009286159903300424"},{"key":"bibr32-0004867419864433","first-page":"24309","volume":"66","author":"International Conference on Harmonisation (ICH)","year":"2001","journal-title":"Notice. 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