Distance-based delivery of cognitive-behavioural therapy for high anxiety sensitivity: A randomized controlled trial

Anxiety disorders are the most common mental illness in Canada (Statistics Canada, 2004). They are pervasive conditions with serious psychological, physiological, economic, and interpersonal implications (Health Canada, 2002). Anxiety sensitivity (AS) is one individual characteristic that has been implicated in the onset and maintenance of anxiety disorders (Schmidt, Lerew, & Jackson, 1999). AS is a fear of anxiety-related sensations, such as increased heart rate, that arises from the tendency to believe that these sensations will have serious physical, psychological, or social consequences (Reiss, 1991). Researchers have found that a brief cognitive-behavioural therapy (CBT) reduces AS among those with high AS (Watt & Stewart, 2008). Increasingly, CBT is recognized as the treatment of choice for anxiety disorders (Norton & Price, 2007). However, access to psychological treatments is limited by geography, fear of stigma, lack of sufficient qualified clinicians, lack of treatment availability, and disability preventing travel. These barriers are particularly relevant for rural Canadians. A distance delivery approach to mental healthcare, in which treatment is delivered via telephone, mail, or internet, is one way to minimize treatment barriers and increase access to care while still delivering standardized, empirically supported treatment. Given the need for treatment of AS and anxiety disorders in Canada, the challenges faced in treatment access, and the promise of distance treatment, we are proposing to study the effectiveness of distance-based CBT in decreasing AS among rural Canadians with high AS. Participants will follow a treatment program from their home and will engage in weekly telephone sessions with a therapist. Past research suggests this treatment reduces high AS, thus we expect it will yield important health benefits to Canadians. This project also aims to use distance service delivery to open up new avenues for treatment access for rural Canadians.