Teletherapy vs. In-Person Cognitive Behavioral Therapy for Generalized Anxiety Disorder

Phase

N/A

Condition

Panic Disorders

Mood Disorders

Anxiety Disorders

Treatment

Third-Wave CBT In-Person

Third-Wave CBT via Teletherapy

Clinical Study ID

NCT07119515

GCUF-IRB-585-2025

Ages 18-45
All Genders

Study Summary

The goal of this randomized controlled trial is to compare the clinical efficacy of teletherapy versus in-person third-wave cognitive behavioral therapy (CBT) in treating generalized anxiety disorder (GAD) among young individuals aged 18-45 years in Pakistan. The main questions it aims to answer are:

Is teletherapy as effective as in-person therapy in reducing anxiety symptoms and stress?
Do therapeutic alliance, treatment adherence, and social support influence treatment outcomes differently across delivery methods? Researchers will compare the teletherapy group (remote sessions via digital platforms) and the in-person therapy group (face-to-face sessions) to evaluate differences in symptom reduction, general health improvement, and moderating factors like therapeutic alliance.

Participants will:

Undergo a 8-week intervention with weekly structured third-wave CBT sessions.
Complete assessments at baseline, post-intervention, and follow-up using validated scales (e.g., Generalized Anxiety Disorder-7 [GAD-7], Hamilton Anxiety Rating Scale [HAM-A]).
Engage in modules including mindfulness, behavioral activation, and exposure therapy, adapted for their assigned delivery method.

This study aims to address gaps in mental health accessibility in Pakistan by evaluating whether teletherapy can serve as a viable alternative to traditional in-person care.

Eligibility Criteria

Inclusion

Inclusion Criteria:

age ≥18-≤45 years -meeting the diagnostic criteria according to DSM-5 TR -ability tounderstand and read English -ability to use digital technology and having access tothe Internet -signed an informed consent form

Exclusion

Exclusion Criteria:

the presence of risk of suicide and self-destructive behaviors -presence of anothersevere mental disorder (i.e., substance abuse, psychotic disorder, or bipolardisorder) -presence of severe personality disorder -presence of a medical conditionwhose severity or characteristics prevent participation in treatment -receivinganother psychological treatment during the study
an increase or change in medication during the study period

Study Design

Third-Wave CBT In-Person

March 10, 2025

August 26, 2025

Study Description

This randomized controlled trial (RCT) compares the efficacy of teletherapy versus traditional in-person delivery of third-wave cognitive behavioral therapy (CBT) for treating generalized anxiety disorder (GAD) among adults (aged 18-45 years) in Pakistan. Conducted at Allied Hospital II, Faisalabad, the study will randomize eligible participants(diagnosed via Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision [DSM-5-TR] criteria) into two parallel arms: (1) a teletherapy group receiving 12 weekly sessions via secure video conferencing, and (2) an in-person group attending face-to-face sessions with identical content. Both interventions will follow a standardized third-wave CBT protocol integrating mindfulness, acceptance, and behavioral strategies. Primary outcomes include changes in anxiety severity (measured by Hamilton Anxiety Rating Scale [HAM-A] and Generalized Anxiety Disorder-7 [GAD-7]) and depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]). Secondary outcomes assess perceived stress (Perceived Stress Scale [PSS]), work and social adjustment (Work and Social Adjustment Scale [WSAS]) and therapeutic alliance (Working Alliance Inventory [WAI]). Assessments will occur at baseline, post-intervention, and follow-up. The study aims to address critical gaps in mental healthcare accessibility in resource-limited settings by evaluating whether teletherapy can achieve comparable outcomes to in-person therapy. Ethical approval will be obtained from GCUF's Institutional Review Board (IRB), and the trial adheres to Consolidated Standards of Reporting Trials (CONSORT) guidelines. Results may inform policy decisions to expand remote mental health services in Pakistan.

Connect with a study center

Allied Hospital II
Faisalabad, Punjab 38000
Pakistan
Active - Recruiting

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