Therapist-Assisted, Online (TAO) Intervention for Anxiety in College Students: TAO Outperformed Treatment as Usual

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How can time spent conducting individual psychotherapy go farther? How can psychotherapy make effective use of ubiquitous smartphones, tablets, and laptop computers? Traditional hour-long, face-to-face therapy is effective, but it cannot meet the demand in many mental health sectors and fails to capitalize on emergent communication tools. There is a need for new treatments that are effective but more efficient. Individual treatment that uses online components to reduce, not eliminate, direct contact with the psychotherapist was first used and proven effective in several other countries. It now is being implemented and researched in the United States. This article details the structure, content, and effectiveness of Therapist Assisted Online (TAO) psychotherapy, a 7-week individual treatment for anxiety that uses online tools to keep client engagement and therapeutic intensity high, with a fraction of the therapist time of conventional therapy. TAO treatment pairs online educational materials with brief therapist contact through phone, chat, or video conferencing. This treatment combines 4 tools associated with improved outcomes: text-message reminders, homework on mobile devices, video conference sessions, and weekly progress measures completed by and reviewed with the client. In research conducted at a large university counseling center, TAO clients had greater reductions in anxiety and greater improvement in global mental health, life functioning, and their sense of well-being than treatment-as-usual clients. Although not all anxiety clients are suitable candidates, TAO can treat many clients for whom treatment as usual is not ideal or practical, without fear that client welfare or therapy effectiveness are affected.

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