Open Access Open Badges Study protocol

Cell phone-supported cognitive behavioural therapy for anxiety disorders: a protocol for effectiveness studies in frontline settings

Joakim Ekberg1*, Toomas Timpka12, Magnus Bång2, Anders Fröberg2, Karin Halje3 and Henrik Eriksson2

Author Affiliations

1 Department of Medical and Health Sciences, Linköping University, Linköping, Sweden

2 Department of Computer Science, Linköping University, Linköping, Sweden

3 Unga Vuxna Clinic, Östergötland County Council, Linköping, Sweden

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BMC Medical Research Methodology 2011, 11:3  doi:10.1186/1471-2288-11-3

Published: 10 January 2011



Reviews of randomized controlled trials (RCTs) of cognitive behavioural therapy (CBT) for anxiety disorders have reported large pre- to post-treatment within-group effect sizes on measures of anxiety when supplied in therapist consultations and in technology-supported settings. However, the stringent experimental control of RCTs results in a lack of external validity, which limits the generalizability of findings to real-world frontline clinical practice. We set out to examine the specification of a protocol for study of the effectiveness of cell phone-supported CBT for in situ management of anxiety disorders.

Methods and design

Nominal group methods were used for requirements analysis and protocol design. Making a distinction between different forms of technology-supported therapy, examination of therapists' role, and implementing trials in existing organizational and community contexts were found to be the central requirements in the protocol.


The resulting protocol (NCT01205191 at for use in frontline clinical practice in which effectiveness, adherence, and the role of the therapists are analyzed, provides evidence for what are truly valuable cell phone-supported CBT treatments and guidance for the broader introduction of CBT in health services.