A Randomized Controlled Feasibility Trial of Internet-Delivered Guided Self-Help for Generalized Anxiety Disorder (GAD) Among University Students in India


Background: Online guided self-help may be an effective and scalable intervention for symptoms of generalized anxiety disorder (GAD) among university students in India. Methods: Based on an online screen for GAD administered at four Indian universities, 222 students classified as having clinical (DSM-5 criteria) or subthreshold (GAD-Q-IV score ≥ 5.7) GAD were randomly assigned to receive either three months of guided self-help cognitive-behavioral therapy (n = 117) or a waitlist control condition (n = 105). Results: Guided self-help participants recorded high program usage on average across all participants enrolled (M = 9.99 hours on the platform; SD = 20.87). Intent-to-treat analyses indicated that participants in the guided self-help condition experienced significantly greater reductions than participants in the waitlist condition on GAD symptom severity (d = -0.40), worry (d = -0.43), and depressive symptoms (d = -0.53). No usage variables predicted symptom change in the guided self-help condition. Participants on average reported that the program was moderately helpful, and a majority (82.1%) said they would recommend the program to a friend. Conclusions: Guided self-help appears to be a feasible and efficacious intervention for university students in India who meet clinical or subthreshold GAD criteria.