In-clinic and standalone internet cognitive behavior therapy treatment for social anxiety in stuttering: A randomized trial of iglebe

© 2019 American Speech-Language-Hearing Association. All rights reserved. Purpose: iGlebe is an individualized, fully automated Internet cognitive behavior therapy (CBT) treatmentprogram that requires no clinician contact. Phase Iand II trials have demonstrated that it may be efficaciousfor treating the social anxiety commonly associatedwith stuttering. The present trial sought to establishwhether the outcomes achieved by iGlebe are noninferiorto those associated with in-clinic CBT from clinicalpsychologists.Method: Fifty adults with stuttering were randomized toreceive in-clinic CBT for anxiety or 5 months online accessto iGlebe. The design was a noninferiority randomizedcontrolled trial with outcomes assessed at prerandomizationand at 6 and 12 months postrandomization. Primaryoutcomes were CIDI-Auto-2.1 diagnoses for anxiety andmood disorders and Brief Fear of Negative Evaluation scalescores (Carleton, McCreary, Norton, & Asmundson, 2006).Secondary outcomes included speech, psychology, andquality-of-life measures.Results: Outcomes consistently showed clinically significantimprovements of around a medium effect size for thecohort as a whole from prerandomization to 6 monthspostrandomization, which were maintained at 12 monthspostrandomization. Comparisons between the 2 treatmentsshowed little difference between iGlebe and in-clinictreatment for all primary and secondary outcomes, with lastobservation carried forward for missing data.Conclusions: iGlebe is a promising individualized treatmentfor social anxiety for adults who stutter and offers a viableand inexpensive alternative to in-clinic CBT with clinicalpsychologists. An issue to emerge from this trial, whichrequires clarification during future clinical trials of iGlebe, isthe posttreatment relation between percentage of syllables stuttered and self-reported stuttering severity ratings