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To investigate the efficacy and mechanisms of change of an Internet-delivered transdiagnostic REBT intervention for adolescents with internalizing problems.
The main objectives of this study are to evaluate the efficacy and mechanisms of change of an Internet-delivered Rational Emotive Behavior Therapy for adolescents (12-15 years) diagnosed with a principal anxiety or depressive disorder according to DSM-5 criteria. Participants will be randomly allocated to one of the two groups: experimental (REBTonAd) and waitlist control. The intervention is structured in 8 modules and will be delivered over six weeks. Assessments will be conducted at four time points: baseline, post-treatment, 3-month follow-up, and 6-month follow-up.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Transdiagnostic Internet-delivered REBT | Experimental | Protocol is based on Rational Emotive Therapy (Ellis, 1962, 1994), structured in 8 modules delivered over 6 weeks (Module 1- Introduction and psychoeducation about emotions, Module 2 - Psychoeducation anxiety and depression, Module 3 - Relaxation, Module 4 - Negative patterns of thinking and cognitive restructuring, Module 5 - Problem solving, Module 6 - Exposure and Behavioral activation, Module 7 - Positive emotions and Module 8 - Gaining maintenance) |
|
| Waitlist | No Intervention | Participants in the control group will complete pre-treatment and post-treatment assessments. After participants in the experimental group complete post-treatment assessment, they will receive the intervention. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Transdiagnostic Internet-delivered REBT | Behavioral | The protocol is based on Rational Emotive and Behavioral Therapy (REBT; Ellis, 1962, 1994). The program will consist of 8 modules, delivered online over six weeks. |
| Measure | Description | Time Frame |
|---|---|---|
| Internalizing problems measured with the Youth Self-Report 11/18 (YSR; Achenbach & Rescorla, 2001) | Change in self-reported internalizing problems from baseline to post-treatment, at 6 months post treatment. Higher scores indicate higher levels of internalizing problems. | Baseline, Immediately after the intervention (an expected average of 6 weeks), 6-month follow-up |
| Measure | Description | Time Frame |
|---|---|---|
| Automatic Thoughts QuestionnaireShort Version (ATQ-SV; Netemeyer et al., 2002) | Change in negative automatic thoughts from baseline. Higher scores indicating higher levels of negative automatic thoughts. | Baseline, Immediately after the intervention (an expected average of 6 weeks), 6-month follow-up |
| The child and adolescent scale of irrationality (CASI; Bernard & Cronan, 1999) |
| Measure | Description | Time Frame |
|---|---|---|
| The anxiety subscale from The Beck Youth Inventories™ -Second Edition for Children and Adolescents (Beck, Beck, & Jolly, 2005). | Change in anxiety subscale from baseline. This subscale contains 20 items, rated on a 4 point Likert scale, with 0 = Never and 3 = Always. The total score is obtained by summing the 20 items, with higher scores indicating higher symptoms of anxiety. | Baseline, Immediately after the intervention (an expected average of 6 weeks), 6-month follow-up |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Anca Dobrean, Ph.D. | BabeČ™-Bolyai University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| BabeČ™-Bolyai University | Cluj-Napoca | Cluj | 400015 | Romania |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41545507 | Derived | Dobrean A, Poetar CR, Florean IS, Balan R, Andersson G. Transdiagnostic Internet-delivered intervention for children and adolescents with anxiety and depressive disorders: a randomized controlled trial. NPJ Digit Med. 2026 Jan 16;9(1):156. doi: 10.1038/s41746-026-02341-x. |
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Change in irrational beliefs from baseline. Higher scores indicate higher levels of irrational beliefs. |
| Baseline, Immediately after the intervention (an expected average of 6 weeks), 6-month follow-up |
| The Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents, The Revised Version - adolescent version (Kiddo-KINDL; Ravens-Sieberer, & Bullinger, 1998) | Change in quality of life from baseline from baseline. Higher scores indicate higher levels of quality of life. | Baseline, Immediately after the intervention (an expected average of 6 weeks), 6-month follow-up |
| The Adolescent Peer Relations Instrument (APRI; Parada, 2000) | Change in bullying victimization from baseline. Higher scores indicate higher levels of peer victimization. | Baseline, Immediately after the intervention (an expected average of 6 weeks), 6-month follow-up |
| Principal diagnosis based on Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria | Diagnostic interview for anxiety disorders and/or depressive disorders | Baseline, 6-month follow-up |
| The depression subscale from the Beck Youth Inventories™ -Second Edition for Children and Adolescents (Beck et al., 2005) | Change in depression subscale from baseline. This subscale contains 20 items, rated on a 4 point Likert scale, with 0 = Never and 3 = Always. The total score is obtained by summing the 20 items, with higher scores indicating higher symptoms of depression. | Baseline, Immediately after the intervention (an expected average of 6 weeks), 6-month follow-up |
| Client Satisfaction Scale | Satisfaction with the program. Higher scores indicate higher treatment satisfaction | Immediately after the intervention (an expected average of 6 weeks) |
| ID | Term |
|---|---|
| D001008 | Anxiety Disorders |
| D000072861 | Phobia, Social |
| D000098647 | Generalized Anxiety Disorder |
| D016584 | Panic Disorder |
| D003865 | Depressive Disorder, Major |
| D003863 | Depression |
| ID | Term |
|---|---|
| D001523 | Mental Disorders |
| D010698 | Phobic Disorders |
| D003866 | Depressive Disorder |
| D019964 | Mood Disorders |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
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