Brief Online Cognitive Behavioral Therapy for Indian Expatriates with Excessive Worry: a Pilot Feasibility Study

Pilot Study Testing an Online-delivered Psychological Intervention for Indian Expatriates in Sweden Who Experience Dysfunctional Worry

Background: Expatriates may face challenges through distance from support systems, cultural adjustments, and language barriers, which may be associated with anxiety and elevated worry, particularly in times of ongoing global crises. Brief online cognitive-behavioral therapy (ICBT) is effective for treating excessive worry but has not been adapted for expatriate communities in Sweden.

This pilot study aimed to investigate the feasibility, acceptability, and preliminary treatment effects of a five-week, therapist-guided, culturally adapted ICBT program. The program targeted excessive worry related to ongoing global crises among Indian expatriates.

Inclusion Criteria:

• identifying as Indian expatriate currently living in Sweden
• self-reported dysfunctional worry, defined as worrying several times a day and the worry being experienced as difficult to control
• age ≥ 18 years;
• able to provide digital informed consent
• having daily access to a device with internet connection.

Exclusion Criteria:

• non-English speaking
• self-reported severe depression (>28 points on the Montgomery Åsberg Depression Rating Scale (MADRS-S; (Svanborg & Åsberg, 1994)
• suicidal risk (5 points on item 9 on the MADRS-S).