FearFighter (UK)

Description:

The FearFighter program uses self-exposure to address anxiety, panic and phobia and is a practice-based self-help treatment system which encourages you to identify your specific problems and develop treatment goals. Access to the program is granted through Primary Care Trusts in the UK, and your eligibility for FearFighter is assessed by a support worker. The program comprises nine key steps which begin with self-rated questionnaires, information about self-exposure therapy, and advice on seeking support for your treatment. Then you move onto identifying your own personal triggers to panic and their related problems, constructing homework tasks involving exposure for each trigger, planning for and learning good coping strategies in situations involving panic and the practice of these during self-exposure, reviews of homework tasks with feedback, and planning for the future to maintain your progress and prevent relapse. The FearFighter program provides access to a helpline run by trained support workers; during the program you receive up to one hour of helpline support. The program is approved by the National Institute of Clinical Excellence (NICE) in the UK.

Service URL:

http://www.fearfighter.com

Agency Responsible:

CCBT Limited: HealthCare Online.

Details

Format:

Website.

Intervention Type:

Psychological – CBT.

Course Length:

Long (more than 5 modules). Nine key steps over approximately 10 weeks

Support Option:

Automated only. Access to trained support workers through a helpline

Target Audience

Primary Category:

Panic disorder.

Secondary Categories:

Phobias and Generalised anxiety disorder.

Target Audience:

Adult.

Language:

English.

Access

Fee:

Free. Under the NHS in over one-third of Primary Care Trusts in the UK

Access:

Closed: Email administrator. You must contact your GP for a referral. It is only available in the UK but its developers are hoping to make it internationally accessible soon.

Contact Details:

enquiries@fearfighter.com

Research evidence

Research Trials:

5

Research RCTs:

2

Outcome Summary:

FearFighter has been associated with significant improvements on global phobia, anxiety/depression, social anxiety and agoraphobia subscales of the Fear Questionnaire (FQ) and work and social adjustment. These benefits have been similar to clinic-based therapy and persisted post-treatment. For example, a large effect was maintained at 4 months in a rural Scottish sample. Two randomised controlled trials (RCTs) have yielded positive results. In 2004 it was reported that FearFighter demonstrated significant and similar improvements to a clinic-based version of the program, and that both were significantly more effective than a relaxation program which excluded exposure. These gains remained significant at 1 and 3 month follow-up. A more recent RCT comparing FearFighter with a minimal cognitive behavioural therapy (CBT) program not including exposure revealed similar improvements at 10 weeks. However, 1 month follow-up revealed significant medium-large improvements for FearFighter on 5 out of 10 measures reflecting self and other assessments of main problems, and self-rated work and social adjustment, FQ-agoraphobia and anxiety/depression. In a recent uncontrolled study, the majority of users of FearFighter obtained some benefit from using the program, but the majority only improved to a small extent, and only about a third felt that most or all of their needs had been met by the program. FearFighter demonstrates good evidence that it is effective for anxiety, phobia and panic as a complement (not a replacement) to professional consultation. However, since the second RCT did not show effects post-treatment more research is needed.

Recommended rating, reviewer 1:

Recommended rating, reviewer 2:

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Research paper citations

1. Kenwright, M., Marks, I.M., Gega, L. & Mataix-Cols, D. (2004). Computer-aided self-help for phobia/panic via internet at home: A pilot study. British Journal of Psychiatry, 184, 448-449.
2. Hayward, L. & MacGregor, A.D. (2007). The feasibility and effectiveness of computer-guided CBT (FearFighter) in a rural area. Behavioural and Cognitive Psychotherapy, 35, 409-419.
3. Schneider, A.J., Mataix-Cols, D., Marks, I.M. & Bachofen, M. (2005). Internet-guided self-help with or without exposure therapy for phobic and panic disorders. Psychotherapy and Psychosomatics, 74, 154-164.
4. Marks, I.M., Kenwright, M., McDonough, M., Whittaker, M. & Mataix-Cols, D. (2004). Saving clinicians’ time by delegating routine aspects of therapy to a computer: A randomized controlled trial in phobia/panic disorder. Psychological Medicine, 34, 9-18. 
5. MacGregor, A. D., Hayward, L., Peck, D. F., & Wilkes, P. (2009). Empirically grounded clinical interventions clients' and referrers' perceptions of computer-guided CBT (FearFighter). Behavioral and Cognitive Psychotherapy, 37(1), 1-9.