The Cool Teens CD-ROM assists adolescents in developing skills to cope with anxiety.
This 8-12 week program is based on the principles of cognitive behavioral therapy (CBT). Cool Teens contains 8 multimedia modules that present information on CBT techniques and anxiety symptoms through text, audio, illustrations, cartoons, and videos. Each module is 30-60 minutes in length. The program uses cognitive restructuring and graded exposure exercises to improve anxiety symptoms. Users also learn about goal setting and relapse prevention. After completion of each module, a clinician contacts each user to encourage continued program engagement and the application of skills to users’ life.
Cognitive Behavioral Therapy (CBT)
Generalized Anxiety Disorder (GAD)
Social Anxiety Disorder
Other Anxiety Disorders
Summary: A case series was conducted with five adolescents recruited from referrals to an anxiety clinic. The purpose of this study was to assess the feasibility of Cool Teens. Four of the teens had a primary diagnosis of generalized anxiety disorder (GAD), while one adolescent had a primary diagnosis of social anxiety disorder. Only one adolescent had no secondary anxiety diagnoses. Each adolescent had access to Cool Teens for 12-weeks, and completed pre-treatment, post-treatment, and 3-month follow-up assessments. Overall, only 2 (40%) of the adolescents completed Cool Teens within twelve weeks. Additionally, 40% of the adolescents had their anxiety symptoms reduced to subclinical levels post-treatment and at the 3-month follow-up. Adolescents with more secondary mental health diagnoses had less improvement than the adolescents with fewer diagnoses. The program was acceptable to the adolescents, who stated that their inability to finish the program was due to exams and a lack of time.
Take Away: The Cool Teens program is feasible for adolescents. Further research is needed to assess the program’s efficacy.
Examination of barriers to treatment and user preferences with computer-based therapy using the Cool Teens CD for adolescent anxiety.
Summary: The five adolescents recruited for the Cool Teens case series (Cunningham et al, 2009) were interviewed about barriers to using the program, as only 20% of the adolescents completed the program. Overall, the adolescents were satisfied with the program. They liked the case examples, music, and content included in the program. Some adolescents felt that the program was not fun and didn’t include adequate personalized content. The adolescents all stated that a lack of time was the major barrier to completing the program. Other barriers to program completion included computer problems, difficulty understanding tasks, and a lack of therapist support.
Take Away: Time, computer problems, and a lack of therapist support prevented teens from engaging with and completing the Cool Teens program.
Summary: This randomized controlled trial tested the efficacy of Cool Teens for anxiety. Adolescents with anxiety were recruited using advertisements in school newspapers, flyers in schools, and referrals from professionals. While over one-third met criteria for generalized anxiety disorder (GAD), some participants were also diagnosed with social anxiety, separation anxiety, obsessive compulsive disorder, or panic disorder. Any adolescents with current psychosis, suicidal ideation, or bipolar disorder were excluded. After the initial screening, 43 adolescents were randomized to Cool Teens or to a waitlist control group. While all participants completed the pre-test assessment and a post-treatment assessment 3 months after randomization, only participants getting Cool Teens completed a follow-up 3 months after the post-treatment assessment. At the post-treatment assessment, the Cool Teens group had significantly larger reductions in the total number of anxiety symptoms, anxiety diagnoses, internalizing symptoms, and negative automatic thoughts. These changes were in concordance with changes noted by the parents of the participants. There were no significant differences in the total number of participants who were in remission post-treatment. Improvements in anxiety were maintained at the 3-month follow-up assessment.
Take Away: Cool Teens may be effective in reducing anxiety symptoms in adolescents. The use of CD-ROM formats are dated at this point, and content is difficult and costly to update and adapt.