Web-Based Single Session Intervention for Perceived Control Over Anxiety During COVID-19: Randomized Controlled Trial

Abstract

Background: Anxiety is rising across the United States during the COVID-19 pandemic, and social distancing mandates preclude in-person mental health care. Greater perceived control over anxiety has predicted decreased anxiety pathology, including adaptive responses to uncontrollable stressors. Evidence suggests that no-therapist, single-session interventions can strengthen perceived control over emotions like anxiety; similar programs, if designed for the COVID-19 context, could hold substantial public health value. Objective: Our registered report evaluated a no-therapist, single-session, online intervention targeting perceived control over anxiety in the COVID-19 context against a placebo intervention encouraging handwashing. We tested whether the intervention could (1) decrease generalized anxiety and increase perceived control over anxiety and (2) achieve this without decreasing social-distancing intentions. Methods: We tested these questions using a between-subjects design in a weighted-probability sample of US adults recruited via a closed online platform (ie, Prolific). All outcomes were indexed via online self-report questionnaires. Results: Of 522 randomized individuals, 500 (95.8%) completed the baseline survey and intervention. Intent-to-treat analyses using all randomized participants (N=522) found no support for therapeutic or iatrogenic effects; effects on generalized anxiety were d=–0.06 (95% CI –0.27 to 0.15; P=.48), effects on perceived control were d=0.04 (95% CI –0.08 to 0.16; P=.48), and effects on social-distancing intentions were d=–0.02 (95% CI –0.23 to 0.19; P=.83). Conclusions: Strengths of this study included a large, nationally representative sample and adherence to open science practices. Implications for scalable interventions, including the challenge of targeting perceived control over anxiety, are discussed.