Online Cognitive Behavioural Therapy for Death Anxiety: A Randomised Controlled Trial
Efficacy of an Online Cognitive Behavioural Therapy Intervention for Treatment of Death Anxiety in Adults With Mental Illness: A Randomised Controlled Trial
The University of Sydney
256 participants
Oct 1, 2025
Interventional
Conditions
Summary
This study primarily aims to evaluate whether a novel online CBT program for fears of death significantly reduces death anxiety amongst individuals with an anxiety-related disorder, compared to a waitlist control group. Given participants in the pilot study demonstrated clinically reliable reductions in death anxiety and other clinical measures after completing the program, we expect a statistically significant reduction in death anxiety amongst individuals with an anxiety disorder compared to the waitlist control will be observed. The study will also explore whether any improvements in death anxiety are associated with improvements in broad mental health. Furthermore, this study also seeks to obtain qualitative and quantitative feedback on the program, to guide further development. This will be critical to improve the program for future phases of the clinical trial. Given prior user evaluations of online interventions with a similar structure and design to the current program (Helgadottir et al., 2009; Menzies et al., 2023), it is hypothesised that the present intervention will be perceived as user-friendly, clear, acceptable, and efficient.
Eligibility
Inclusion Criteria7
- More than 18 years old
- Diagnosed anxiety-related disorder, assessed using a structured diagnostic interview (the Anxiety and Related Disorders Interview Schedule: Lifetime Edition
- Access to regular internet/email
- Currently live in Australia
- Functional written and spoken English
- High in death anxiety on the Death Anxiety Beliefs and Behaviours Scale (DABBS; i.e. above the clinical cutoff of 55)
- If taking anti-depressant medication, have been on a stable dose for more than 8 weeks
Exclusion Criteria4
- Endorsing frequent thoughts of suicide on the PHQ-9
- Having received consistent psychotherapy in the last 6 months
- Having a psychotic illness
- Having current substance abuse or dependence
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Interventions
This trial is designed to assess the efficacy of a novel online treatment for death anxiety compared to a waitlist control. The Overcome Death Anxiety program consists of 7 online modules, all of which are based on the principles of Cognitive Behaviour Therapy (CBT). Across the 7 modules, participants will begiven psychoeducation about the relationship between thoughts and emotion and will be shown how to challenge unhelpful thoughts related to their own specific fears about death. The role of avoidance in maintaining anxiety will also be explained, with modules incorporating specific individualised exposure tasks. The ODA program is standalone, automated, and individualised. Participants will have up to 5 months from commencement to access the modules. Although the duration of each module varies, the program is expected take approximately 10 hours in total to complete. The modules consist of a variety of materials including some pre-recorded videos, interactive written exercises and quizzes, and reflection tasks.
Locations(1)
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ACTRN12623000544673