The effect of cognitive behavioral therapy on female sexual dysfunction:
A research that compares internet-based with face-to-face therapy

After two year practizing internet-based, sexual, cognitive behavioral therapy
it is time to lay the theoretical foundations for an effective internettherapy.
There are good results of internetbased therapy, but there is no research done
on internettherapy for sexual dysfuntioning.
When we put internet sextherapy into practice we see a demant for working at
problems via internet. The question is: "Do the effects of treatment last after
a follow-up period of six months?
The advances of internettherapy is that the client chooses their own save
environment and moments of doing exercises and reports. They have more control
over their own proces in this way in comparison with a regular face-to-face
therapy.
Second is that in internettherapy the main means of communication is writing
instead of talking.

The main question of this study is;
Is there a difference in effectiveness between internettherapy, regular
face-to-face treatment and a control-/waiting listgroup without treatment.

Hypotheses:
1) The effect of cognitive behavioral therapy in internettherapy and
face-to-face therapy is larger then without therapy on women with a sexual
dysfuntion.
2) The impact of Internet therapy is just as large as the impact of
treatment-as-usual (face-to-face Cognitive Behavioral Therapy).

Objective of the study is to measure Cognitive Behavioral Therapy by means of
internet compared to regular face-to-face therapy and waiting list at several
types of sexual dysfunctions of women.

Randomized controlled trial with repeated measurings, between-group- and
within-subjects design. The study stretches himself from over a period of 20
weeks with a follow-up period of 20 weeks. The testpersons become doubleblind
randomized.

The test persons become random ate assigned to several groups. The therapy
lasts maximum 20 weeks. During the internet- and the face-to-face-treatment,
the test person gets a personal coach and de upportunity to talk to this
intaker or personal coach by telephone. There exists the possibility extra of
calling in aid of a doctor/seksuoloog and fysiotherapist, during the treatment.
Internet therapy (GROUP 1):
The ppn. to get a cognitive behaviour therapy for sexual problems in the form
of onlinetreatment with personal accompaniment.
The instructions and exercises are structured in a protocol. The personal
speculator or coach (psychologist/seksuoloog) becomes supervised and has a
weekly intervision. A psychiatrist, relation- and psychotherapist,
doctor/seksuoloog and fysiotherapeut are involved in the treatment if
necessary. The coach give feedback on the exercises and accompany the pp. by
means of internet one time in a week and monthly a telephone evaluation. On
average the pp has two exercises in a week and one report of approximately a
half hour.
The coach and the pp. to remain involved motivation mails. Both get reported,
if the treatment passes through not well. At insufficiently pass through the pp
become approached telephonically.
The Internet therapy offers the ppn. their own Internet portal, My Virenze, in
which they have a library with information on sexuality, sexual problems and
relation. They receive housework tasks, which are part of behaviour therapy,
for example the cognitive behavioral reports and sensate focus tasks. After the
report of the exercise by the ppn., the coach gets the possibility of giving
feedback. Feedback reads the pp. in My Virenze to continue with a new exercise.
The treatment has been built from modules. A module consists of three
interventions and a telephone evaluation.
After three modules, respectively aimed at the conscience of the complaint,
body perception and relation, the pp goes by to a more intensive form of
treatment, in which the emphasis is laid on skills.
Face-to-facetherapie (GROUP 2):
The ppn. to get standard face-to-face state-of-the-art cognitive behaviour
therapy (Hengeveld & Brewaeys, 2002, Brewaeys, 2003). The treatment exists from
maximum ten conversations with the same contents, as the Internet therapy.
Waiting list (GROUP 3):
The waiting list period lasts 12 weeks. After each treatment the participants
themselves choose for the Internet therapy or face-to-face-therapie.

The questionnaires are already a component fixed of the treatment at the
institution, like the follow-up measures. The measuring at follow-up can as
extra work be considered, because one is already done with treatment and it is
nevertheless still faced with the period of sexual problems. When the test
person is dissatisfied with the results, then it is possible that the therapist
offers a new treatmentplan in consultation with the test person.
It is possible that test persons go elsewhere in psychological treatment during
the follow-up period. For this must be checked at the follow-up measuring.
There is also a check for the training and experience level of the personal
mentor by means of the integrity test at end measuring.