Effectiveness of cognitive behavioural group therapy for social anxiety disorder: long-term benefits and aftercare

AbstractBackground:Empirical research demonstrates the short- to medium-term efficacy and effectiveness of cognitive behavioural group therapy (CBGT) for social anxiety disorder (SAD). Little is known about the durability of gains beyond 1 year following treatment in real-life clinical settings. Literature regarding the impact of aftercare programs as an adjunct to CBGT treatment on SAD is scarce.Aims:To evaluate the long-term effectiveness of CBGT for SAD in a community sample and to explore the relationship between long-term treatment outcomes and aftercare support group attendance.Method:A longitudinal cohort design evaluated changes in standardized psychological measures assessing aspects of SAD, anxiety and depression. Questionnaires were completed before the program (time 1, N = 457), after the program (time 2, n = 369) and at an average of 4.6 years follow-up (time 3, n = 138).Results:Large treatment effect sizes at post-intervention were maintained at long-term follow-up on measures of SAD, anxiety and depression. There was no statistically significant relationship between frequency of attendance at an aftercare support group and degree of improvement from post-treatment severity on any measure.Conclusions:CBGT is an effective intervention in the long-term in a routine clinical setting and should be considered a viable treatment option for SAD. Recommendations for future research, treatment implications and study limitations are considered.

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Effectiveness of a cognitive behavioural group therapy (CBGT) for social anxiety disorder: immediate and long-term benefits

The Cognitive Behaviour Therapist ◽

10.1017/s1754470x13000111 ◽

2013 ◽

Vol 6 ◽

Cited By ~ 4

Author(s):

Odhran McCarthy ◽

David Hevey ◽

Amy Brogan ◽

Brendan D. Kelly

Keyword(s):

Anxiety Disorder ◽

Social Anxiety ◽

Social Anxiety Disorder ◽

Post Intervention ◽

Group Format ◽

Cognitive Behavioural ◽

Clinically Significant ◽

Psychological Scales

AbstractThis study examines the effectiveness of a group CBT (CBGT) intervention in reducing a variety of symptoms and problem areas associated with social anxiety disorder. A longitudinal cohort design assessed changes in standardized psychological scales assessing general mood and specific aspects of social anxiety. Questionnaires were completed pre-programme (time 1, n = 252), post-programme (time 2, n = 202), and at 12 months follow-up (time 3, n = 93). A consistent significant pattern was found for all variables: pre-intervention scores were significantly higher than both post-intervention scores and 12-month follow-up scores. Large effect sizes were found and rates of clinical significant changes varied, with over half of the participants recording clinically significant changes in general mood. Individual CBT can be translated successfully into a group format for social anxiety. Given the high completion rate, the intervention is acceptable to participants, feasible, and effective in a routine clinical service.

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Long-Term Effectiveness and Cost-Effectiveness of Videoconference-Delivered Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder, Panic Disorder, and Social Anxiety Disorder in Japan: One-Year Follow-Up of a Single-Arm Trial (Preprint)

10.2196/preprints.17157 ◽

2019 ◽

Author(s):

Kazuki Matsumoto ◽

Sayo Hamatani ◽

Kazue Nagai ◽

Chihiro Sutoh ◽

Akiko Nakagawa ◽

...

Keyword(s):

Cost Effectiveness ◽

Anxiety Disorder ◽

Social Anxiety ◽

Panic Disorder ◽

Social Anxiety Disorder ◽

Behavioral Therapy ◽

Obsessive Compulsive ◽

Compulsive Disorder

BACKGROUND Face-to-face individual cognitive behavioral therapy (CBT) and internet-based CBT (ICBT) without videoconferencing are known to have long-term effectiveness for obsessive-compulsive disorder (OCD), panic disorder (PD), and social anxiety disorder (SAD). However, videoconference-delivered CBT (VCBT) has not been investigated regarding its long-term effectiveness and cost-effectiveness. OBJECTIVE The purpose of this study was to investigate the long-term effectiveness and cost-effectiveness of VCBT for patients with OCD, PD, or SAD in Japan via a 1-year follow-up to our previous 16-week single-arm study. METHODS Written informed consent was obtained from 25 of 29 eligible patients with OCD, PD, and SAD who had completed VCBT in our clinical trial. Participants were assessed at baseline, end of treatment, and at the follow-up end points of 3, 6, and 12 months. Outcomes were the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Panic Disorder Severity Scale (PDSS), Liebowitz Social Anxiety Scale (LSAS), Patient Health Questionnaire–9 (PHQ-9), General Anxiety Disorder–7 (GAD-7), and EuroQol-5D-5L (EQ-5D-5L). To analyze long-term effectiveness, we used mixed-model analysis of variance. To analyze cost-effectiveness, we employed relevant public data and derived data on VCBT implementation costs from Japanese national health insurance data. RESULTS Four males and 21 females with an average age of 35.1 (SD 8.6) years participated in the 1-year follow-up study. Principal diagnoses were OCD (n=10), PD (n=7), and SAD (n=8). The change at 12 months on the Y-BOCS was −4.1 (F1=4.45, P=.04), the change in PDSS was −4.4 (F1=6.83, P=.001), and the change in LSAS was −30.9 (F1=6.73, P=.01). The change in the PHQ-9 at 12 months was −2.7 (F1=7.72, P=.007), and the change in the GAD-7 was −3.0 (F1=7.09, P=.009). QALY at 12 months was 0.7469 (SE 0.0353, 95% Cl 0.6728-0.821), and the change was a significant increase of 0.0379 (P=.01). Total costs to provide the VCBT were ¥60,800 to ¥81,960 per patient. The set threshold was ¥189,500 ($1723, €1579, and £1354) calculated based on willingness to pay in Japan. CONCLUSIONS VCBT was a cost-effective way to effectively treat Japanese patients with OCD, PD, or SAD. CLINICALTRIAL University Hospital Medical Information Network Clinical Trials Registry UMIN000026609; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000030495

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Targeting fear of positive evaluation in patients with social anxiety disorder via a brief cognitive behavioural therapy protocol: a proof-of-principle study

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465820000491 ◽

2020 ◽

Vol 48 (6) ◽

pp. 745-750

Author(s):

Justin W. Weeks ◽

M. Taylor Wilmer ◽

Carrie M. Potter ◽

Elizabeth M. Waldron ◽

Mark Versella ◽

...

Keyword(s):

Anxiety Disorder ◽

Social Anxiety ◽

Cognitive Behavioural Therapy ◽

Social Anxiety Disorder ◽

Behavioural Therapy ◽

Cognitive Behavioural ◽

Proof Of Principle ◽

Fear Of Positive Evaluation ◽

Positive Evaluation

AbstractBackground:Our aim was to develop a brief cognitive behavioural therapy (CBT) protocol to augment treatment for social anxiety disorder (SAD). This protocol focused specifically upon fear of positive evaluation (FPE). To our knowledge, this is the first protocol that has been designed to systematically target FPE.Aims:To test the feasibility of a brief (two-session) CBT protocol for FPE and report proof-of-principle data in the form of effect sizes.Method:Seven patients with a principal diagnosis of SAD were recruited to participate. Following a pre-treatment assessment, patients were randomized to either (a) an immediate CBT condition (n = 3), or (b) a comparable wait-list (WL) period (2 weeks; n = 4). Two WL patients also completed the CBT protocol following the WL period (delayed CBT condition). Patients completed follow-up assessments 1 week after completing the protocol.Results:A total of five patients completed the brief, FPE-specific CBT protocol (two of the seven patients were wait-listed only and did not complete delayed CBT). All five patients completed the protocol and provided 1-week follow-up data. CBT patients demonstrated large reductions in FPE-related concerns as well as overall social anxiety symptoms, whereas WL patients demonstrated an increase in FPE-related concerns.Conclusions:Our brief FPE-specific CBT protocol is feasible to use and was associated with large FPE-specific and social anxiety symptom reductions. To our knowledge, this is the first treatment report that has focused on systematic treatment of FPE in patients with SAD. Our protocol warrants further controlled evaluation.

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Therapist-guided internet-delivered cognitive–behavioural therapy supplemented with group exposure sessions for adolescents with social anxiety disorder: a feasibility trial

BMJ Open ◽

10.1136/bmjopen-2017-018345 ◽

2017 ◽

Vol 7 (12) ◽

pp. e018345 ◽

Cited By ~ 13

Author(s):

Martina Nordh ◽

Sarah Vigerland ◽

Lars-Göran Öst ◽

Brjánn Ljótsson ◽

David Mataix-Cols ◽

...

Keyword(s):

Anxiety Disorder ◽

Social Anxiety ◽

Cognitive Behavioural Therapy ◽

Social Anxiety Disorder ◽

Behavioural Therapy ◽

Post Treatment ◽

Feasibility Trial ◽

Cognitive Behavioural ◽

Exposure Sessions

ObjectivesSocial anxiety disorder (SAD) is one of the most common psychiatric disorders in youth, with a prevalence of about 3%–4% and increased risk of adverse long-term outcomes, such as depression. Cognitive–behavioural therapy (CBT) is considered the first-line treatment for youth with SAD, but many adolescents remain untreated due to limited accessibility to CBT. The aim of this study was to develop and evaluate the feasibility and preliminary efficacy of a therapist-guided internet-delivered CBT treatment, supplemented with clinic-based group exposure sessions (BIP SOFT).DesignA proof-of-concept, open clinical trial with 6-month follow-up.ParticipantsThe trial was conducted at a child and adolescent psychiatric research clinic, and participants (n=30) were 13–17 years old (83% girls) with a principal diagnosis of SAD.Intervention12 weeks of intervention, consisting of nine remote therapist-guided internet-delivered CBT sessions and three group exposure sessions at the clinic for the adolescents and five internet-delivered sessions for the parents.ResultsAdolescents were generally satisfied with the treatment, and the completion rate of internet modules, as well as attendance at group sessions, was high. Post-treatment assessment showed a significant decrease in clinician-rated, adolescent-rated and parent-rated social anxiety (d=1.17, 0.85 and 0.79, respectively), as well as in general self-rated and parent-rated anxiety and depression (d=0.76 and 0.51), compared with pretreatment levels. Furthermore, 47% of participants no longer met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for SAD at post-treatment. At a 6-month follow-up, symptom reductions were maintained, or further improved, and 57% of participants no longer met criteria for SAD.ConclusionTherapist-guided and parent-guided internet-delivered CBT, supplemented with a limited number of group exposure sessions, is a feasible and promising intervention for adolescents with SAD.Trial registration numberNCT02576171; Results.

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