scholarly journals Delivering cognitive therapy for adolescent social anxiety disorder in NHS CAMHS: a clinical and cost analysis

2021 ◽  
pp. 1-13
Author(s):  
Eleanor Leigh ◽  
Cathy Creswell ◽  
Paul Stallard ◽  
Polly Waite ◽  
Mara Violato ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Cognitive Therapy ◽  
Social Anxiety Disorder ◽  
Clinical Care ◽  
Preliminary Evidence ◽  
Anxiety Symptoms ◽  
Depression Symptoms ◽  
Process Measures ◽  
The Cost

Abstract Background: Cognitive therapy, based on the Clark and Wells (1995) model, is a first-line treatment for adults with social anxiety disorder (SAD), and findings from research settings suggest it has promise for use with adolescents (Cognitive Therapy for Social Anxiety Disorder in Adolescents; CT-SAD-A). However, for the treatment to be suitable for delivery in routine clinical care, two questions need to be addressed. Aims: Can therapists be trained to achieve good outcomes in routine Child and Adolescent Mental Health Services (CAMHS), and what are the costs associated with training and treatment? Method: CAMHS therapists working in two NHS trusts received training in CT-SAD-A. They delivered the treatment to adolescents with SAD during a period of supervised practice. We examined the clinical outcomes for the 12 patients treated during this period, and estimated costs associated with treatment and training. Results: Treatment produced significant improvements in social anxiety symptoms, general anxiety and depression symptoms, and reductions in putative process measures. Seventy-five per cent (9 out of 12) patients showed a reliable and clinically significant improvement in social anxiety symptoms, and 64% (7/11) lost their primary diagnosis of SAD. The total cost to the NHS of the CT-SAD-A treatment was £4047 (SD = £1003) per adolescent treated, of which £1861 (SD = £358) referred to the specific estimated cost of face-to-face delivery; the remaining cost was for training and supervising therapists who were not previously familiar with the treatment. Conclusions: This study provides preliminary evidence that clinicians can deliver good patient outcomes for adolescents with SAD in routine CAMHS during a period of supervised practice after receiving a 2-day training workshop. Furthermore, the cost of delivering CT-SAD-A with adolescents appeared to be no more than the cost of delivering CT-SAD with adults.

scholarly journals Cognitive Therapy for Social Anxiety Disorder in Adolescents: A Development Case Series

2015 ◽  
Vol 44 (1) ◽  
pp. 1-17 ◽  
Author(s):  
Eleanor Leigh ◽  
David M. Clark
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Young People ◽  
Cognitive Therapy ◽  
Social Anxiety Disorder ◽  
Case Series ◽  
Process Measures ◽  
General Anxiety ◽  
Differential Effectiveness ◽  
End Of Treatment

Background: Social anxiety disorder is common and typically starts in childhood or adolescence. Cognitive Therapy for Social Anxiety Disorder (CT-SAD) in adults is a well-established treatment that shows strong evidence of differential effectiveness when compared to other active treatments. In contrast, CBT approaches to social anxiety in young people have yet to demonstrate differential effectiveness and there is some evidence that young people with social anxiety disorder respond less well than those with other anxiety disorders. Aims: To adapt CT-SAD for use with adolescents and conduct a pilot case series. Method: Five adolescents, aged 11–17 years, with a primary DSM-5 diagnosis of social anxiety disorder received a course of CT-SAD adapted for adolescents. Standardized clinical interview and questionnaire assessments were conducted at pre and posttreatment, and 2 to 3-month follow-up. Results: All five participants reported severe social anxiety at baseline and achieved remission by the end of treatment. Significant improvements were also observed in general anxiety, depression, concentration in the classroom, and putative process measures (social anxiety related thoughts, beliefs and safety behaviours). Conclusions: An adapted form of CT-SAD shows promise as a treatment for adolescents.

scholarly journals Internet-Delivered Cognitive Therapy for Social Anxiety Disorder: A Development Pilot Series

2013 ◽  
Vol 41 (4) ◽  
pp. 383-397 ◽  
Author(s):  
Richard Stott ◽  
Jennifer Wild ◽  
Nick Grey ◽  
Sheena Liness ◽  
Emma Warnock-Parkes ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Randomized Controlled Trials ◽  
Cognitive Therapy ◽  
Social Anxiety Disorder ◽  
Controlled Trials ◽  
Secure Messaging ◽  
Face To Face ◽  
Randomized Controlled ◽  
The Face

Background: Randomized controlled trials have established that individual cognitive therapy based on the Clark and Wells (1995) model is an effective treatment for social anxiety disorder that is superior to a range of alternative psychological and pharmacological interventions. Normally the treatment involves up to 14 weekly face-to-face therapy sessions. Aim: To develop an internet based version of the treatment that requires less therapist time. Method: An internet-delivered version of cognitive therapy (iCT) for social anxiety disorder is described. The internet-version implements all key features of the face-to-face treatment; including video feedback, attention training, behavioural experiments, and memory focused techniques. Therapist support is via a built-in secure messaging system and by brief telephone calls. A cohort of 11 patients meeting DSM-IV criteria for social anxiety disorder worked through the programme and were assessed at pretreatment and posttreatment. Results: No patients dropped out. Improvements in social anxiety and related process variables were within the range of those observed in randomized controlled trials of face-to-face CT. Nine patients (82%) were classified as treatment responders and seven (64%) achieved remission status. Therapist time per patient was only 20% of that in face-to-face CT. Conclusions: iCT shows promise as a way of reducing therapist time without compromising efficacy. Further evaluation of iCT is ongoing.

The impact of alcohol use disorders and alcohol consumption on treatment-seeking individuals with social anxiety disorder

2021 ◽  
Vol 85 (2) ◽  
pp. 100-122
Author(s):  
Mirjana Subotic-Kerry ◽  
Andrew J. Baillie ◽  
Lexine A. Stapinski ◽  
Maree J. Abbott ◽  
Jo MacDonald ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Social Anxiety Disorder ◽  
Alcohol Use Disorders ◽  
Anxiety Symptoms ◽  
Social Situations ◽  
Low Incidence ◽  
The Impact

Comorbid social anxiety and alcohol use disorders (SAD-AUD) in the community and the complex interactions that occur between these disorders have emerged as a significant clinical, public health, and research issue. The authors examined (a) the rates of comorbid SAD-AUD, (b) the impact of comorbid SAD-AUD on outcomes targeting social anxiety disorder, and (c) the effect of pretreatment alcohol consumption and alcohol use before, during, and after social situations on a composite measure of social anxiety in 172 adults presenting with social anxiety disorder. There was low incidence of AUD in this sample of individuals with SAD. Results indicated that alcohol consumption did not lead to worse social anxiety symptoms; however, alcohol use before and during social situations was associated with more severe social anxiety symptoms. These findings suggest that the function of alcohol use may be more important than the overall level of alcohol use and has implications for treatment.

scholarly journals Evaluation of the Clinical Global Impression Scale among individuals with social anxiety disorder

2003 ◽  
Vol 33 (4) ◽  
pp. 611-622 ◽  
Author(s):  
T. I. ZAIDER ◽  
R. G. HEIMBERG ◽  
D. M. FRESCO ◽  
F. R. SCHNEIER ◽  
M. R. LIEBOWITZ
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Anxiety Disorders ◽  
Social Anxiety Disorder ◽  
Clinical Global Impression ◽  
Severity Of Illness ◽  
Anxiety Symptoms ◽  
Self Report ◽  
Clinical Global Impression Scale ◽  
Additional Variance

Background. The clinical Global Impression Scale (CGI) is commonly used as a primary outcome measure in studies evaluating the efficacy of treatments for anxiety disorders. The current study evaluated the psychometric properties and predictors of clinicians' ratings on an adapted version of the CGI among individuals with social anxiety disorders.Method. An independent assessor administered the CGI Severity of Illness and Improvement ratings to 123 patients at baseline and the subset of treated patients again mid- and post-treatment.Results. Improvement ratings were strongly related to both concurrent Severity of Illness and changes in Severity of Illness ratings from baseline. Additionally, both CGI ratings were positively correlated with both self-report and clinician-administered measures of social anxiety, depression, impairment and quality of life. Measures of social anxiety symptoms accounted for a large portion of the variance in Severity of Illness ratings, with significant additional variance accounted for by measures of impairment and depression. Changes in social anxiety symptoms from baseline accounted for significant variance in Improvement ratings, but no significant additional variance was accounted for by changes in impairment and depressive symptoms.Conclusions. Our findings support the utility of the CGI as an index of global severity and symptom-specific improvement among individuals with social anxiety disorder.

scholarly journals The Cost Effectiveness of Psychological and Pharmacological Interventions for Social Anxiety Disorder: A Model-Based Economic Analysis

PLoS ONE ◽  
2015 ◽  
Vol 10 (10) ◽  
pp. e0140704 ◽  
Author(s):  
Ifigeneia Mavranezouli ◽  
Evan Mayo-Wilson ◽  
Sofia Dias ◽  
Kayleigh Kew ◽  
David M. Clark ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Economic Analysis ◽  
Social Anxiety Disorder ◽  
Pharmacological Interventions ◽  
Model Based ◽  
The Cost

scholarly journals Mindfulness Training led to Catharsis and Mindfulness-To-Meaning in a Patient with Social Anxiety Disorder Comorbid with Persistent Depressive Disorder (Dysthymia) - A Case Report with Patient's Personal Note -

2021 ◽  
Author(s):  
Hisanobu Kaiya ◽  
Asuka Hasegawa ◽  
Chika Komatsu ◽  
Shota Noda ◽  
Fusaka Minami ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Depressive Disorder ◽  
Social Anxiety Disorder ◽  
World View ◽  
Well Being ◽  
Mindfulness Training ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Persistent Depressive Disorder

Abstract Background:The use of mindfulness in the treatment of anxiety and depression is becoming more and more widespread, but there are few reports that it has fundamentally changed patients' sense of life. Case Presentation:This report showed 9 year’s progress of treatment for Social Anxiety Disorder and Persistent Depressive Disorder in a 41year-old female patient experiencing a long-term painful married life with a carefree husband and controlling mother-in-law. During the past 25 months, she received 180 sessions of mindfulness training, resulting in complete remission of the anxiety and depression symptoms. After the 30th session she experienced an episode of the catharsis during the mindfulness training and experienced what can be called Mindfulness-To-Meaning, which is characterized by durable eudaimonic well-being in the face of adversity. Discussion and Conclutions:The psychological mechanisms that supported arriving at Mindfulness-To-Meaning were delineated as: Heightened (1) awareness which promoted (2) verbalization of the primary theme of suppression, in which the stress was (3) appraised metacognitively. Then (4) decentering permitted integrating this painful theme into a new adaptive self and world view, which resulted in (5) emotional catharsis, or release. Furthermore (6)　positive appraisal of this experience enhanced awareness and led to the experience of (7) Mindfulness-To-Meaning .

scholarly journals Long-Term Effectiveness of Cognitive Therapy for Refractory Social Anxiety Disorder: One-Year Follow-Up of a Randomized Controlled Trial

2019 ◽  
Vol 88 (4) ◽  
pp. 244-246 ◽  
Author(s):  
Naoki Yoshinaga ◽  
Kazumi Kubota ◽  
Kensuke Yoshimura ◽  
Rieko Takanashi ◽  
Yasushi Ishida ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Cognitive Therapy ◽  
Social Anxiety Disorder ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
One Year

The Effectiveness of Mindfulness-based Cognitive Therapy on Sleep Quality of Students with Social Anxiety Disorder

2020 ◽  
Author(s):  
Saeed Mohammadi ◽  
Mahboobeh Maleki ◽  
Mojtaba Tashkeh ◽  
Aliakbar Foroughi ◽  
Golfam Goodarz
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Sleep Quality ◽  
Sleep Disorders ◽  
Cognitive Therapy ◽  
Social Anxiety Disorder ◽  
Sleep Problems ◽  
Sleeping Problems ◽  
Post Test ◽  
Social Interaction Anxiety Scale

Background and Objective: Anxiety disorders are usually accompanied with sleep disorders. Since limited studies have focused on the effectiveness of mindfulness-based cognitive therapy (MBCT) on anxiety-related problems such as sleep disorders, the current research was conducted to investigate the effectiveness of this intervention on sleep problems. Materials and Methods: This study was a clinical trial with control and treatment groups. The sample consisted of 24 university students diagnosed with social anxiety disorder (SAD). Social Interaction Anxiety Scale (SIAS) and Pitts-burgh Sleep Quality Index (PSQI) were used to assess the dependent variables. There were measurements during pre-test, post-test, and follow-up stages. Results: The treatment could significantly improve the anxiety and sleeping problems in patients with social anxiety. Assessing the aspects of sleep quality showed that the intervention could improve the subjective aspects, latency, dis-turbance, and daily dysfunctions of sleep effectively; however, there was no significant effect on the duration of sleep, taking sleep medications, or sleep efficiency. Conclusion: Mindfulness treatment could be used for improving sleep quality in patients with social anxiety. This treatment could also improve the aspects of sleep quality which are related to sleep threshold.

Sign in / Sign up

Export Citation Format

Share Document