scholarly journals Internet-Based Cognitive Therapy for Social Anxiety Disorder in Hong Kong: Therapist Training and Dissemination Case Series (Preprint)

2019 ◽  
Author(s):  
Graham R Thew ◽  
Candice LYM Powell ◽  
Amy PL Kwok ◽  
Mandy H Lissillour Chan ◽  
Jennifer Wild ◽  
...  
Keyword(s):  
Hong Kong ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Cognitive Therapy ◽  
Clinical Supervision ◽  
Social Anxiety Disorder ◽  
Cultural Context ◽  
Case Series ◽  
Therapist Training ◽  
Self Report

BACKGROUND Guided internet-based psychological interventions show substantial promise for expanding access to evidence-based mental health care. However, this can only be achieved if results of tightly controlled studies from the treatment developers can also be achieved in other independent settings. This dissemination depends critically on developing efficient and effective ways to train professionals to deliver these interventions. Unfortunately, descriptions of therapist training and its evaluation are often limited or absent within dissemination studies. OBJECTIVE This study aimed to describe and evaluate a program of therapist training to deliver internet-based Cognitive Therapy for social anxiety disorder (iCT-SAD). As this treatment was developed in the United Kingdom and this study was conducted in Hong Kong with local therapists, an additional objective was to examine the feasibility, acceptability, and initial efficacy of iCT-SAD in this cultural context, based on data from a pilot case series. METHODS Training in iCT-SAD was provided to 3 therapists and included practice of the face-to-face format of therapy under clinical supervision, training workshops, and treating 6 patients with the iCT-SAD program. Training progress was evaluated using standardized and self-report measures and by reviewing patient outcomes. In addition, feedback from patients and therapists was sought regarding the feasibility and acceptability of the program. RESULTS The training program was effective at increasing therapists’ iCT-SAD knowledge and skills, resulting in levels of competence expected of a specialist Cognitive Behavioral Therapy practitioner. The 6 patients treated by the trainees all completed their treatment and achieved a mean pre- to posttreatment change of 53.8 points (SD 39.5) on the primary patient outcome measure, the Liebowitz Social Anxiety Scale. The within-group effect size (Cohen d) was 2.06 (95% CI 0.66-3.46). There was evidence to suggest that the patients’ clinical outcomes were sustained at 3-month follow-up. These clinical results are comparable to those achieved by UK patients treated by the developers of the internet program. Patient and therapist feedback did not identify any major cultural barriers to implementing iCT-SAD in Hong Kong; some modest language suggestions were made to assist understanding. CONCLUSIONS The therapist training implemented here facilitated the successful dissemination of an effective UK-developed internet intervention to Hong Kong. The treatment appeared feasible and acceptable in this setting and showed highly promising initial efficacy. A randomized controlled trial is now required to examine this more robustly. As therapist training is critical to the successful dissemination of internet interventions, further research to develop, describe, and evaluate therapist training procedures is recommended.

scholarly journals Internet-Based Cognitive Therapy for Social Anxiety Disorder in Hong Kong: Therapist Training and Dissemination Case Series

10.2196/13446 ◽  
2019 ◽  
Vol 3 (2) ◽  
pp. e13446 ◽  
Author(s):  
Graham R Thew ◽  
Candice LYM Powell ◽  
Amy PL Kwok ◽  
Mandy H Lissillour Chan ◽  
Jennifer Wild ◽  
...  
Keyword(s):  
Hong Kong ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Cognitive Therapy ◽  
Social Anxiety Disorder ◽  
Case Series ◽  
Therapist Training

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 Efficacy of Behavioral Experiments in Cognitive Therapy for Social Anxiety Disorder: Study protocol for a randomized controlled trial

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Celina Clément ◽  
Jihong Lin ◽  
Ulrich Stangier
Keyword(s):  
Clinical Trials ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Cognitive Therapy ◽  
Social Anxiety Disorder ◽  
Self Report ◽  
Secondary Outcome ◽  
Behavioral Experiments ◽  
Randomized Controlled ◽  
Study Results

Abstract Background While the efficacy of cognitive therapy (CT) has been well established for social anxiety disorder (SAD) in several randomized controlled trials, there are still large differences between trials with respect to effect sizes. The present study investigates the question of whether enhanced training and the use of behavioral experiments (BEs) increases the efficacy of traditional CT, based on verbal methods of cognitive restructuring. Methods/design A mixed within/between conditions design will be applied, with therapists and patients being randomly allocated to one of two conditions: (1) training of CT plus BEs, (2) training of CT “as usual”. Sixty patients with the primary diagnosis of SAD will be recruited and treated in the outpatient clinic of the Department of Psychology, University of Frankfurt. To ensure adherence to therapist protocols, all therapists will be trained and supervised by the project coordinators. In addition, videotaped treatment sessions will be independently evaluated to guarantee both adherence to protocols and the quality of the intervention. Treatment effects will be assessed by independent SAD symptom ratings using the Liebowitz Social Anxiety Scale as the primary outcome measure and self-report measures as secondary outcome measures. Discussion The present cognitive behavioral therapy (CBT) trial will be the first to clarify the contribution of BEs to the efficacy of CT in a randomized controlled design. Study results are relevant to clinical training and implementation of evidence-based treatments. Trial registration German Clinical Trials Register International Clinical Trials Registry Platform (ICTRP) identifier: DRKS00014349. Trial status: recruiting.

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.

Prevalence and features of spontaneous recurrent images in social anxiety disorder: findings from a Korean community sample

2019 ◽  
Vol 48 (2) ◽  
pp. 172-184 ◽  
Author(s):  
Da Eun Suh ◽  
Kyung-Ah Chang ◽  
Ji Un Hwang ◽  
Jung-Hye Kwon
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Community Sample ◽  
Structured Interview ◽  
Social Contexts ◽  
Self Report ◽  
Social Situations ◽  
Distress Level ◽  
Negative Images

AbstractBackground:Previous studies have indicated that people with social anxiety disorder (SAD) often experience spontaneous, recurrent images (SRI). It was assumed that Koreans with interdependent self-views may contain more features related to social contexts in their self-images than those reported in Western cultures.Aims:In the present study, we aimed to explore the prevalence and content of SRIs in individuals with SAD in Korea. Furthermore, we investigated the relationship between features of SRIs and variables of SAD.Method:Sixty-four individuals with SAD (27.00 ± 7.42 years, 64.1% female), diagnosed with SAD, completed self-report questionnaires related to social anxiety. Afterwards, a semi-structured interview was used to assess features and content of the individuals’ SRI.Results:Thirty (47%) of the participants reported experiencing SRIs in social situations. The content of the SRIs were classified under three themes: negative self-images, negative images of others, and abstract images. The distress level of SRIs was positively associated with social phobia scales (r = .385, p < .05) and physical anxiety symptoms (r = .478, p < .05). Frequency of SRIs was positively associated with avoidance scores (r = .402, p < .05).Conclusions:The results demonstrated differences in the prevalence and content of the SRIs between Western and non-Western cultures. Fewer individuals with SAD in Korea reported having SRIs, and the content of these SRIs involved people other than the self. Some features of SRIs were associated with variables of SAD.

scholarly journals Modular CBT for Youth Social Anxiety Disorder: A Case Series Examining Initial Effectiveness

2020 ◽  
Vol 5 (1) ◽  
pp. 16-27
Author(s):  
Liesbeth G. E. Telman ◽  
Francisca J. A. Van Steensel ◽  
Ariënne J. C. Verveen ◽  
Susan M. Bögels ◽  
Marija Maric
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Case Series

scholarly journals Extended-release methylphenidate monotherapy in patients with comorbid social anxiety disorder and adult attention-deficit/hyperactivity disorder: retrospective case series

2017 ◽  
Vol 7 (11) ◽  
pp. 241-247 ◽  
Author(s):  
Ahmet Koyuncu ◽  
Fahri Çelebi ◽  
Erhan Ertekin ◽  
Burcu Ece Kök ◽  
Raşit Tükel
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Extended Release ◽  
Case Series ◽  
Hyperactivity Disorder ◽  
The Relationship

Background: The relationship between social anxiety disorder (SAD) and attention-deficit/hyperactivity disorder (ADHD) is a subject which has recently become a topic of interest for research. Methods: In this study, 20 patients with comorbid SAD and adult ADHD who were treated with extended-release methylphenidate monotherapy were evaluated retrospectively. Results: Clinical response for both ADHD and SAD symptoms was observed in 17 of 20 patients. Overall, one patient did not respond to treatment and two patients dropped out of treatment at the beginning due to adverse effects. Conclusion: Extended-release methylphenidate improved both SAD and ADHD symptoms and was generally well tolerated. Further studies are required to investigate the relationship between SAD and ADHD.

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.

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