Internet-Delivered Acceptance-Based Cognitive-Behavioral Intervention for Social Anxiety Disorder With and Without Therapist Support: A Randomized Trial.
A 10-minute weekly video plus texts cuts dropout in half while keeping the same anxiety gains as pure self-help.
01Research in Context
What this study did
Researchers tested an online CBT program for adults with social anxiety.
Half got a weekly 10-minute video call plus texts from a therapist.
The other half used the same program with no human contact.
Both groups did eight weeks of acceptance, mindfulness, and exposure exercises.
What they found
Both groups felt much less anxious and more confident in social settings.
The therapist group stayed in the program twice as often.
Yet their symptom gains were no bigger than the self-help group.
Brief human contact mainly kept people from dropping out.
How this fits with other research
Bromley et al. (1998) showed CBT works for social phobia, but only in person.
Gershkovich et al. (2017) now proves the same gains can happen online.
Lee et al. (2022) and Chovet Santa Cruz et al. (2024) extend the idea: remote tools help parents and kids too.
Sauer-Zavala et al. (2019) adds that reordering CBT modules can speed early gains, hinting you could mix flexible pacing with Marina’s low-support model.
Why it matters
You can offer effective social-anxiety treatment without weekly office visits.
A short video check-in keeps clients engaged but does not add clinical work.
This frees your time for clients who need more intensive support.
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02At a glance
03Original abstract
Social anxiety disorder (SAD) is one of the most prevalent psychiatric disorders in the United States. Although evidenced-based behavioral treatments are available, less than 20% of those with SAD receive treatment. Internet-based interventions can address barriers to treatment access, and guided Internet-based treatments have been demonstrated to be effective for SAD. However, the optimal role (if any) of the therapist in such programs remains unclear. We examined the acceptability and efficacy of a novel Internet-based cognitive-behavior therapy for SAD that utilizes traditional behavioral interventions (e.g., exposure) within the context of a model emphasizing mindfulness and psychological acceptance. Forty-two participants were randomized to an eight-module self-help intervention with ( n = 20) or without ( n = 22) adjunctive therapist support; the therapist support was delivered through 10 to 15 min of weekly videoconferencing and daily text messages. Both groups experienced a significant reduction in SAD symptoms and improvements in functioning and quality of life, with no significant differences between groups in both completer-only and intent-to-treat analyses. However, the therapist support group evidenced lower attrition than the minimal support group (20% vs. 50%). Implications for dissemination and future directions are discussed.
Behavior modification, 2017 · doi:10.1177/0145445517694457