Cognitive therapy versus exposure and applied relaxation in social phobia: A randomized controlled trial.
A new cognitive therapy (CT) program was compared with an established behavioral treatment. Sixty-two patients meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) criteria for social phobia were randomly assigned to CT, exposure plus applied relaxation (EXP = AR), or wait-list (WAIT). CT and EXP = AR were superior to WAIT on all measures. On measures of social phobia, CT led to greater improvement than did EXP = AR. Percentages of patients who no longer met diagnostic criteria for social phobia at posttreatment-wait were as follows: 84% in CT, 42% in EXP = AR, and 0% in WAIT. At the 1-year follow-up, differences in outcome persisted. In addition, patients in EXP = AR were more likely to have sought additional treatment. Therapist effects were small and nonsignificant. CT appears to be superior to EXP = AR in the treatment of social phobia.
Clark
David M
DM
Department of Psychology, Institute of Psychiatry, King's College London, London, United Kingdom. d.clark@iop.kcl.ac.uk
Ehlers
Anke
A
Hackmann
Ann
A
McManus
Freda
F
Fennell
Melanie
M
Grey
Nick
N
Waddington
Louise
L
Wild
Jennifer
J
D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010698:Phobic Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D011613:Psychotherapy / Q000379:methods; D012064:Relaxation Therapy; D012720:Severity of Illness Index