title: Shyness programme: longer term benefits, cost-effectiveness, and acceptability.
abstract: OBJECTIVE
  In two randomized controlled trials Titov et al. demonstrated significant benefit from an Internet- and email-based treatment programme for social phobia: the Shyness programme. Data are presented about the longer term outcomes (6 months after treatment), cost-effectiveness relative to face-to-face treatment, and the acceptability of the programme to participants.
  
  
  METHODS
  Participants completed outcome and acceptability questionnaires at 6 months after treatment. Repeated measures analyses of variance were calculated using an intention-to-treat design. Cost-effectiveness in years lived with disability averted were calculated based on between-group effect sizes.
  
  
  RESULTS
  A total of 59% of treatment group participants completed the 6 month follow-up questionnaires. Between post-treatment and 6 month follow up participants continued to make improvements in symptoms of social phobia, while maintaining improvements in mood, psychological distress, and disability. At 6 month follow up the mean within-group effect size (Cohen's d) for the two social phobia measures increased from 1.2 to 1.4. Cost-effectiveness in years lived with disability (YLD) averted was calculated as one-quarter that of face-to-face group treatment, or $AUD1495 for one YLD gained, compared to $AUD5686/YLD gained. Participants rated the Internet treatment to be as effective and helpful as face-to-face treatment.
  
  
  CONCLUSIONS
  The present results confirm the reliability of the short-term findings reported in the first two Shyness programmes. The procedure appears to be very cost-effective, and acceptable to participants. These data provide further support for the development of Internet-based virtual clinics for common mental disorders.
authors.affiliation: School of Psychiatry, University of New South Wales, New South Wales, Australia. nickt@unsw.edu.au
authors.forename: Nickolai
authors.initials: N
authors.lastname: Titov
authors.forename: Gavin
authors.initials: G
authors.lastname: Andrews
authors.forename: Luke
authors.initials: L
authors.lastname: Johnston
authors.forename: Genevieve
authors.initials: G
authors.lastname: Schwencke
authors.forename: Isabella
authors.initials: I
authors.lastname: Choi
mesh_terms: D015928:Cognitive Behavioral Therapy / Q000191:economics*; D003362:Cost-Benefit Analysis; D034742:Electronic Mail / Q000191:economics*; D005500:Follow-Up Studies; D006801:Humans; D020407:Internet / Q000191:economics*; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D010555:Personality Inventory / Q000706:statistics & numerical data; D010698:Phobic Disorders / Q000191:economics* / Q000628:therapy*; D011594:Psychometrics; D016032:Randomized Controlled Trials as Topic; D012792:Shyness; D012917:Social Adjustment