Guided and unguided self-help for social anxiety disorder: randomised controlled trial.
BACKGROUND
Internet-delivered self-help programmes with added therapist guidance have shown efficacy in social anxiety disorder, but unguided self-help has been insufficiently studied.


OBJECTIVE
To evaluate the efficacy of guided and unguided self-help for social anxiety disorder.


METHODS
Participants followed a cognitive-behavioural self-help programme in the form of either pure bibliotherapy or an internet-based treatment with therapist guidance and online group discussions. A subsequent trial was conducted to evaluate treatment specificity. Participants (n = 235) were randomised to one of three conditions in the first trial, or one of four conditions in the second.


RESULTS
Pure bibliotherapy and the internet-based treatment were better than waiting list on measures of social anxiety, general anxiety, depression and quality of life. The internet-based therapy had the highest effect sizes, but directly comparable effects were noted for bibliotherapy augmented with online group discussions. Gains were well maintained a year later.


CONCLUSIONS
Unguided self-help through bibliotherapy can produce enduring improvement for individuals with social anxiety disorder.
Furmark
Tomas
T
Department of Psychology, Uppsala University, Box 1225, SE-751 42 Uppsala, Sweden. tomas.furmark@psyk.uu.se
Carlbring
Per
P
Hedman
Erik
E
Sonnenstein
Annika
A
Clevberger
Peder
P
Bohman
Benjamin
B
Eriksson
Anneli
A
Hållén
Agneta
A
Frykman
Mandus
M
Holmström
Annelie
A
Sparthan
Elisabeth
E
Tillfors
Maria
M
Ihrfelt
Elisabeth Nilsson
EN
Spak
Maria
M
Eriksson
Anna
A
Ekselius
Lisa
L
Andersson
Gerhard
G
D000328:Adult; D000368:Aged; D001638:Bibliotherapy / Q000379:methods*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010698:Phobic Disorders / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D012648:Self Care / Q000379:methods*; D012792:Shyness; D017216:Telemedicine / Q000379:methods; D013813:Therapy, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult