title: Guided and unguided self-help for social anxiety disorder: randomised controlled trial.
abstract: 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.
authors.affiliation: Department of Psychology, Uppsala University, Box 1225, SE-751 42 Uppsala, Sweden. tomas.furmark@psyk.uu.se
authors.forename: Tomas
authors.initials: T
authors.lastname: Furmark
authors.forename: Per
authors.initials: P
authors.lastname: Carlbring
authors.forename: Erik
authors.initials: E
authors.lastname: Hedman
authors.forename: Annika
authors.initials: A
authors.lastname: Sonnenstein
authors.forename: Peder
authors.initials: P
authors.lastname: Clevberger
authors.forename: Benjamin
authors.initials: B
authors.lastname: Bohman
authors.forename: Anneli
authors.initials: A
authors.lastname: Eriksson
authors.forename: Agneta
authors.initials: A
authors.lastname: Hållén
authors.forename: Mandus
authors.initials: M
authors.lastname: Frykman
authors.forename: Annelie
authors.initials: A
authors.lastname: Holmström
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Sparthan
authors.forename: Maria
authors.initials: M
authors.lastname: Tillfors
authors.forename: Elisabeth Nilsson
authors.initials: EN
authors.lastname: Ihrfelt
authors.forename: Maria
authors.initials: M
authors.lastname: Spak
authors.forename: Anna
authors.initials: A
authors.lastname: Eriksson
authors.forename: Lisa
authors.initials: L
authors.lastname: Ekselius
authors.forename: Gerhard
authors.initials: G
authors.lastname: Andersson
mesh_terms: 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