title: Efficacy of the trial-based thought record, a new cognitive therapy strategy designed to change core beliefs, in social phobia.
abstract: BACKGROUND
  Social anxiety disorder (SAD) often follows a chronic course and is associated with substantial impairment in functioning. Although results from clinical trials clearly establish evidence for efficacy of cognitive behavioural therapy in treating this disorder, up to 50% of patients with SAD show little or no improvement. Thus, new approaches that have promised in improving the efficacy of treatment for SAD are needed. One such approach is the trial-based thought record (TBTR), which targets the restructuring of patients' core beliefs.
  
  
  OBJECTIVE
  To determine whether patients receiving TBTR would report fewer symptoms of social anxiety and general psychiatric distress following treatment, relative to conventional cognitive therapy (CCT).
  
  
  METHODS
  A two-arm randomized trial comparing TBTR (n = 17) with a set of CCT techniques (n = 19), which included the standard seven-column dysfunctional thought record and the positive data log in SAD patients according to DSM-IV.
  
  
  RESULTS
  Scores on many outcome measures decreased significantly across the course of treatment in both groups (P < 0·001), including the Liebowitz Social Anxiety Scale, Fear of Negative Evaluation Scale (FNE), Social Avoidance and Distress Scale (SADS), Beck Anxiety Inventory, and Clinical Global Impression - Improvement. In addition, a one-way ancova, taking baseline values as covariates, showed that TBTR was significantly more efficacious than CCT in reducing the scores of FNE (P = 0·01 at mid-treatment and P = 0·004 at post-treatment), and SADS (P = 0·03 at post-treatment).
  
  
  CONCLUSIONS
  This study provides preliminary evidence that TBTR is at least as efficacious as CCT in reducing symptoms of SAD, pointing to the need for additional studies of TBTR in SAD and other psychiatric disorders.
authors.affiliation: Department of Neuroscience and Mental Health, University Hospital Professor Edgard Santos, Federal University of Bahia, Salvador, Bahia, Brazil. irismar.oliveira@uol.com.br
authors.forename: I R
authors.initials: IR
authors.lastname: de Oliveira
authors.forename: V B
authors.initials: VB
authors.lastname: Powell
authors.forename: A
authors.initials: A
authors.lastname: Wenzel
authors.forename: M
authors.initials: M
authors.lastname: Caldas
authors.forename: C
authors.initials: C
authors.lastname: Seixas
authors.forename: C
authors.initials: C
authors.lastname: Almeida
authors.forename: T
authors.initials: T
authors.lastname: Bonfim
authors.forename: M C
authors.initials: MC
authors.lastname: Grangeon
authors.forename: M
authors.initials: M
authors.lastname: Castro
authors.forename: A
authors.initials: A
authors.lastname: Galvão
authors.forename: R
authors.initials: R
authors.lastname: de Oliveira Moraes
authors.forename: D
authors.initials: D
authors.lastname: Sudak
mesh_terms: D000328:Adult; D001938:Brazil; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003469:Culture; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004282:Documentation / Q000379:methods; D004644:Emotions; D005260:Female; D005500:Follow-Up Studies; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010698:Phobic Disorders / Q000523:psychology / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D012917:Social Adjustment; D012934:Social Isolation / Q000523:psychology*; D013850:Thinking; D055815:Young Adult