title: Internet-delivered cognitive therapy for social anxiety disorder: a development pilot series.
abstract: BACKGROUND
  Randomized controlled trials have established that individual cognitive therapy based on the Clark and Wells (1995) model is an effective treatment for social anxiety disorder that is superior to a range of alternative psychological and pharmacological interventions. Normally the treatment involves up to 14 weekly face-to-face therapy sessions.
  
  
  OBJECTIVE
  To develop an internet based version of the treatment that requires less therapist time.
  
  
  METHODS
  An internet-delivered version of cognitive therapy (iCT) for social anxiety disorder is described. The internet-version implements all key features of the face-to-face treatment; including video feedback, attention training, behavioural experiments, and memory focused techniques. Therapist support is via a built-in secure messaging system and by brief telephone calls. A cohort of 11 patients meeting DSM-IV criteria for social anxiety disorder worked through the programme and were assessed at pretreatment and posttreatment.
  
  
  RESULTS
  No patients dropped out. Improvements in social anxiety and related process variables were within the range of those observed in randomized controlled trials of face-to-face CT. Nine patients (82%) were classified as treatment responders and seven (64%) achieved remission status. Therapist time per patient was only 20% of that in face-to-face CT.
  
  
  CONCLUSIONS
  iCT shows promise as a way of reducing therapist time without compromising efficacy. Further evaluation of iCT is ongoing.
authors.affiliation: Institute of Psychiatry, Kings College London, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Stott
authors.forename: Jennifer
authors.initials: J
authors.lastname: Wild
authors.forename: Nick
authors.initials: N
authors.lastname: Grey
authors.forename: Sheena
authors.initials: S
authors.lastname: Liness
authors.forename: Emma
authors.initials: E
authors.lastname: Warnock-Parkes
authors.forename: Siobhan
authors.initials: S
authors.lastname: Commins
authors.forename: Jennifer
authors.initials: J
authors.lastname: Readings
authors.forename: Georgina
authors.initials: G
authors.lastname: Bremner
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Woodward
authors.forename: Anke
authors.initials: A
authors.lastname: Ehlers
authors.forename: David M
authors.initials: DM
authors.lastname: Clark
mesh_terms: D000328:Adult; D001288:Attention; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015331:Cohort Studies; D030141:Feedback, Psychological; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020407:Internet; D008297:Male; D010698:Phobic Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D010865:Pilot Projects; D012649:Self Concept; D012919:Social Behavior; D013689:Telephone; D013813:Therapy, Computer-Assisted / Q000379:methods*; D013996:Time and Motion Studies; D016896:Treatment Outcome; D014741:Video Recording