title: Work-related CBT versus vocational services as usual for unemployed persons with social anxiety disorder: A randomized controlled pilot trial.
abstract: We designed and pilot-tested a group-based, work-related cognitive-behavioral therapy (WCBT) for unemployed individuals with social anxiety disorder (SAD). WCBT, delivered in a vocational service setting by vocational service professionals, aims to reduce social anxiety and enable individuals to seek, obtain, and retain employment. We compared WCBT to a vocational services as usual control condition (VSAU). Participants were unemployed, homeless, largely African American, vocational service-seeking adults with SAD (N = 58), randomized to receive either eight sessions of WCBT plus VSAU or VSAU alone and followed three months post-treatment. Multilevel modeling revealed significantly greater reductions in social anxiety, general anxiety, depression, and functional impairment for WCBT compared to VSAU. Coefficients for job search activity and self-efficacy indicated greater increases for WCBT. Hours worked per week in the follow-up period did not differ between the groups, but small sample size and challenges associated with measuring work hours may have contributed to this finding. Overall, the results of this study suggest that unemployed persons with SAD can be effectively treated with specialized work-related CBT administered by vocational service professionals. Future testing of WCBT with a larger sample, a longer follow-up period, and adequate power to assess employment outcomes is warranted.
authors.affiliation: University of Michigan, USA. Electronic address: himlej@umich.edu.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Himle
authors.affiliation: Michigan State University, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Bybee
authors.affiliation: Jewish Vocational Services, Detroit, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Steinberger
authors.affiliation: Jewish Vocational Services, Detroit, USA.
authors.forename: Wayne T
authors.initials: WT
authors.lastname: Laviolette
authors.affiliation: University of Michigan, USA.
authors.forename: Addie
authors.initials: A
authors.lastname: Weaver
authors.affiliation: University of Michigan, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Vlnka
authors.affiliation: Jewish Vocational Services, Detroit, USA.
authors.forename: Zipora
authors.initials: Z
authors.lastname: Golenberg
authors.affiliation: University of Michigan, USA.
authors.forename: Debra Siegel
authors.initials: DS
authors.lastname: Levine
authors.affiliation: Temple University, USA.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Heimberg
authors.affiliation: University of Michigan, USA.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: O'Donnell
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D000072861:Phobia, Social / Q000628:therapy*; D010865:Pilot Projects; D011615:Psychotherapy, Group / Q000379:methods; D012050:Rehabilitation, Vocational / Q000379:methods; D016896:Treatment Outcome; D014478:Unemployment; D055815:Young Adult
keywords: CBT; Employment; Group; Social anxiety; Underserved populations