title: Imagery enhancements increase the effectiveness of cognitive behavioural group therapy for social anxiety disorder: a benchmarking study.
abstract: Emerging evidence suggests that imagery-based techniques may enhance the effectiveness of traditional verbal-linguistic cognitive interventions for emotional disorders. This study extends an earlier pilot study by reporting outcomes from a naturalistic trial of an imagery-enhanced cognitive behavioural group therapy (IE-CBGT, n = 53) protocol for social anxiety disorder (SAD), and comparing outcomes to historical controls who completed a predominantly verbally-based group protocol (n = 129). Patients were consecutive referrals from health professionals to a community clinic specialising in anxiety and mood disorders. Both treatments involved 12, two-hour group sessions plus a one-month follow-up. Analyses evaluated treatment adherence, predictors of dropout, treatment effect sizes, reliable and clinically significant change, and whether self-reported tendencies to use imagery in everyday life and imagery ability predicted symptom change. IE-CBGT patients were substantially more likely to complete treatment than controls (91% vs. 65%). Effect sizes were very large for both treatments, but were significantly larger for IE-CBGT. A higher proportion of the IE-CBGT patients achieved reliable change, and better imagery ability was associated with larger symptom change. Outcomes compared very favourably to published group and individual treatments for SAD, suggesting that IE-CBGT may be a particularly effective and efficient mode of treatment delivery.
authors.affiliation: Centre for Clinical Interventions, Perth, Australia; School of Psychology and Speech Pathology, Curtin University, Perth, Australia. Electronic address: peter.mcevoy@curtin.edu.au.
authors.forename: Peter M
authors.initials: PM
authors.lastname: McEvoy
authors.affiliation: Centre for Clinical Interventions, Perth, Australia; School of Psychology, University of Western Australia, Perth, Australia.
authors.forename: David M
authors.initials: DM
authors.lastname: Erceg-Hurn
authors.affiliation: Centre for Clinical Interventions, Perth, Australia.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Saulsman
authors.affiliation: Psychology Department, University of Regina, Saskatchewan, Canada.
authors.forename: Michel A
authors.initials: MA
authors.lastname: Thibodeau
mesh_terms: D000293:Adolescent; D000328:Adult; D019985:Benchmarking; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D019018:Imagery, Psychotherapy / Q000379:methods*; D008297:Male; D010349:Patient Compliance; D010698:Phobic Disorders / Q000523:psychology / Q000628:therapy*; D011615:Psychotherapy, Group / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cognitive behaviour therapy; Effectiveness; Group therapy; Imagery; Social anxiety disorder