title: A sorrow shared is a sorrow halved? A three-arm randomized controlled trial comparing internet-based clinician-guided individual versus group treatment for social anxiety disorder.
abstract: A growing body of evidence suggests that internet-based cognitive behavioural treatments (ICBT) are effective to treat social anxiety disorder (SAD). Whereas the efficacy of clinician-guided ICBT has been established, ICBT in a group format has not yet been systematically investigated. This three-arm RCT compared the efficacy of clinician-guided group ICBT (GT) with clinician guided individual ICBT (IT) and a wait-list (WL). A total of 149 individuals meeting the diagnostic criteria for SAD were randomly assigned to one of three conditions. Primary endpoints were self-report measures of SAD and diagnostic status taken at baseline, after the twelve-week intervention and at six-month follow-up. Secondary endpoints were symptoms of depression, interpersonal problems and general symptomatology. At post-treatment, both active conditions showed superior outcome regarding SAD symptoms (GT vs. WL: d = 0.84-0.74; IT vs. WL: d = 0.94-1.22). The two active conditions did not differ significantly in symptom reduction (d = 0.12-0.26, all ps > 0.63), diagnostic response rate or attrition. Treatment gains were maintained at follow-up. The group format reduced weekly therapist time per participant by 71% (IT: 17 min, GT: 5 min). Findings indicate that a clinician-guided group format is a promising approach in treating SAD.
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland. Electronic address: ava.schulz@psy.unibe.ch.
authors.forename: Ava
authors.initials: A
authors.lastname: Schulz
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland. Electronic address: timo.stolz@psy.unibe.ch.
authors.forename: Timo
authors.initials: T
authors.lastname: Stolz
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland. Electronic address: alessia.vincent@students.unibe.ch.
authors.forename: Alessia
authors.initials: A
authors.lastname: Vincent
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland. Electronic address: tobias.krieger@psy.unibe.
authors.forename: Tobias
authors.initials: T
authors.lastname: Krieger
authors.affiliation: Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Campus Valla I:3, SE-581 83 Linköping, Sweden; Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Tomtebodavägen 18A, 171 77 Stockholm, Sweden. Electronic address: gerhard.andersson@liu.se.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Andersson
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland. Electronic address: thomas.berger@ptp.unibe.ch.
authors.forename: Thomas
authors.initials: T
authors.lastname: Berger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072861:Phobia, Social / Q000628:therapy*; D011615:Psychotherapy, Group; D013813:Therapy, Computer-Assisted; D016896:Treatment Outcome; D055815:Young Adult
keywords: Group therapy; Guided self-help; ICBT; Internet treatment; Peer support; RCT; Social anxiety disorder