A Randomized Controlled Trial of Individual Cognitive Therapy, Group Cognitive Behaviour Therapy and Attentional Placebo for Adolescent Social Phobia

Abstract

Background: Very few studies have investigated the effects of individual disorder-specific treatment of social phobia (SP) in adolescents. The objective of this study was to compare the effects of individual cognitive therapy for SP, group cognitive behavioural therapy (CBTG) and attentional placebo (AP) among adolescents with a primary diagnosis of SP. Methods: A randomized controlled design was used, and a total of 279 adolescents were assessed. Fifty-seven adolescents, between 13 and 16 years old, were allocated to individual cognitive therapy, CBTG or AP. The participants were assessed before treatment, at the end of treatment and at a 12-month follow-up using both self-report and a semi-structured interview. Results: The individual cognitive therapy showed significant reductions in symptoms, impairment and diagnostic criteria both at the end of treatment and at the 12-month follow-up. Compared with CBTG and AP, the individual cognitive therapy group demonstrated significantly greater effects on both symptom reduction and impairment. There were no significant differences between CBTG and AP. Conclusions: In a direct comparison between the most commonly used treatments for adolescent SP, we found that individual therapy was the most effective, yielding better effects than both CBTG and AP.

Virtual reality exposure using three-dimensional images for the treatment of social phobia

“…Techniques such as exposure, social skills training, and cognitive restructuring are used. [1][2][3][4] One of the most efficient methods for treating phobias is exposure, [5][6][7] which can be in vivo or imagined (in vitro). In vivo exposure is superior to imagination, but it is costly and timeconsuming, and situational elements are difficult to control.…”

Cognitive-Behavioral and Psychodynamic Therapy in Adolescents with Social Anxiety Disorder: A Multicenter Randomized Controlled Trial

“…A direct comparison with existing RCT on CBT for SAD in adolescents can best be made based on the SPAI/SPAI-C. Here, we found within-group pre-post effect sizes of d = 1.19 (CBT) and d = 1.11 (PDT) compared to d = 0.60 for individual CBT [10], d = 0.77 for a generic CBT online program [12], or d = 2.96 for individual CBT [11]. However, Ingul et al [11] only conducted a completer analysis and no ITT analysis from pre to post.…”

“…However, as an important limitation of this trial, the small sample size did not allow for a direct comparison of the 2 active treatments. In contrast to the SOPHO-NET adult trial, the adolescent study was not sufficiently powered to meaningfully compare both active treatments in terms of statistical significance, although the sample size was comparable to those of other relevant trials in adolescents [10, 11]. Furthermore, it is also important to keep in mind how remission was determined.…”

“…Here, we found within-group pre-post effect sizes of d = 1.19 (CBT) and d = 1.11 (PDT) compared to d = 0.60 for individual CBT [10], d = 0.77 for a generic CBT online program [12], or d = 2.96 for individual CBT [11]. However, Ingul et al [11] only conducted a completer analysis and no ITT analysis from pre to post. Hence, the results are not comparable with our ITT results, especially due to the high attrition rates reported in their study [11].…”

“…In the existing studies, mostly group CBT was conducted [9], but 2 RCT also examined individual CBT [10, 11]. In these trials, the authors report recovery rates for individual CBT of 29% and 27% for group CBT, compared to 16% for psychoeducational-supportive psychotherapy [10], and clinically significant improvement in 69.8% for individual CBT and 21.1% for group CBT, compared to 27.8% in an attentional placebo condition [11] in a sample of completers.…”