Comparing systemic therapy and cognitive behavioral therapy for social anxiety disorders: study protocol for a randomized controlled pilot trial

Abstract

BackgroundSocial anxiety disorders are among the most prevalent anxiety disorders in the general population. The efficacy of cognitive behavioral therapy (CBT) for social anxiety disorders is well demonstrated. However, only three studies point to the efficacy of systemic therapy (ST) in anxiety disorders, and only two of them especially focus on social anxiety disorders. These ST studies either do not use a good comparator but minimal supportive therapy, they do not use a multi-person ST but a combined therapy, or they do not especially focus on social anxiety disorders but mood and anxiety disorders in general. Though ST was approved as evidence based in Germany for a variety of disorders in 2008, evidence did not include anxiety disorders. This is the first pilot study that will investigate multi-person ST, integrating a broad range of systemic methods, specifically for social anxiety disorders and that will compare ST to the "gold standard" CBT.DesignThis article describes the rationale and protocol of a prospective, open, interventive, balanced, bi-centric, pilot randomized controlled trial (RCT). A total of 32 patients with a primary SCID diagnosis of social anxiety disorder will be randomized to either CBT or ST. Both treatments will be manualized.The primary outcome will include social anxiety symptoms at the end of therapy. Therapy will be restricted to no more than 26 hours (primary endpoint). Secondary outcomes will include psychological, social systems and interpersonal functioning, symptom adjustment, and caregiver burden, in addition to change measures, therapist variables and treatment adherence. At the secondary endpoints, 9 and 12 months after the beginning of therapy, we will again assess all outcomes.DiscussionThe study is expected to pilot test a RCT which will be the first to directly compare CBT and multi-person ST, integrating a broad range of systemic methods, for social anxiety disorders, and it will provide empirical evidence for the calculation of the number of patients needed for a confirmatory RCT.Trial registrationClinicalTrials.gov: NCT02360033; date of registration: 21 January 2015.

When Significant Others Suffer: German Validation of the Burden Assessment Scale (BAS)

“…Prevention and treatment providers are in need of a better understanding of caregivers’ mental and physical impairment if they aim at a sustainable support for both the mentally ill and the also often impaired relatives [ 15 ]. (2) The detection of changes in family members’ burden is an important outcome considering the evaluation of social systems interventions [ 16 ]. Social systems are understood as a collectivity of individuals who are bound together as a unit by multiple interactions [ 17 ] and differentiated from their environment by a boundary of meaning [ 16 ].…”

“…(2) The detection of changes in family members’ burden is an important outcome considering the evaluation of social systems interventions [ 16 ]. Social systems are understood as a collectivity of individuals who are bound together as a unit by multiple interactions [ 17 ] and differentiated from their environment by a boundary of meaning [ 16 ]. In the case of mental illness, both the affected individual as well as the members of the social system it belong to may seek help.…”

Comparing Cognitive Behavioral Therapy and Systemic Therapy for Social Anxiety Disorder: Randomized Controlled Pilot Trial (SOPHO‐CBT/ST)

“…There were no important changes to methods after trial commencement. Because the study protocol and procedure are published elsewhere (Hunger, Hilzinger, Koch, et al., 2016), it is summarized here.…”

“…/ 1391 the study protocol and procedure are published elsewhere (Hunger, Hilzinger, Koch, et al, 2016), it is summarized here.…”

Integrative systemic and family therapy for social anxiety disorder: Manual and practice in a pilot randomized controlled trial (SOPHO-CBT/ST)

“…Following the studies of Willutzki et al (2004), Rakowska (2011), and Leichsenring et al (2009), we aimed to investigate the IFST for social anxiety disorder (SAD) considering its feasibility and trends of change in psychological, social system, and global functioning. This section will summarize the findings published in the original pilot RCT (Hunger et al, 2016a(Hunger et al, , 2020. The interested reader can find a detailed review of studies and evidence of psychotherapies for the treatment of SAD elsewhere (Hilzinger et al, 2016).…”