Evaluating a Web-Based Social Anxiety Intervention Among University Students: Randomized Controlled Trial

Abstract

BackgroundTreatment rates for social anxiety, a prevalent and potentially debilitating condition, remain among the lowest of all major mental disorders today. Although computer-delivered interventions are well poised to surmount key barriers to the treatment of social anxiety, most are only marginally effective when delivered as stand-alone treatments. A new, Web-based cognitive behavioral therapy (CBT) intervention called Overcome Social Anxiety was recently created to address the limitations of prior computer-delivered interventions. Users of Overcome Social Anxiety are self-directed through various CBT modules incorporating cognitive restructuring and behavioral experiments. The intervention is personalized to each user’s symptoms, and automatic email reminders and time limits are used to encourage adherence.ObjectiveThe purpose of this study was to conduct a randomized controlled trial to investigate the effectiveness of Overcome Social Anxiety in reducing social anxiety symptoms in a nonclinical sample of university students. As a secondary aim, we also investigated whether Overcome Social Anxiety would increase life satisfaction in this sample.MethodsFollowing eligibility screening, participants were randomly assigned to a treatment condition or a wait-list control condition. Only those assigned to the treatment condition were given access to Overcome Social Anxiety; they were asked to complete the program within 4 months. The social interaction anxiety scale (SIAS), the fear of negative evaluation scale (FNE), and the quality of life enjoyment and satisfaction questionnaire—short form (Q-LES-Q-SF) were administered to participants from both conditions during baseline and 4-month follow-up lab visits.ResultsOver the course of the study, participants assigned to the treatment condition experienced a significant reduction in social anxiety (SIAS: P<.001, Cohen d=0.72; FNE: P<.001, Cohen d=0.82), whereas those assigned to the control condition did not (SIAS: P=.13, Cohen d=0.26; FNE: P=.40, Cohen d=0.14). Additionally, a direct comparison of the average change in social anxiety in the 2 conditions over the course of the study showed that those assigned to the treatment condition experienced significantly more improvement than those assigned to the control condition (SIAS: P=.03, Cohen d=0.56; FNE: P=.001, Cohen d=0.97). Although participants assigned to the treatment condition experienced a slight increase in life satisfaction, as measured by Q-LES-Q-SF scores, and those assigned to the control condition experienced a slight decrease, these changes were not statistically significant (treatment: P=.35, Cohen d=−0.18; control: P=.30, Cohen d=0.18).ConclusionsOur findings indicate that Overcome Social Anxiety is an effective intervention for treating symptoms of social anxiety and that it may have further utility in serving as a model for the development of new interventions. Additionally, our findings provide evidence that contemporary Web-based interventions can be sophisticated enough to benefit users even whe...

Efficacy of an unguided internet‐based self‐help intervention for social anxiety disorder in university students: A randomized controlled trial

“…A small pilot study ( N = 38) on therapist guided self‐help found comparable effects for changes in SAD on the SPS ( d = 1.18 vs. 1.14 in the present study) but somewhat smaller effects with regard to changes on the SIAS ( d = 0.81 vs. d = 1.17 in the present study; Tillfors et al, ). Recently, McCall et al () reported somewhat smaller within‐group changes for unguided self‐help in a non‐clinical student sample with SAD symptoms (SIAS: d = 0.72), where between‐group effects were comparable with the present study ( d = 0.56). However, the authors reported completer data only, and the dropout rate in the study was substantial (>35%).…”

“…A small open trial ( n = 38) that delivered PDFs with self‐help material and offered minimal contact with a psychotherapist resulted in large pre–post within‐group effects (Social Interaction Anxiety Scale [SIAS]: d = 0.81; Social Phobia Scale [SPS]: d = 1.18) for both the iCBT group and the iCBT group with additional in vivo group exposure (Tillfors et al, ). Another unguided web‐based intervention that was personalized to each user's symptoms yielded smaller pre–post effect sizes in a non‐clinical sample of psychology students (e.g., SIAS: d = 0.72; McCall, Richardson, Helgadottir, & Chen, ).…”

Internet and Computer-Based Cognitive Behavioral Therapy for Anxiety and Depression in Adolescents and Young Adults: Systematic Review and Meta-Analysis

“…In 14 studies, participants were guided through the intervention by a therapist or researcher. The other 10 interventions were self-guided (ie, unguided) [ 58 , 59 , 65 - 72 ]. Guidance was provided through telephone and/or email contact [ 63 , 64 , 73 - 78 ], chat sessions [ 79 ], or face-to-face guidance during the participant’s completion of the modules [ 60 - 62 , 80 , 81 ].…”

Using Psychological Artificial Intelligence (Tess) to Relieve Symptoms of Depression and Anxiety: Randomized Controlled Trial

“…With 1 app for patients suffering from suicidal thoughts, more subjects reported suicidal ideation using the app than they did on the traditionally administered Patient Health Questionnaire (PHQ-9) [9]. Psychological artificial intelligence (AI) delivering cognitive behavioral therapy (CBT) has been shown to be a feasible, engaging, and effective solution for reducing symptoms of depression and anxiety in college students [10-12]. However, the efficacy of using psychological AI to deliver integrative mental health care, including CBT, requires further exploration.…”