Intensive Group-Based CBT for Child Social Phobia: A Pilot Study

Abstract

Objective: Although CBT has proven efficacious in the treatment of child social phobia (SP), most children do not present for treatment and child SP may be less responsive to treatment than other anxiety disorders. Intensive, group-based, SP-specific CBT may improve the efficacy of, and access to, treatment for child SP. The aim of this study was to provide a preliminary examination of such a program. Method: Forty Australian children aged 7-12 years (15 male and 25 female) were allocated into treatment and waitlist groups. Clinical interviews to determine diagnostic status were conducted prior to treatment, following treatment and at 6-month follow-up. Parent and child questionnaire measures of child anxiety symptoms, internalising symptoms, depression, social skills, social competence, and parental social anxiety were administered at the same time points. Treatment was delivered in four separate 3-hour sessions conducted over three consecutive weekends. Results: At postassessment, 52.4% of children in the treatment group and 15.8% of children in the waitlist group were free of their SP diagnosis. At post-assessment, compared to waitlist children, treatment group children demonstrated a greater drop in clinical severity, a greater increase in overall functioning, and held fewer clinical diagnoses. Treatment group children also reported a greater reduction in SP symptoms compared to waitlist children, and treatment group parents reported a greater reduction in child internalising and anxiety symptoms, a greater increase in child social competence, and a greater decrease in parental SP symptoms, compared to parents of children in the waitlist group. By 6-month follow-up, 76.9% of the treatment group were free of their SP diagnosis and gains on all other measures were maintained. Conclusions: The results of this study are encouraging, and suggest that brief, intensive, group CBT for children with social anxiety is beneficial for many youngsters. A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPTIntensive Group-Based CBT for Child Social Phobia 3 Social Phobia (SP) or Social Anxiety Disorder, is an anxiety disorder where the individual demonstrates a marked fear or anxiety about one or more social situations where they are exposed to possible scrutiny by others (American Psychiatric Association, 2013). It is one of the most common childhood anxiety disorders (Costello, Egger, & Angold, 2005), is associated with a myriad of deleterious short-and long-term consequences (Beidel, Turner, & Morris, 1999), and follows a chronic course if left untreated (Weissman et al., 1999).Fortunately, there have now been a number of studies confirming that cognitive behaviour therapy (CBT) is efficacious in treating childhood SP.Beidel and colleagues (Beidel & Turner, 2007;Beidel, Turner, & Young, 2006) conducted a series of studies demonstrating the efficacy of their behaviourally oriented Social Effectiveness Therapy for Children (SET-C). In the original randomized control trial of the SET-C program , it was found that...

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