The present study investigated the efficacy of an 8-day, 6-session, intensive individual cognitive behavioral therapy protocol for social anxiety disorder using a multiple baseline across subjects design with 1, 2, and 3 months follow-up assessments. Participants were 5 outpatients with generalized social anxiety disorder. The intervention had variable effects on clinician-rated and selfreport measures of anxiety and depression. The results question the efficacy of intensive psychotherapy as a general therapeutic strategy for social anxiety disorder. Directions for future research are discussed.
Keywords social anxiety disorder; cognitive-behavioral therapy; intensive treatmentIn the current climate of accountability in the managed healthcare system, increasing pressure to contain health care expenditures has treatment researchers working to maximize the efficiency of existing treatments. Probably the most common approach to streamlining interventions is simply to condense therapy into a smaller number of treatment sessions. Briefer treatment has a number of potential benefits, including more rapid relief from debilitating psychiatric symptoms and increased cost-effectiveness, advantages for both consumers and third-party payers alike. In addition, while the general consensus in the literature suggests that 13-18 sessions are required for 50% of patients to improve, patients in naturalistic settings actually participate in an average of only 5 treatment sessions (Hansen, Lambert, & Forman, 2002). Thus, condensed treatments may reach and effectively treat a greater number of patients than traditional psychotherapies.Several studies of cognitive and behavioral therapies for anxiety disorders, depression, eating disorders, couples therapy, alcohol use, and pain management have demonstrated successful outcomes with brief (defined here as fewer than 10 sessions) psychotherapy. Of these, brief interventions for panic disorder (with and without agoraphobia) (Baker Morissette, Spiegel & Heinrichs, 2005; Botella & Garcia-Palacios, 1999) and specific phobias (Öst 1989, 1996Öst, Salkovskis, & Hellstrom, 1991;Öst, Hellstrom, & Kaver, 1992) have the most empirical support (Hazlett-Stevens & Craske, 2002).In their current format, traditional treatments for social anxiety disorder demonstrate varying degrees of effectiveness, often failing to result in high end-state functioning. In addition, existing treatments can be time consuming and costly. Mounting evidence has provided support for the efficacy of short-term, intensive treatments for some anxiety disorders, including For the present study, we aimed to add to the literature by developing and evaluating a modified version of CBT; specifically, an eight-day, six-session, intensive treatment format. Wells' (1997) CBT manual served as a model for the current intervention. All components of CBT were included, albeit delivered over the course of eight consecutive days, rather than 6-12 weeks, and exposure components consisted of massed rather than spaced exposures.It w...