Self-help cognitive–behavioral therapy with minimal therapist contact for social phobia: A controlled trial

Abramowitz, Jonathan S.; Moore, Elizabeth L.; Braddock, Autumn E.; Harrington, Diana L.

doi:10.1016/j.jbtep.2008.04.004

Cited by 42 publications

(39 citation statements)

References 12 publications

(15 reference statements)

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“…Os estudos controlados avaliados apontam para a eficácia das intervenções cognitivas e comportamentais (tais como EXP e TTC), sozinhas ou associadas a outras técni-cas (relaxamento e treino em respiração), na redução dos sintomas do TAS [17][18][19] quando comparadas a outros tipos de abordagens psicoterápicas ou a grupo controle [21][22][23][24][25][26][28][29][30][31][32][33][34]41,43 . Tais achados são confi rmados por Acarturk et al 52 em estudo meta-analítico recente que afi rmou também que essa efi cácia tende a se manter e, em alguns casos, até melhorar nas medidas de follow-up.…”

Section: Discussionunclassified

“…As novas formas de apresentação da TCC, como a autoterapia através de um livro-guia 31 , a terapia via internet [24][25][26][28][29][30] Tratamento cognitivo e/ou comportamental e transtorno de ansiedade social -MULULO ET AL.…”

Section: Discussionunclassified

“…A gravidade do TAS também diferia entre os estudos: enquanto em alguns ensaios os pacientes selecionados apresentavam gravidade leve a moderada 29 , em outros 6 o subtipo generalizado grave do TAS era o critério de inclusão. A forma de recrutamento dos pacientes também diferia entre os estudos, excluindo muitas vezes pacientes com TAS que não buscaram ajuda, potencialmente mais graves e com maiores limitações.…”

Section: Discussionunclassified

“…Outro programa de TCC via internet 29 , com contato míni-mo com terapeuta ao vivo (e não via e-mail), também foi mais efi caz do que a LE para 21 pacientes com TAS leve a moderado no pós-teste de 8 semanas e na reavaliação após 3 meses.…”

Section: Tcc Versus Terapia De Suporte Educacionalunclassified

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Eficácia do tratamento cognitivo e/ou comportamental para o transtorno de ansiedade social

Mululo

Menezes

Fontenelle

et al. 2009

Rev. psiquiatr. Rio Gd. Sul

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ResumoObjetivo: Avaliar a efi cácia do tratamento cognitivo e/ou comportamental no transtorno de ansiedade social quando comparado a outras intervenções terapêuticas, incluindo farmacoterapia. Método: Realizamos análise sistemática de todos os ensaios clínicos controlados randomizados envolvendo terapia cognitiva e/ou comportamental versus outras formas de tratamento, publicados até março de 2009, indexados nas seguintes bases de dados: MEDLINE, PsycINFO, Registro Cochrane de Ensaios Controlados, LILACS e ISI/Web of Science. Resultados: Os estudos avaliados não demonstraram diferenças signifi cativas entre a terapia cognitiva e/ou comportamental e a farmacoterapia. Esses tratamentos combinados não apresentaram maior efi cácia do que as intervenções isoladamente. Quando comparada ao grupo controle, a terapia cognitiva e/ou comportamental é efi caz na redução dos sintomas de ansiedade social, tanto no seu formato padrão quanto nas novas formas de intervenção. A exceção foi o treino em habilidades sociais, que, isoladamente, não se mostrou efi caz. A terapia cognitiva e/ou comportamental também demonstrou ser superior aos outros tipos de psicoterapias. Conclusão: A terapia cognitiva e/ou comportamental mostrou-se efi caz na redução da ansiedade social em pacientes com transtorno de ansiedade social. No entanto, a heterogeneidade dos estudos avaliados, seja no que diz respeito a aspectos envolvendo o tratamento (duração do tratamento e protocolos utilizados) ou os pacientes avaliados (gravidade e forma de recrutamento), difi cultaram a comparação dos resultados. Novos estudos de tratamento cognitivo e/ou comportamental e novas revisões envolvendo essas abordagens são necessários para melhor avaliação de nossos achados. Descritores: Fobia social, terapia cognitiva, terapia comportamental, transtorno de ansiedade social, revisão. AbstractObjective: To ascertain whether cognitive and/or behavioral treatment of patients with social anxiety disorder is superior in terms of effi cacy than other types of therapeutic interventions, including pharmacotherapy. Method: Systematic analysis of all randomized clinical trials on cognitive and/or behavioral therapy vs. other forms of treatment, published until March 2009, indexed in the following databases: MEDLINE, PsycINFO, Cochrane Controlled Trials Register, LILACS and ISI Web of Science. Results: The reported results do not suggest signifi cant differences in the effi cacy of cognitive and/or behavioral therapy and pharmacotherapy. Such treatments combined did not show higher effi cacy than interventions alone. Compared with the control group, cognitive and/or behavioral therapy was superior in reducing social anxiety disorder, either in the classic model or in the newest propositions. The only exception was the social skills training, which was not effective for patients with social anxiety disorder. Cognitive and/or behavioral therapy was also superior to other psychotherapeutic interventions. Conclusion: Cognitive and/or behavioral therapy is an effective treatment for pati...

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Section: Discussionunclassified

Section: Tcc Versus Terapia De Suporte Educacionalunclassified

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Eficácia do tratamento cognitivo e/ou comportamental para o transtorno de ansiedade social

Mululo

Menezes

Fontenelle

et al. 2009

Rev. psiquiatr. Rio Gd. Sul

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“…Treatments that may be appropriate using these criteria include self-help and guided self-help. Recent studies have demonstrated the efficacy of internet-based self-help or guided self-help [87] and bibliotherapy self-help or guided self-help for individuals diagnosed with SAD [137,138]. No known studies have conducted cost-effectiveness analyses using these treatments for SAD specifically.…”

Section: Alternative Treatment Strategies: Self-help and Guided Self-helpmentioning

confidence: 99%

Issues and controversies surrounding the diagnosis and treatment of social anxiety disorder

Dalrymple

2012

Expert Review of Neurotherapeutics

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Baseline Severity as a Moderator of the Waiting List–Controlled Association of Cognitive Behavioral Therapy With Symptom Change in Social Anxiety Disorder

et al. 2023

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ImportanceSocial anxiety disorder (SAD) can be adequately treated with cognitive behavioral therapy (CBT). However, there is a large gap in knowledge on factors associated with prognosis, and it is unclear whether symptom severity predicts response to CBT for SAD.ObjectiveTo examine baseline SAD symptom severity as a moderator of the association between CBT and symptom change in patients with SAD.Data SourcesFor this systematic review and individual patient data meta-analysis (IPDMA), PubMed, PsycInfo, Embase, and the Cochrane Library were searched from January 1, 1990, to January 13, 2023. Primary search topics were social anxiety disorder, cognitive behavior therapy, and randomized controlled trial.Study SelectionInclusion criteria were randomized clinical trials comparing CBT with being on a waiting list and using the Liebowitz Social Anxiety Scale (LSAS) in adults with a primary clinical diagnosis of SAD.Data Extraction and SynthesisAuthors of included studies were approached to provide individual-level data. Data were extracted by pairs of authors following the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline, and risk of bias was assessed using the Cochrane tool. An IPDMA was conducted using a 2-stage approach for the association of CBT with change in LSAS scores from baseline to posttreatment and for the interaction effect of baseline LSAS score by condition using random-effects models.Main Outcomes and MeasuresThe main outcome was the baseline to posttreatment change in symptom severity measured by the LSAS.ResultsA total of 12 studies including 1246 patients with SAD (mean [SD] age, 35.3 [10.9] years; 738 [59.2%] female) were included in the meta-analysis. A waiting list–controlled association between CBT and pretreatment to posttreatment LSAS change was found (b = –20.3; 95% CI, −24.9 to −15.6; P &lt; .001; Cohen d = –0.95; 95% CI, −1.16 to −0.73). Baseline LSAS scores moderated the differences between CBT and waiting list with respect to pretreatment to posttreatment symptom reductions (b = –0.22; 95% CI, −0.39 to −0.06; P = .009), indicating that individuals with severe symptoms had larger waiting list–controlled symptom reductions after CBT (Cohen d = –1.13 [95% CI, −1.39 to −0.88] for patients with very severe SAD; Cohen d = –0.54 [95% CI, −0.80 to −0.29] for patients with mild SAD).Conclusions and RelevanceIn this systematic review and IPDMA, higher baseline SAD symptom severity was associated with greater (absolute but not relative) symptom reductions after CBT in patients with SAD. The findings contribute to personalized care by suggesting that clinicians can confidently offer CBT to individuals with severe SAD symptoms.

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Self-help cognitive–behavioral therapy with minimal therapist contact for social phobia: A controlled trial

Cited by 42 publications

References 12 publications

Eficácia do tratamento cognitivo e/ou comportamental para o transtorno de ansiedade social

Eficácia do tratamento cognitivo e/ou comportamental para o transtorno de ansiedade social

Issues and controversies surrounding the diagnosis and treatment of social anxiety disorder

Baseline Severity as a Moderator of the Waiting List–Controlled Association of Cognitive Behavioral Therapy With Symptom Change in Social Anxiety Disorder

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