Cognitive-behavioral therapy modifies the naturalistic course of social anxiety disorder: findings from an ABA design study in routine clinical practices

Psychiatry Clin Neurosci. 2013 Apr;67(3):139-47. doi: 10.1111/pcn.12035.

Abstract

Aims: While randomized evidence appears to have established efficacy of cognitive-behavioral therapy (CBT) and some pharmacotherapy for social anxiety disorder (SAD), their real-world effectiveness has been called into question by long-term naturalistic cohort studies of patients with SAD as they show very low probability of recovery and sustained social dysfunctions despite some drug and psychological therapies.

Method: The present study examines the effectiveness of group CBT for SAD in real-world settings (n=62) by examining the course of patients' symptomatology and social functions through approximately 6 months on the waiting list, through 6 months receiving the manualized group CBT intervention consisting of 16 2-h sessions, and for 12 months after the treatment.

Results: We found: (i) that the patients with SAD changed little or possibly worsened through the 6 months on the waiting list, although two in three of them were on antidepressants, benzodiazepines or both; (ii) that both their symptomatology and social function improved significantly and substantively through the group CBT; and (iii) that this improvement was maintained through the 3- and 12-month follow ups.

Conclusions: We can implement and must disseminate evidence-based, effective CBT for more patients with SAD to lessen their suffering and stop the perpetuation of their symptoms.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age of Onset
  • Antidepressive Agents / therapeutic use
  • Benzodiazepines / therapeutic use
  • Cognitive Behavioral Therapy / methods*
  • Cohort Studies
  • Depression / psychology
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Humans
  • Male
  • Phobic Disorders / complications
  • Phobic Disorders / psychology*
  • Phobic Disorders / therapy*
  • Psychotropic Drugs / therapeutic use
  • Research Design
  • Surveys and Questionnaires
  • Treatment Outcome

Substances

  • Antidepressive Agents
  • Psychotropic Drugs
  • Benzodiazepines