An initial test of a new self-guided internet-based intervention for social anxiety: iExposure

Cogn Behav Ther. 2025 Jan;54(1):1-16. doi: 10.1080/16506073.2024.2368519. Epub 2024 Jun 19.

Abstract

Social anxiety is a prevalent mental health concern that impacts approximately 12% of the US population. There is a need for targeted mechanism-focused interventions for social anxiety that are also highly scalable. Using a recently developed naturalistic paradigm with simulated teleconferencing interactions as the central treatment element, we developed a new self-guided internet-based intervention for social anxiety called iExposure. This randomized clinical trial aimed at testing two mechanism-driven exposure augmentation strategies for social anxiety. Participants (N = 53) were randomized to four sessions of either (a) standard iExposure (n = 18), (b) iExposure +Attention Control (n = 22), or (c) iExposure + Attention Guidance (n = 13) and administered over two weeks. At follow-up across conditions, there were large reductions in communication anxiety d = -1.51 and moderate reductions in social anxiety d = -0.60. The attention control condition led to larger reductions in social anxiety compared to standard iExposure d = -0.81 and attention guidance did not enhance iExposure for general symptoms of social anxiety, d = -0.27. These findings provide preliminary support for the utility of iExposure. Further research is needed with a larger sample to understand its efficacy with regard to the role of attention augmentation strategies.

Keywords: Social anxiety; attention; exposure; eye tracking; internet-based intervention.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Cognitive Behavioral Therapy / methods
  • Female
  • Humans
  • Implosive Therapy / methods
  • Internet-Based Intervention*
  • Male
  • Middle Aged
  • Phobia, Social* / psychology
  • Phobia, Social* / therapy
  • Young Adult