Dissertation
A randomized trial of an Internet-based self-help intervention for social anxiety disorder with and without therapist support
Doctor of Philosophy (Ph.D.), Drexel University
01 Apr 2015
DOI:
https://doi.org/10.17918/etd-6339
Abstract
Social anxiety disorder (SAD) is one of the most prevalent psychiatric disorders in United States. Although evidenced-based behavioral treatments are available, less than 20% of those with SAD receive treatment (Grant et al., 2005). The disparity between the number of individuals affected and those obtaining treatment is due to a number of factors, including limited accessibility to therapists practicing evidence-based interventions such as cognitive behavior therapy, geographic factors, and financial cost. Internet-based interventions may be utilized to overcome some of these barriers. Guided Internet-based therapeutic interventions have been demonstrated to be effective for social anxiety (e.g., Andersson et al., 2006). The optimal role (if any) of the therapist in such programs, including the amount of therapist time necessary for effective treatment, remains unclear. The purpose of the current study was to assess the acceptability and efficacy of a novel Internet-based self-help CBT intervention for the treatment of SAD in adults, and to assess the additive role of minimal therapist support delivered through the videoconferencing platform VSee and text messaging on treatment outcome. The intervention program was derived from an acceptance-based CBT that utilizes traditional behavioral interventions (e.g., exposure) within the context of a model emphasizing mindfulness and psychological acceptance. Forty-two participants were randomized to two groups: An Internet self-help intervention only (n = 22) versus an Internet self-help intervention with therapist support (n = 20). Both groups received the Internet program consisting of eight weekly modules. The therapist support group also received weekly 10-15 minute therapist support delivered through VSee and daily text-messages. Participants were assessed pre-treatment, mid-treatment, and post-treatment on both outcome and process measures. Participants in both conditions rated the program as highly acceptable; therapists in the support condition rated the program as feasible. Both groups experienced a significant reduction in SAD symptoms and improvements in functioning and quality of life. There was no significant difference in symptom reduction or quality of life measures between groups in both completer-only and intent-to-treat analyses. However, the therapist-support group evidenced lower attrition than the minimal support group (20% vs. 50%). Implications for dissemination and future directions are discussed.
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Details
- Title
- A randomized trial of an Internet-based self-help intervention for social anxiety disorder with and without therapist support
- Creators
- Marina Gershkovich - DU
- Contributors
- James D. Herbert (Advisor) - Drexel University (1970-)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Psychological and Brain Sciences (Psychology); College of Arts and Sciences; Drexel University
- Other Identifier
- 6339; 991014632346304721