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Accelerated Outpatient Individual Cognitive Behavioural Therapy for Social Anxiety Disorder: A Preliminary Pilot Study

Published online by Cambridge University Press:  25 April 2018

Bethany M. Wootton Open the ORCID record for Bethany M. Wootton [Opens in a new window] ,
Alexandra Hunn ,
Annabelle Moody ,
Bethany R. Lusk ,
Valerie A. Ranson  and
Kim L. Felmingham
Bethany M. Wootton*
Affiliation:
Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, 2007, Australia Department of Medicine (Psychology), University of Tasmania, Locked Bag 30, Hobart, TAS, 7001, Australia
Alexandra Hunn
Affiliation:
Department of Medicine (Psychology), University of Tasmania, Locked Bag 30, Hobart, TAS, 7001, Australia
Annabelle Moody
Affiliation:
Department of Medicine (Psychology), University of Tasmania, Locked Bag 30, Hobart, TAS, 7001, Australia
Bethany R. Lusk
Affiliation:
Department of Medicine (Psychology), University of Tasmania, Locked Bag 30, Hobart, TAS, 7001, Australia
Valerie A. Ranson
Affiliation:
Department of Medicine (Psychology), University of Tasmania, Locked Bag 30, Hobart, TAS, 7001, Australia
Kim L. Felmingham
Affiliation:
School of Psychological Sciences, University of Melbourne, Parkville, VIC, 3010, Australia
*
Correspondence to Bethany M. Wootton, Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia. E-mail: bethany.wootton@uts.edu.au
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Abstract

Background: Social anxiety disorder (SAD) is a common and chronic mental health condition. Given the significant prevalence and impairment caused by SAD, it is important to investigate novel ways to improve the efficacy of cognitive behavioural therapy (CBT) for SAD. One approach may be to provide CBT in an accelerated fashion, which involves multiple sessions per week. Such accelerated treatments have been shown to be effective in other anxiety disorders, but in SAD this accelerated treatment has only been studied in a group treatment format. Aims: The aim of this study was to provide a preliminary investigation of the efficacy of individual accelerated CBT (aCBT) in the treatment of SAD. Method: The studied utilized an open trial design. Seventeen participants commenced the treatment, which consisted of 12 sessions delivered over 4 weeks. Results: The results indicated that participants obtained moderate to large effect sizes on measures of SAD at post-treatment (range d = 0.76–0.92) and 3-month follow-up (range d = 1.31–1.79). In addition, at post-treatment, 59% of participants no longer met criteria for SAD, and this number increased to 71% at 3-month follow-up. Conclusions: The results provide preliminary evidence to suggest that individual aCBT may be an important treatment option for individuals with SAD.

Keywords

social anxiety disordertreatment outcomeacceleratedintensiveindividual cognitive behavioural therapy
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 46 , Issue 6 , November 2018 , pp. 690 - 705
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2018 

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Footnotes

*

Co-first authors.

References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th edn). American Psychiatric Association.Google Scholar
Antony, M. M., Coons, M. J., McCabe, R. E., Ashbaugh, A. and Swinson, R. P. (2006). Psychometric properties of the social phobia inventory: further evaluation. Behaviour Research and Therapy, 44, 1177–1185. doi: 10.1016/j.brat.2005.08.013Google Scholar
Barkowski, S., Schwartze, D., Strauss, B., Burlingame, G. M., Barth, J. and Rosendahl, J. (2016). Efficacy of group psychotherapy for social anxiety disorder: a meta-analysis of randomized-controlled trials. Journal of Anxiety Disorders, 39, 44–64. doi: 10.1016/j.janxdis.2016.02.005Google Scholar
Bevan, A., Oldfield, V. B. and Salkovskis, P. M. (2010). A qualitative study of the acceptability of an intensive format for the delivery of cognitive-behavioural therapy for obsessive-compulsive disorder. British Journal of Clinical Psychology, 49, 173–191. doi: 10.1348/014466509X447055Google Scholar
Bögels, S. M. and Reith, W. (1999). Validity of two questionnaires to assess social fears: the Dutch social phobia and anxiety inventory and the blushing, trembling and sweating questionnaire. Journal of Psychopathology and Behavioral Assessment, 21, 51–66. doi: 10.1023/A:1022812227606Google Scholar
Chaker, S., Hofmann, S. G. and Hoyer, J. (2010). Can a one-weekend group therapy reduce fear of blushing? Results of an open trial. Anxiety, Stress and Coping, 23, 303–318.Google Scholar
Chase, R. M., Whitton, S. W. and Pincus, D. B. (2012). Treatment of adolescent panic disorder: a non-randomized comparison of intensive versus weekly CBT. Child and Family Behavior Therapy, 34, 305–323. doi: 10.1080/07317107.2012.732873Google Scholar
Clark, D. M., Ehlers, A., McManus, F., Hackmann, A., Fennell, M., Campbell, H. et al. (2003). Cognitive therapy versus fluoxetine in generalized social phobia: a randomized placebo-controlled trial. Journal of Consulting and Clinical Psychology, 71, 1058–1067. doi: 10.1037/0022-006X.71.6.1058Google Scholar
Connor, K. M., Davidson, J. R. T., Erik Churchill, L., Sherwood, A., Foa, E. and Weisler, R. H. (2000). Psychometric properties of the social phobia inventory (SPIN). New self- rating scale. British Journal of Psychiatry, 176, 379–386. doi: 10.1192/bjp.176.4.379Google Scholar
Donovan, C. L., Cobham, V., Waters, A. M. and Occhipinti, S. (2014). Intensive group-based CBT for child social phobia: a pilot study. Behavior Therapy. doi: 10.1016/j.beth.2014.12.005Google Scholar
Ehlers, A., Hackmann, A., Grey, N., Wild, J., Liness, S., Albert, I. et al. (2014). A randomized controlled trial of 7-day intensive and standard weekly cognitive therapy for PTSD and emotion-focused supportive therapy. American Journal of Psychiatry, 171, 294–304. doi: 10.1176/appi.ajp.2013.13040552Google Scholar
Foa, E. B., Liebowitz, M. R., Kozak, M. J., Davies, S., Campeas, R., Franklin, M. E. et al. (2005). Randomized, placebo-controlled trial of exposure and ritual prevention, clomipramine, and their combination in the treatment of obsessive-compulsive disorder. American Journal of Psychiatry, 162, 151–161. doi: 10.1176/appi.ajp.162.1.151Google Scholar
Jacobson, N. S. and Truax, P. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19. doi: 10.1037//0022-006X.59.1.12Google Scholar
Jónsson, H., Kristensen, M. and Arendt, M. (2015). Intensive cognitive behavioural therapy for obsessive-compulsive disorder: a systematic review and meta-analysis. Journal of Obsessive-Compulsive and Related Disorders, 6, 83–96. doi: 10.1016/j.jocrd.2015.04.004Google Scholar
Keller, M. B. (2006). Social anxiety disorder clinical course and outcome: review of Harvard/Brown Anxiety Research Project (HARP) findings. Journal of Clinical Psychiatry, 67 (suppl. 12), 14–19.Google Scholar
Kessler, R. C., Petukhova, M., Sampson, N. A., Zaslavsky, A. M. and Wittchen, H. U. (2012). Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. International Journal of Methods in Psychiatric Research, 21, 169–184. doi: 10.1002/mpr.1359Google Scholar
Knuts, I. J., Esquivel, G., Overbeek, T. and Schruers, K. R. (2015). Intensive behavioral therapy for agoraphobia. Journal of Affective Disorders, 174, 19–22. doi: 10.1016/j.jad.2014.11.029Google Scholar
Liebowitz, M. R. (1987). Social phobia. Modern Problems of Pharmacopsychiatry, 22, 141–173.Google Scholar
Lovibond, S. H. and Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scales. Sydney: Psychology Foudation of Australia.Google Scholar
Mattick, R. P. and Clarke, J. C. (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy, 36, 455–470. doi: 10.1016/S0005-7967(97)10031-6Google Scholar
Mayo-Wilson, E., Dias, S., Mavranezouli, I., Kew, K., Clark, D. M., Ades, A. E. and Pilling, S. (2014). Psychological and pharmacological interventions for social anxiety disorder in adults: a systematic review and network meta-analysis. The Lancet Psychiatry, 1, 368–376. doi: 10.1016/S2215-0366(14)70329-3Google Scholar
Mörtberg, E., Berglund, G. and Sundin, Ö. (2005). Intensive cognitive behavioural group treatment for social phobia: a pilot study. Cognitive Behaviour Therapy, 34, 41–49. doi: 10.1080/16506070510010657Google Scholar
Mörtberg, E., Clark, D. M., Sundin, Ö. and Åberg Wistedt, A. (2007). Intensive group cognitive treatment and individual cognitive therapy vs. treatment as usual in social phobia: A randomized controlled trial. Acta Psychiatrica Scandinavica, 115, 142–154. doi: 10.1111/j.1600-0447.2006.00839.xGoogle Scholar
National Institute for Health and Clinical Excellence (2013). Social anxiety disorder: recognition, assessment and treatment. CG159. London: National Institute for Health and Care Excellence.Google Scholar
Newman, M. G., Kachin, K. E., Zuellig, A. R., Constantino, M. J. and Cashman-McGrath, L. (2003). The social phobia diagnostic questionnaire: preliminary validation of a new self-report diagnostic measure of social phobia. Psychological Medicine, 33, 623–635. doi: 10.1017/S0033291703007669Google Scholar
Osman, A., Gutierrez, P. M., Barrios, F. X., Kopper, B. A. and Chiros, C. E. (1998). The social phobia and social interaction anxiety scales: evaluation of psychometric properties. Journal of Psychopathology and Behavioral Assessment, 20, 249–264. doi: 10.1023/A:1023067302227Google Scholar
Osman, A., Wong, J. L., Bagge, C. L., Freedenthal, S., Gutierrez, P. M. and Lozano, G. (2012). The Depression Anxiety Stress Scales-21 (DASS-21): further examination of dimensions, scale reliability, and correlates. Journal of Clinical Psychology, 68, 1322–1338. doi: 10.1002/jclp.21908Google Scholar
Öst, L. G. and Ollendick, T. H. (2017). Brief, intensive and concentrated cognitive behavioral treatments for anxiety disorders in children: a systematic review and meta-analysis. Behaviour Research and Therapy, 97, 134–145. doi: 10.1016/j.brat.2017.07.008Google Scholar
Posner, K., Brown, G. K., Stanley, B., Brent, D. A., Yershova, K. V., Oquendo, M. A. et al. (2011). The Columbia-suicide severity rating scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. American Journal of Psychiatry, 168, 1266–1277. doi: 10.1176/appi.ajp.2011.10111704Google Scholar
Rapee, R. M. and Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in social phobia. Behaviour Research and Therapy, 35, 741–756. doi: 10.1016/S0005-7967(97)00022-3Google Scholar
Sinclair, S. J., Siefert, C. J., Slavin-Mulford, J. M., Stein, M. B., Renna, M. and Blais, M. A. (2012). Psychometric evaluation and normative data for the Depression, Anxiety, and Stress Scales-21 (DASS-21) in a non-clinical sample of US adults. Evaluation and the Health Professions, 35, 259–279. doi: 10.1177/0163278711424282Google Scholar
Stangier, U., Heidenreich, T., Peitz, M., Lauterbach, W. and Clark, D. M. (2003). Cognitive therapy for social phobia: individual versus group treatment. Behaviour Research and Therapy, 41, 991–1007. doi: 10.1016/S0005-7967(02)00176-6Google Scholar
Storch, E. A., Geffken, G. R., Merlo, L. J., Mann, G., Duke, D., Munson, M. et al. (2007). Family-based cognitive-behavioral therapy for pediatric obsessive-compulsive disorder: comparison of intensive and weekly approaches. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 469–478. doi: 10.1097/chi.0b013e31803062e7Google Scholar
Stulz, N., Lutz, W., Kopta, S. M., Minami, T. and Saunders, S. M. (2013). Dose–effect relationship in routine outpatient psychotherapy: does treatment duration matter? Journal of Counseling Psychology, 60, 593–600. doi: 10.1037/a0033589Google Scholar
Teng, E. J., Barrera, T. L., Hiatt, E. L., Chaison, A. D., Dunn, N. J., Petersen, N. J. and Stanley, M. A. (2015). Intensive weekend group treatment for panic disorder and its impact on co-occurring PTSD: a pilot study. Journal of Anxiety Disorders, 33, 1–7. doi: 10.1016/j.janxdis.2015.04.002Google Scholar
Tolin, D. F., Gilliam, C., Wootton, B. M., Bowe, W., Bragdon, L. B., Davis, E. et al. (2018). Psychometric properties of a structured diagnostic interview for DSM-5 anxiety, mood, and obsessive-compulsive and related disorders. Assessment, 25, 3–13. doi: 10.1177/1073191116638410Google Scholar
Wootton, B. M., Dear, B. F., Johnston, L., Terides, M. D. and Titov, N. (2014). Self-guided internet administered treatment for obsessive-compulsive disorder: results from two open trials. Journal of Obsessive-Compulsive and Related Disorders, 3, 102–108. doi: 10.1016/j.jocrd.2014.03.001Google Scholar
Wootton, B. M. and MacGregor, A. (2016). Accelerated outpatient individual cognitive-behaviour therapy for panic disorder: a case study. Clinical Psychologist. doi: 0.1111/cp.12100Google Scholar
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