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Internet-Based CBT for Social Anxiety Has Staying Power 5 Years Later

11 Mar

Researchers from the Karolinska Institute in Stockholm, Sweden evaluated the long-term effects of internet-based cognitive behavioral therapy (CBT) for social anxiety disorder. Several trials had demonstrated its effectiveness in the short term, but long term impact was unclear.   

This was a 5-year follow-up study of 80 people with SAD who had undergone Internet-based CBT. The assessment comprised a diagnostic interview and self-report questionnaires.

The main outcome measure was the Liebowitz Social Anxiety Scale-Self-Report (LSAS-SR). Additional measures of social anxiety were the Social Interaction Anxiety Scale (SIAS) and the Social Phobia Scale (SPS).

Attrition rates were low: 89% (71/80) of the participants completed the diagnostic interview and 80% (64/80) responded to the questionnaires.

Results were strong.  Improvements gained at the 1-year follow-up were sustained 5 years after completed treatment.

Mixed-effect models analysis showed a significant effect of time on the three social anxiety measures, LSAS-SR, SIAS, and SPS (F(3,98-102) = 16.05 - 29.20, P < .001) indicating improvement.

From baseline to 5-year follow-up, participants' mean scores on the LSAS-SR were reduced from 71.3 to 40.3. The effect sizes of the LSAS-SR were large (Cohen's d range 1.30 - 1.40, 95% conf. level)

The investigators concluded that internet-based CBT for SAD is a treatment that can result in large and enduring effects.

Citation:  Hedman E, Furmark T, Carlbring P, Ljótsson B, Rück C, Lindefors N, Andersson G. A 5-Year follow-up of internet-based cognitive behavior therapy for social anxiety disorder. Journal of Medical Internet Research. 2011 Jun 15;13 (2):e39. This email address is being protected from spambots. You need JavaScript enabled to view it.

Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award