Elsevier

Behavior Therapy

Volume 40, Issue 4, December 2009, Pages 414-424
Behavior Therapy

Efficacy of a Manualized and Workbook-Driven Individual Treatment for Social Anxiety Disorder

https://doi.org/10.1016/j.beth.2008.12.001Get rights and content

Abstract

Social anxiety disorder is a prevalent and impairing disorder for which viable cognitive-behavioral therapies exist. However, these treatments have not been easily packaged for dissemination and may be underutilized as a result. The current study reports on the findings of a randomized controlled trial of a manualized and workbook-driven individual cognitive-behavioral treatment for social anxiety disorder (Hope, Heimberg, Juster, & Turk, 2000; Hope, Heimberg, & Turk, 2006). This treatment package was derived from an empirically supported group treatment for social anxiety disorder and intended for broad dissemination, but it has not previously been subjected to empirical examination on its own. As a first step in that examination, 38 clients seeking treatment for social anxiety disorder at either the Adult Anxiety Clinic of Temple University or the Anxiety Disorders Clinic of the University of Nebraska-Lincoln were randomly assigned to receive either immediate treatment with this cognitive-behavioral treatment package or treatment delayed for 20 weeks. Evaluation at the posttreatment/postdelay period revealed substantially greater improvements among immediate treatment clients on interviewer-rated and self-report measures of social anxiety and impairment. Three-month follow-up assessment revealed maintenance of gains. Clinical implications and directions for future research are discussed.

Section snippets

Study Design

Participants initially presented to the Adult Anxiety Clinic of Temple University or the Anxiety Disorders Clinic at the University of Nebraska-Lincoln for difficulties with anxiety. At the University of Nebraska, all potential participants underwent an initial evaluation with the Anxiety Disorders Interview Schedule for DSM-IV (ADIS-IV; T. Brown, DiNardo, & Barlow, 1994), and at Temple, all potential participants underwent the Anxiety Disorders Interview Schedule for DSM-IV, Lifetime Version

Attrition

Of the 22 clients assigned to the delayed treatment condition, 3 dropped during the wait period and did not provide postdelay data. Of the 16 clients assigned to the immediate treatment condition, all but 1 completed treatment and provided posttreatment data.

Both intent-to-treat (ITT) and completer analyses were performed. For the ITT analyses, participants’ last observation was carried forward. For participants in the delayed treatment condition, this meant carrying forward their pretreatment

Discussion

The current study evaluated the efficacy of a manualized individual therapy program (Hope et al., 2000, Hope et al., 2006). Data from this study indicate that the Managing Social Anxiety program was efficacious. At posttreatment, clients who received treatment showed significantly greater improvement in their social anxiety symptoms and were more likely to be classified as treatment responders than clients who were assigned to the DT condition. Furthermore, clients who received treatment showed

Deborah Roth Ledley, Richard G. Heimberg, Talia I. Zaider, Cynthia L. Turk, and David M. Fresco were affiliated with the Adult Anxiety Clinic of Temple University at the time that the study was initiated. Debra A. Hope, Sarah A. Hayes, Melanie Van Dyke, and Cynthia Kraus were affiliated with the Department of Psychology, University of Nebraska-Lincoln at the time that the study was initiated.

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    Deborah Roth Ledley, Richard G. Heimberg, Talia I. Zaider, Cynthia L. Turk, and David M. Fresco were affiliated with the Adult Anxiety Clinic of Temple University at the time that the study was initiated. Debra A. Hope, Sarah A. Hayes, Melanie Van Dyke, and Cynthia Kraus were affiliated with the Department of Psychology, University of Nebraska-Lincoln at the time that the study was initiated.

    Drs. Heimberg and Hope retain their original affiliations. Dr. Ledley is now in independent practice in Plymouth Meeting, PA. Dr. Zaider is now at the Memorial Sloan Kettering Cancer Center, New York. Dr. Turk is now at Washburn University, Topeka. Dr. Fresco is now at Kent State University, Kent. Dr. Hayes is now at University of Massachusetts-Boston, Dr. Van Dyke is now at the St. Louis Behavioral Medicine Institute, and Dr. Kraus is now at Michael E. DeBakey Veterans Affairs Medical Center, Houston.

    Portions of this paper were presented at the annual meeting of the Association for Advancement of Behavior Therapy, Boston, MA, November 2003.

    Drs. Heimberg, Hope, and Turk disclose financial interest in the published materials evaluated in this article.

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