Testing the Efficacy of Theoretically Derived Improvements in the Treatment of Social Phobia

Centre for Emotional Health, Macquarie University, Sydney, Australia.
Journal of Consulting and Clinical Psychology (Impact Factor: 4.85). 05/2009; 77(2):317-27. DOI: 10.1037/a0014800
Source: PubMed


Recent theoretical models of social phobia suggest that targeting several specific cognitive factors in treatment should enhance treatment efficacy over that of more traditional skills-based treatment programs. In the current study, 195 people with social phobia were randomly allocated to 1 of 3 treatments: standard cognitive restructuring plus in vivo exposure, an "enhanced" treatment that augmented the standard program with several additional treatment techniques (e.g., performance feedback, attention retraining), and a nonspecific (stress management) treatment. The enhanced treatment demonstrated significantly greater effects on diagnoses, diagnostic severity, and anxiety during a speech. The specific treatments failed to differ significantly on self-report measures of social anxiety symptoms and life interference, although they were both significantly better than the nonspecific treatment. The enhanced treatment also showed significantly greater effects than standard treatment on 2 putative process measures: cost of negative evaluation and negative views of one's skills and appearance. Changes on these process variables mediated differences between the treatments on changes in diagnostic severity.

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    • " , 1999 ) , ( c ) the effect sizes were amongst the largest in the published literature , including trials that have included control groups ( Clark et al . , 2003 , 2006 ) , and ( d ) the historical control treatment used in this study has been demonstrated to be more efficacious than more tradi - tional CBT and stress management control groups ( Rapee et al . , 2009 ) and equally effective across research and community mental health settings ( McEvoy et al . , 2012 ) . Another limitation was that treatment adherence was not independently assessed , but was instead supported by the use of detailed therapist notes , handouts , and worksheets . Effectiveness trials emphasise external validity and the "
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    Behaviour Research and Therapy 12/2014; 65. DOI:10.1016/j.brat.2014.12.011 · 3.85 Impact Factor
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    • "Few studies have examined actual changes in impaired social functioning/behavior, which is an important element in SAD's clinical presentation (Beidel, Rao, Scharfstein, Wong, & Alfano, 2010). Even among the few investigations that included behavioral tasks in their assessment battery, most used the tasks only to assess social anxiety, not social behavior (Clark et al., 2006; Herbert et al., 2005; Rapee et al., 2009). Given the plethora of available treatment trials for SAD, why the lack of attention to assessing objective social skill? "
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