Mindfulness and acceptance-based versus cognitive behavioral group therapy for social anxiety disorder: A randomized controlled trial. Manuscript under review

Department of Psychology, Wilfrid Laurier University, 75 University Ave., Waterloo, Ontario N2L 3C5, Canada. Electronic address: .
Behaviour Research and Therapy (Impact Factor: 3.85). 10/2013; 51(12):889-898. DOI: 10.1016/j.brat.2013.10.007
Source: PubMed


Recent research has supported the use of mindfulness and acceptance-based interventions for Social Anxiety Disorder (SAD).
The purpose of the present study was to compare mindfulness and acceptance-based group therapy (MAGT) with cognitive behavioral group therapy (CBGT) with respect to outcome. It was hypothesized that MAGT and CBGT would both be superior to a control group but not significantly different from one another.
Individuals (N = 137, mean age = 34 years, 54% female, 62% White, 20% Asian) diagnosed with SAD were randomly assigned to MAGT (n = 53), CBGT (n = 53) or a waitlist control group (n = 31). The primary outcome was social anxiety symptom severity assessed at baseline, treatment midpoint, treatment completion, and 3-month follow-up. Secondary outcomes were cognitive reappraisal, mindfulness, acceptance, and rumination. Depression, valued living, and group cohesion were also assessed.
As hypothesized, MAGT and CBGT were both more effective than the control group but not significantly different from one another on social anxiety reduction and most other variables assessed.
The present research provides additional support for the use of mindfulness and acceptance-based treatments for SAD, and future research should examine the processes by which these treatments lead to change.

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    • "Goals emphasized in mindfulness-based SAD treatment programs include reducing experiential avoidance (using meditative and other interventions designed to enhance acceptance), improving non-judgmental awareness, and practicing the cognitive diffusion of thoughts, emotions and physical symptoms. Exercises may include (among others) body scanning, mindful meditation and mindful stretching, as well as homework on core mindfulness concepts (Kocovski et al., 2013). "
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    ABSTRACT: Social anxiety disorder (SAD) is a common debilitating mental illness with large negative effects on quality of life and economic productivity. Modern psychotherapy treatments utilizing cognitive–behavioral theory are increasingly delivered over the Internet and more recently using smartphone applications. The Challenger App written natively for the Apple iPhone was developed at the Stockholm University Department of Psychology for the treatment of SAD and uses a number of advanced features not previously seen in past mental health applications; these include real-time location awareness, notifications, anonymous social interaction between users, a high-degree of personalization and use of gamification techniques. This paper explores design considerations for the various components of the app, their theoretical and evidence base, and research opportunities that exist for apps making use of these novel features.
    Internet Interventions 08/2015; 2(4). DOI:10.1016/j.invent.2015.08.001
    • "Goals emphasized in mindfulness-based SAD treatment programs include reducing experiential avoidance using meditative and other interventions designed to enhance acceptance, nonjudgmental awareness and cognitive defusion of thoughts, emotions and physical symptoms. Exercises may include (among others) body scanning, mindful meditation and mindful stretching, as well as homework on core mindfulness concepts (Kocovski et al. 2013). "
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    ABSTRACT: Background: Randomized controlled trials have yielded promising results for internet-delivered cognitive behavior therapy (iCBT) for patients with social anxiety disorder (SAD). Smartphone assisted treatment is potentially cost effective and could also bring the treatment closer to the patient’s real life environment than desktop application delivered iCBT. The newly developed smartphone application “Challenger” is generating exercises that are customized to the user’s environment, involving places and people in their vicinity. Based on what skills the user wants to improve, appropriate challenges are randomly selected and created by the app. The user can follow their progress and history on a board game, where they move forward for each challenge they complete. They can also fill their own board with rewards that they find appealing and motivating. After a challenge completion, the user is prompted to write a note reflecting on the experience and to report their anxiety level during the challenge. If the user so chooses, the note can then be sent anonymously, much like a message in a bottle, to another randomly selected user to provide supportive feedback. That feedback is sent back to the challangee which can then choose to “like”, be indifferent to, or dislike (report abuse) the feedback.In summary, “Challenger” generates customized behavioral experiments, as well as exposure exercises that are performed in the patients vicinity and provides the means to reflect on the experience and to receive anonymous social community support. Objective: The present study aims to evaluate the feasibility and acceptance of the newly developed smartphone application “Challenger” for treating social anxiety disorder (SAD) and to report on the preliminary data regarding how the anonymous social community support function is being used. It also aims to assess significant changes in the self-reported social anxiety symptoms and ecological momentary assessments over time. Methods: A set of valid and commonly used questionnaires were used in the study. Level of social anxiety symptoms was assessed using MINI-SPIN every other day. In addition, once a week PHQ9 and GAD7 were administered in the smartphone application in order to get a general level of depression and anxiety respectively. Result: At the present date 92 participants have enrolled in the treatment program. The MINI-SPIN scores (M=6.75, SD=3.62) indicate that this is a sample of participants with primarily social anxiety problems. The PHQ9 (n=85, M=3.38, SD=2.43) and GAD-7 (n=84, M=4.07, SD=2.60) scores suggests that the group is well-functioning with low levels of depression and general anxiety. Concerning the social feedback system we can report that 62% (n=161) of the notes being sent have been liked. About 10% has received the opinion “indifferent”, while 13% were given feedback but not yet rated. 15% was not given feedback yet and 0 comments has been reported as abusive. Conclusions: Preliminary results indicate that using Challenger could decrease social anxiety and depressive symptoms, but data collection is still at an early stage and we will know much more at the time of the conference.
    8th Medicine 2.0 Summit & World Congress. 13-14 November, 2014., Maui, Hawaii, USA.; 11/2014
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    ABSTRACT: Despite significant advances in the understanding and treatment of social anxiety disorder (SAD) over the past two decades, there remains much room for improvement. Most individuals with SAD do not receive an evidence-based treatment, and even the best-established treatments leave most patients with residual symptoms and suboptimal functioning. Moreover, treatment mechanisms of action are poorly understood. There has recently been considerable growth in CBT models that de-emphasize direct cognitive change efforts, and instead focus on cultivating mindfulness and psychological acceptance of distressing experiences in the service of behavior change. These intervention models have begun to be applied to understanding and treating SAD. The results of initial research are promising, both in terms of treatment outcomes and theoretical treatment processes. Mindfulness and acceptance-based CBT models for SAD are likely to play an increasingly important role in future treatment development, research, and dissemination efforts.
    The Wiley Blackwell Handbook of Social Anxiety Disorder, 03/2014: pages 588-607; , ISBN: 9781119968603
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