The study aims at examining the effects of additional training in manualized cognitive-behavioral therapy (CBT) on outcome in routine psychotherapy for social phobia. The investigators will investigate how CBT, specifically the treatment procedures and manuals proposed by Clark and Wells (1995), can be transferred from controlled trials into the less structured setting of routine clinical care, and whether the health care system benefits from such developments. Private practitioners (N=36) will be randomized to one of two treatment conditions (i.e., training in manualized CBT vs. treatment as usual without specific training). The investigators plan to enroll 160 patients (80 per condition) to be able to detect differences of d=.50 between conditions at 1-beta=.80, given the drop-out rate of 25% (N=116 completers; N=58 per condition). The study is genuinely designed to promote faster and more widespread dissemination of effective interventions. The following research questions can be examined: (1) Can manualized CBT be successfully implemented into routine outpatient care? (2) Will the new methods lead to an improvement of treatment courses aned outcomes? (3) Will treatment effects in routine psychotherapeutic treatments be comparable to those of the controlled, strictly manualized treatment of the main study?
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
116
Cognitive-behavioral therapy (CBT) for social phobia following the Clark and Wells (1995) model of social phobia.
Cognitive-behavioral therapy for social phobia following no specific model.
Outpatient clinical services and day clinic center Technical University Dresden (IAP-TUD)
Dresden, Saxony, Germany
RECRUITINGSeverity of Social Phobia Symptoms
Symptom severity will be assessed via the Liebowitz Social Anxiety Scale (LSAS).
Time frame: Data will be collected for an expected treatment period of 30 weeks in average (corresponding to an expected average of n=25 sessions), at treatment completion, at 6 and 12 months post-treatment.
Diagnostic Status of Social Phobia
Diagnostic status will be assessed via SCID-I.
Time frame: Data will be collected for an expected treatment period of 30 weeks in average (corresponding to an expected average of n=25 sessions), at treatment completion, at 6 and 12 months post-treatment.
Assessment of Symptoms of Social Anxiety (Performance Anxiety)
To further assess symptoms of social anxiety, the Social Phobia Anxiety Inventory (SPAI) will be used.
Time frame: Data will be collected for an expected treatment period of 30 weeks in average (corresponding to an expected average of n=25 sessions), at treatment completion, at 6 and 12 months post-treatment.
Assessment of Symptoms of Social Anxiety (Social Phobic Cognitions)
To further assess cognitive symptoms of social anxiety, the Social Phobic Cognitions Questionnaire will be used.
Time frame: Data will be collected for an expected treatment period of 30 weeks in average (corresponding to an expected average of n=25 sessions), at treatment completion, at 6 and 12 months post-treatment.
Assessment of a Change in Safety Behaviors in Social Anxiety
To further assess safety behaviors in social anxiety the Safety Behaviors Questionnaire will be used.
Time frame: Data will be collected for an expected treatment period of 30 weeks in average (corresponding to an expected average of n=25 sessions), at treatment completion, at 6 and 12 months post-treatment.
Assessment of Other Social Anxiety Symptoms
To further assess symptoms of social anxiety, the Brief Social Phobia Scale(BSPS) will be used.
Time frame: Data will be collected for an expected treatment period of 30 weeks in average (corresponding to an expected average of n=25 sessions), at treatment completion, at 6 and 12 months post-treatment.
Assessment of Symptoms of Depression
To further assess symptoms of depression, the Beck Depression Inventory (BDI), will be employed.
Time frame: Data will be collected for an expected treatment period of 30 weeks in average (corresponding to an expected average of n=25 sessions), at treatment completion, at 6 and 12 months post-treatment.
Assessment of Emotion Regulation
To assess the level of emotion regulation, the Affective Style Questionnaire (ASQ) will be employed.
Time frame: Data will be collected for an expected treatment period of 30 weeks in average (corresponding to an expected average of n=25 sessions), at treatment completion, at 6 and 12 months post-treatment.
Assessment of the Quality of Life
To assess the quality of life in patients, the Quality of Life (QoL) questionnaire will be used.
Time frame: Data will be collected for an expected treatment period of 30 weeks in average (corresponding to an expected average of n=25 sessions), at treatment completion, at 6 and 12 months post-treatment.
Assessment of the Times Missing from Work
The times missing from work will be assessed via a separate questionnaire.
Time frame: Data will be collected for an expected treatment period of 30 weeks in average (corresponding to an expected average of n=25 sessions), at treatment completion, at 6 and 12 months post-treatment.
Assessment of the General Level of Severity of Social Anxiety Symptoms
To get a global impression from the diagnosticitian on the general level of severity of social anxiety symptoms, the Clinical Global Impression scale (CGI) will be used.
Time frame: Data will be collected for an expected treatment period of 30 weeks in average (corresponding to an expected average of n=25 sessions), at treatment completion, at 6 and 12 months post-treatment.
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