The purpose of the study is to investigate the effects of four versions of a workshop for social anxiety and public speaking stress. All participants are current University of Colorado Boulder undergraduate students. Participation in this research study lasts for approximately 8 weeks, and includes a pre-workshop questionnaire, 3 weekly workshop sessions (ranging from 2 to 3 hours each, including a 5-minute post-session questionnaire), a post-workshop questionnaire, and a 1-month follow-up questionnaire.
The present study seeks to evaluate the feasibility, acceptability, and efficacy potential of a full factorial trial of a peer-led common humanity- and exposure-based workshop for social anxiety within a Multiphase Optimization Strategy (MOST) trial framework. The present study seeks to enroll and randomize participants (up to N = 200) by cohort to one of four conditions, reflecting a full factorial trial design. The inclusion of common humanity enhancements and the presence of a peer leader will each serve as independent variables, comprising of the following four study conditions: 1) common humanity with peer leader, 2) common humanity without peer leader, 3) peer leader without common humanity, and 4) exposure only (no common humanity and no peer leader). The investigators will assess outcomes after the workshop sessions (mid1, mid2, mid3, Post\[T1\]) and one-month following the conclusion of the last workshop session (T2). The study has the following aims and hypotheses: Aim 1: To evaluate the feasibility and acceptability of conducting a full factorial trial of a group exposure workshop for social anxiety within a MOST trial framework. Hypothesis 1a (feasibility): At least 50% of screened, eligible participants will enroll in the study. Hypothesis 1b (feasibility): Enrolled research participants will attend on average at least 2 out of 3 workshop sessions. Hypothesis 1c (feasibility): Workshops will be delivered with high fidelity (80% of content checklist items covered, on average) and low contamination (20% or less inclusion of content specific to other conditions, on average) in each randomized condition. Hypothesis 1d (acceptability): Participants will report a median satisfaction with the workshops of 4 or higher on the 1-5 Acceptability of Intervention Measure (AIM). Hypothesis 1e (acceptability): Participation in the group workshops will be acceptable, indicated by high overall satisfaction with the workshop across conditions (mean rating of \>20 on the Client Satisfaction Questionnaire-8). Hypothesis 1f (acceptability): ≤20% of participants will report a study burden of 4 or higher on a 1-5 burden measure. Aim 2: To evaluate the feasibility and efficacy potential of primary and secondary outcomes. Please note that the investigators do not expect to find statistically significant differences between conditions in this pilot study - only patterns of differences in the predicted directions outlined below. This pilot study will establish the foundation for a larger, definitively powered, future trial. Hypothesis 2a (Feasibility of assessment): At least 70% of participants will complete pre, post, and follow-up surveys. Hypothesis 2b (Efficacy potential): Compared to the exposure only condition, reliable change magnitudes (Jacobson \& Truax, 1991) will be higher within the peer and compassion-enhanced conditions, with additive effects for the fully enhanced condition, on measures of 1) participant retention, 2) social anxiety, 3) depression, and 4) self-compassion. Hypothesis 2c (Cultivating community): Compared to the exposure-only condition, reliable change magnitudes will be higher within the peer and compassion-enhanced conditions, with additive effects for the fully enhanced condition, on measures of 1) stigma and 2) sense of belonging. Hypothesis 2d (Barriers to access and engagement): Compared to the exposure only condition, reliable change magnitudes will be higher in the peer and compassion-enhanced conditions, with additive effects for the fully enhanced condition, on measures of 1) enjoyableness, 2) likelihood to recommend, and 3) readiness and willingness to engage in therapy. Across conditions, participants will indicate a preference for peer co-facilitators over mental health providers only.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
200
Group exposure therapy for social anxiety and public speaking fears.
Group exposure therapy for social anxiety and public speaking fears plus piloted exercises from the investigators' previous studies among socially anxious undergraduates (Slivjak et al., 2022; Slivjak \& Arch, in preparation), refined during the investigators' quality improvement project, that are designed to enhance compassion.
Group exposure therapy for social anxiety and public speaking fears facilitated by a pair of doctoral student and undergraduate student co-facilitators who explicitly use appropriate self-disclosure to establish the co-facilitators as individuals with lived experiences of social anxiety and public speaking fears.
Group exposure therapy for social anxiety and public speaking fears plus piloted exercises from the investigators' previous studies among socially anxious undergraduates (Slivjak et al., 2022; Slivjak \& Arch, in preparation), refined during the investigators' quality improvement project, that are designed to enhance compassion. These groups are facilitated by a pair of doctoral student and undergraduate student co-facilitators who explicitly use appropriate self-disclosure to establish the co-facilitators as individuals with lived experiences of social anxiety and public speaking fears.
Renee Crown Wellness Institute and Department of Psychology & Neuroscience, University of Colorado Boulder
Boulder, Colorado, United States
RECRUITINGAttendance rate
Average number of workshop sessions attended by enrolled research participants.
Time frame: 3 weeks during the intervention (workshops 1, 2, and 3, 1 week apart)
Enrollment rate
Ratio of screened, eligible participants who enrolled in the study.
Time frame: Pre-intervention (from screening to enrollment)
Acceptability of Intervention Measure (AIM)
Workshop satisfaction rating, Range = 1 - 5, Higher scores indicate better outcome (greater acceptability)
Time frame: 48 hours after the final intervention session and 1-month follow-up
Client Satisfaction Questionnaire-8 (CSQ-8)
Satisfaction with workshops, Range = 8 - 32, Higher scores indicate better outcome (greater satisfaction)
Time frame: 48 hours after the final intervention session and 1-month follow-up
Social Phobia Inventory (SPIN)
Social anxiety symptom measure, Range = 0 - 68, Higher scores indicate worse outcome (worse social phobia)
Time frame: 48 hours after the final intervention session and 1-month follow-up
Liebowitz Social Anxiety Scale (LSAS)
Measure assessing fear/anxiety across a broad range of social and performance situations, Range = 0 - 144, Higher scores indicate worse outcome (worse social anxiety)
Time frame: 48 hours after the final intervention session and 1-month follow-up
Personal Report of Communication Apprehension (PRCA-24)
Measure of trait communication and public speaking anxiety, Range = 24 - 120, Higher scores indicate worse outcome (greater communication apprehension)
Time frame: 48 hours after the final intervention session and 1-month follow-up
Fidelity
Percentage of content checklist items covered during in-person workshops.
Time frame: 3 weeks during the intervention (workshops 1, 2, and 3, 1 week apart)
Contamination
Percentage of content specific to other conditions covered in each randomized condition.
Time frame: 3 weeks during the intervention (workshops 1, 2, and 3, 1 week apart)
Study Burden
Rating of study burden.
Time frame: 48 hours after the final intervention session and 1-month follow-up
Survey Completion
Percentage of participants who complete pre, post, and follow-up surveys.
Time frame: between 10 and 0 days before the first intervention session, 48 hours after the final intervention session, and 1-month follow-up
Participant Retention
Percentage of participants who completed workshops.
Time frame: 3 weeks during the intervention (workshops 1, 2, and 3, 1 week apart)
Patient Health Questionnaire-8 (PHQ-8)
Measure of depressive symptoms, Range = 0 - 24, Higher scores indicate worse outcome (worse depression)
Time frame: 48 hours after the final intervention session and 1-month follow-up
Self-Compassion Scale - Short (SCS)
Measure of trait self-compassion and common humanity, Range = 1 - 5, Higher scores indicate better outcome (greater self-compassion)
Time frame: 48 hours after the final intervention session and 1-month follow-up
Stigma and Self-Stigma Scale, help seeking behaviors and self-stigma subscales (SASS)
Measure of stigma toward mental health problems. Help-seeking behaviors subscale: Range = 0 - 24, Higher scores indicate worse outcome (worse help-seeking behaviors) Self-stigma subscale: Range = 0 - 24, Higher scores indicate worse outcome (greater self-stigma)
Time frame: 48 hours after the final intervention session and 1-month follow-up
Sense of Belonging Scale
Measure of how connected participants feel to their group members, Range = 1-7, Higher = Higher scores indicate better outcome (greater sense of belonging)
Time frame: 48 hours after the final intervention session and 1-month follow-up
Likelihood to Recommend
Rating of how likely participants would be to recommend the workshop to others.
Time frame: 48 hours after the final intervention session and 1-month follow-up
Enjoyableness
Rating of degree to which participants found the workshop to be enjoyable.
Time frame: 48 hours after the final intervention session and 1-month follow-up
Provider preference
Rating of whether participants have a preference for peer co-facilitators over mental health providers only.
Time frame: between 0 and 10 days before the first intervention session, 48 hours after the final intervention session, and 1-month follow-up
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