This pilot study compares two 4-week, smartphone-based treatments for social anxiety: one uses a psychodynamic therapy approach and the other uses a cognitive behavioral therapy approach. Both treatments are guided by an AI assistant rather than a human therapist. The AI assistant is programmed to support participants in reflecting on core therapeutic principles, much like a well-informed coach would. Participants are randomly assigned to one of three groups: psychodynamic therapy with AI support, cognitive behavioral therapy with AI support, or a waitlist control. Those in the waitlist group can receive an active treatment after the 4-week waiting period. All participants complete weekly online questionnaires to monitor anxiety and any changes in mood or well-being.
This study builds upon earlier findings from the STePS project by investigating the feasibility and effectiveness of two brief, smartphone-delivered treatments for social anxiety, delivered entirely through an AI-guided platform. The study is a randomized, controlled pilot trial with three arms. Two intervention groups receive a 4-week treatment via smartphone: one group receives a psychodynamic therapy approach and the other receives a cognitive behavioral therapy approach. In both treatments, the AI assistant prompts reflection and engagement with the therapeutic material instead of a traditional therapist. The third group serves as a waitlist control, with participants given the option to choose one of the active treatments after the study period.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
90
This intervention uses an AI-enabled chatbot within a smartphone app to deliver psychotherapy modules. The chatbot guides participants through the modules by providing reflective prompts, motivational support and automated reminders to enhance engagement. All communication is encrypted to protect privacy.
Stockholm university
Stockholm, Stockholm County, Sweden
Social Phobia Inventory (SPIN)
The Social Phobia Inventory (SPIN) is a 17-item self-report questionnaire that measures fear, avoidance and physiological symptoms of social anxiety. Each item is rated on a 5-point Likert scale (0 = "not at all" to 4 = "extremely"), yielding a total score range from 0 to 68. Higher scores indicate more severe social anxiety symptoms.
Time frame: Baseline (pre-randomization), weekly during the 4-week intervention, post-treatment at week 4, and 1-month follow-up
Liebowitz Social Anxiety Scale Self-Report (LSAS-SR)
The Liebowitz Social Anxiety Scale Self-Report (LSAS-SR) is a 24-item self-report instrument measuring the severity of social anxiety by assessing fear and avoidance across 24 social and performance situations. Total scores range from 0 to 144, with higher scores indicating greater social anxiety severity. It supplements the primary Social Phobia Inventory (SPIN) measure by providing additional insight into the participants' subjective experience of social anxiety and functional impairment.
Time frame: Baseline, 4 weeks, and 1 month
Patient Health Questionnaire-9 (PHQ-9)
The Patient Health Questionnaire-9 (PHQ-9) is a 9-item self-report measure assessing depressive symptom severity over the past two weeks. Total scores range from 0 to 27, with higher scores indicating more severe depressive symptoms. A 2-item short form (Patient Health Questionnaire-2) is administered weekly to monitor mood, while the full 9-item version is collected at baseline, 4 weeks, and 1 month. This measure captures any effects of the intervention on depressive symptoms alongside anxiety outcomes.
Time frame: Baseline, weekly during weeks 1 through 4 (Patient Health Questionnaire-2 short form), 4 weeks (full scale), and 1 month
Generalized Anxiety Disorder-7 (GAD-7)
The Generalized Anxiety Disorder-7 (GAD-7) is a 7-item self-report scale assessing the severity of generalized anxiety symptoms over the past two weeks. Total scores range from 0 to 21, with higher scores indicating more severe anxiety. A 2-item short form (Generalized Anxiety Disorder-2) is administered weekly, while the full 7-item version is collected at baseline, 4 weeks, and 1 month. This measure evaluates treatment effects on overall anxiety alongside social anxiety symptoms.
Time frame: Baseline, weekly during weeks 1 through 4 (Generalized Anxiety Disorder-2 short form), 4 weeks (full scale), and 1 month
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