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Cognitive-behavioral therapy efficacy via videoconferencing for social (public speaking) anxiety disorder : a single case design Pelletier, Marie-Helene

Abstract

Social (public speaking) anxiety disorder is the most prevalent of all anxiety disorders, and it often impairs social and occupational functioning. Intervention studies indicate that cognitive-behavioral therapy (CBT) is an efficacious treatment for social anxiety. However, access to therapists skilled in CBT for social anxiety is often difficult. In order to respond to the problem of access, the use of videoconferencing for mental health care has developed. No published study has investigated the efficacy of CBT for social anxiety when provided via videoconferencing. The purpose of this study, therefore, was to determine the efficacy of CBT for social anxiety when provided via videoconferencing. A single-case replication design was employed that included a baseline period of 3 weeks, followed by 12 weeks of . treatment, 1-week post-intervention period, and 3-month follow-up. Five participants completed treatment. It was hypothesized that participants would reduce their social anxiety symptoms (i.e., decrease anxiety during speech task, increase duration of speech task, and decrease public speaking anxiety) assessed on standardized measures of social anxiety. Exploratory analyses of changes in self-monitored social anxiety, negative cognitions (public self-consciousness, fear of negative evaluation, internal attributions), working alliance, client satisfaction with treatment, and client comfort with videoconferencing were also performed. Analyses included visual and statistical significance, as well as clinical significance (i.e., endstate functioning, social phobia diagnostic status). The results indicated that two of three hypotheses were supported (i.e., anxiety during speech task reduced and duration of speech task increased over time). At 3-month follow-up, treatment gains were maintained or improved further; 3 participants no longer met the DSM-IV-TR criteria for social anxiety disorder, and 4 participants met criteria for moderate or high level of endstate functioning (i.e., clinical significance). Exploratory analyses revealed that self-monitored social anxiety decreased for 3 of 5 participants, and that a decrease in negative cognitions was associated with a decrease in social anxiety. Working alliance ratings remained high throughout treatment. Satisfaction with videoconferencing decreased over treatment for the participant who did not improve. Generally, comfort with videoconferencing increased over time. The results offer preliminary support for further research about the efficacy of the intervention.

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