Social anxiety in adolescents : comparable treatment gains following cognitive behavioral group therapy and intensive cognitive behavioral therapy

Social Anxiety Disorder (SAD) is one of the most common and debilitating anxiety disorders in adolescents. Cognitive Behavioral Therapy has been identified as an empirically supported psychosocial treatment for adolescents with SAD, both in an individual and a group format (CBGT). However, many adolescents do not response to standard CBT, with high dropout rates being among the primary reasons. As such, shorter and more intensive CBT (ICBT) provides a promising new treatment venue. The current study is the first to evaluate the effectiveness of four-day ICBT among Icelandic adolescents with SAD and compare its treatment outcomes with the standard 10-week CBGT. Participants comprised 40 16-19 year-old adolescents with a primary diagnosis of SAD based on a semi-structured clinical interview prior to treatment. Participants completed self-report measures on social and general anxiety and depressive symptoms at pre- and post-treatment and at the four-week follow up. Participants were allowed to choose to either a 10-week CBGT or a four-day ICBT targeting SAD. Twenty-eight adolescents (82% females; Mage = 17.07; SD = 1.02) completed the 10-week CBGT and 12 adolescents (78% females, Mage = 17.08; SD = 1.08) completed the four-day treatment. The results revealed that social and general anxiety, and depressive symptoms, decreased following both treatment conditions, indicating that both treatments are effective in reducing symptoms of SAD. The treatment gains were maintained or increased at the follow-up. Effect sizes indicate a large treatment effect on SAD symptoms from pre-treatment to follow-up for both CBGT (d = 1.14, d = 1.12) and ICBT (d = 0.98, d = 1.19). Furthermore, the proportion of participants scoring above an established clinical cutoff on a self-report measure on social anxiety decreased after treatment, indicating a clinically meaningful decrease in SAD symptoms. This study provides the first evidence that both CBGT and ICBT are effective in reducing SAD symptoms in Icelandic adolescents. The replication the findings in a larger sample and the examination of the long-term outcomes of these treatment conditions are needed