The DOI matches its Crossref record; 52 of the 55 references it cites were found in a registry or an index.
Cost-effectiveness of Internet-based cognitive behavior therapy vs. cognitive behavioral group therapy for social anxiety disorder: Results from a randomized controlled trial
Abstract
Social anxiety disorder (SAD) is highly prevalent and associated with a substantial societal economic burden, primarily due to high costs of productivity loss. Cognitive behavior group therapy (CBGT) is an effective treatment for SAD and the most established in clinical practice. Internet-based cognitive behavior therapy (ICBT) has demonstrated efficacy in several trials in recent years. No study has however investigated the cost-effectiveness of ICBT compared to CBGT from a societal perspective, i.e. an analysis where both direct and indirect costs are included. The aim of the present study was to investigate the cost-effectiveness of ICBT compared to CBGT from a societal perspective using a prospective design. We conducted a randomized controlled trial where participants with SAD were randomized to ICBT (n=64) or CBGT (n=62). Economic data were assessed at pre-treatment, immediately following treatment and six months after treatment. Results showed that the gross total costs were significantly reduced at six-month follow-up, compared to pre-treatment in both treatment conditions. As both treatments were equivalent in reducing social anxiety and gross total costs, ICBT was more cost-effective due to lower intervention costs. We conclude that ICBT can be more cost-effective than CBGT in the treatment of SAD and that both treatments reduce societal costs for SAD.
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In the citing paper
“Previous effective CBT interventions for health anxiety have been approximately 12 modules [24,25].”
From A Cognitive Behavioral Therapy Chatbot (Otis) for Health Anxiety Management: Mixed Methods Pilot Study (2022) · cites this paper as [25]
In the citing paper
“Psychological therapies have been consistently shown as effective in helping individuals of all ages to deal with distress”
From A review of cyberbullying and suggestions for online psychological therapy (2015) · cites this paper as Hedman et al., 2011
In the citing paper
“in recent years, internet-based psychological treatment is gaining momentum and showing positive affects for a range of clinical populations (e.g., Hedman et al., 2011;Vernmark et al., 2010)”
From A review of cyberbullying and suggestions for online psychological therapy (2015) · cites this paper as Hedman et al., 2011
In the citing paper
“numerous studies have found ICBT to be cost-effective and to be a real means of promoting access to psychological therapies for the general public (Carlbring and Andersson, 2006;Hedman et al., 2011)”
From A review of cyberbullying and suggestions for online psychological therapy (2015) · cites this paper as Hedman et al., 2011
In the citing paper
“Previous research has indicated that Internet-based therapy for social phobia might be cost-effective relative to face-to-face therapy [35,36].”
From Short-term effectiveness of web-based guided self-help for phobic outpatients: randomized controlled trial. (2014) · cites this paper as [35]
Citations
Cites
An Introduction to the Bootstrap
Efron, B., & Tibshirani, R. J. (1994) · doi:10.1201/9780429246593 · Cited by 40,500
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.6.593 · Cited by 20,391
(1998) · The Journal of Clinical Psychiatry · Cited by 19,139
EuroQol: a new facility for the measurement of health-related quality of life
(1990) · Health Policy · doi:10.1016/0168-8510(90)90421-9 · Cited by 15,736
Jacobson, N. S., & Truax, P. (1991) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.59.1.12 · Cited by 7,770
The mini international neuropsychiatric interview
Lecrubier, Y., Sheehan, D. V., Hergueta, T., & Weiller, E. (1998) · European Psychiatry · doi:10.1016/s0924-9338(99)80239-9 · Cited by 5,899
EQ-SD: a measure of health status from the EuroQol Group
Rabin, R., & Charro, F. D. (2001) · Annals of Medicine · doi:10.3109/07853890109002087 · Cited by 5,613
(1997) · doi:10.1097/00005650-199711000-00002 · Cited by 4,544
A Proof for the Queuing Formula: L = λ W
Little, J. D. C. (1961) · Operations Research · doi:10.1287/opre.9.3.383 · Cited by 2,777
A cognitive model of social phobia
Adrian Wells, A. (1995) · Research Explorer (The University of Manchester) · Cited by 2,701
Flagged first, then by citations
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Sorted by citations
Items 101–182 of 182
Assessing the costs and cost-effectiveness of ICare internet-based interventions (protocol)
Beecham, J., Bonin, E.-M., Görlich, D., Baños, R., Beintner, I., Buntrock, C., Bolinski, F., Botella, C., Ebert, D. D., Herrero, R., et al. (2019) · Internet Interventions · doi:10.1016/j.invent.2018.02.009 · Cited by 13
Siddaway, A. P., Meiser‐Stedman, R., Chester, V., Finn, J., Leary, C. O., Peck, D. F., & Loveridge, C. (2022) · Depression and Anxiety · doi:10.1002/da.23272 · Cited by 14
Tan, Y., Liao, Z., Qiu, Y., Zhu, J., & Yu, E. (2016) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2015.12.016 · Cited by 13
Bangirana, P., Boivin, M. J., & Giordani, B. (2013) · Springer eBooks · doi:10.1007/978-1-4614-6834-9_13 · Cited by 13
Katzman, M. A., Bleau, P., Blier, P., Chokka, P. R., Kjernisted, K. D., & Ameringen, M. V. (2021) · doi:10.32920/14638581 · Cited by 13
Lopes, R. D. C. T., Šipka, D., Krieger, T., Klein, J. P., & Berger, T. (2021) · Internet Interventions · doi:10.1016/j.invent.2021.100480 · Cited by 13
Nissling, L., Fahlke, C., Lilja, J. L., Skoglund, I., & Weineland, S. (2020) · JMIR Formative Research · doi:10.2196/19226 · Cited by 13
Johnson, S. B., & Anderson, P. L. (2016) · Anxiety Stress & Coping · doi:10.1080/10615806.2016.1138289 · Cited by 14
Internet-Based Cognitive Behavior Therapy for Social Anxiety Disorder
Hedman‐Lagerlöf, E., Botella, C., & Berger, T. (2016) · Springer eBooks · doi:10.1007/978-3-319-06083-5_4 · Cited by 13
Andersson, E., Ljótsson, B., Hedman‐Lagerlöf, E., Mattson, S., Enander, J., Andersson, G., Kaldo, V., Lindefors, N., & Rück, C. (2014) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2014.10.002 · Cited by 11
Self-citationNeeds and Demands for eHealth Pain Management Interventions in Chronic Pain Patients
Stoppok, P., Frewer, A.-L., Schweda, A., Geiger, S., Skoda, E., Müßgens, D., Bingel, U., Teufel, M., & Bäuerle, A. (2023) · Journal of Personalized Medicine · doi:10.3390/jpm13040675 · Cited by 10
Internet‐Delivered Treatments for Social Anxiety Disorder
Andersson, G., Carlbring, P., & Furmark, T. (2014) · Wiley eBooks · doi:10.1002/9781118653920.ch26 · Cited by 10
Self-citationNielsen, E. G., & Minda, J. P. (2021) · Journal of Occupational & Environmental Medicine · doi:10.1097/jom.0000000000002393 · Cited by 9
Tulbure, B. T., Månsson, K. N. T., & Andersson, G. (2012) · Trials · doi:10.1186/1745-6215-13-202 · Cited by 8
Self-citationBiagianti, B., Conelea, C. A., Dabit, S., Ross, D., Beard, K. L., Harris, E., Shen, E., Jordan, J. T., & Bernstein, G. A. (2023) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2023.0001 · Cited by 8
Timmer, A. J., Unsworth, C. A., & Browne, M. (2019) · Disability and Rehabilitation · doi:10.1080/09638288.2018.1535630 · Cited by 9
Anksiyete Bozukluklarının Tedavisinde İnternet Tabanlı Bilişsel Davranışçı Terapi Uygulamaları
Huyut, B. Ç. (2019) · Yaşam Becerileri Psikoloji Dergisi · doi:10.31461/ybpd.622846 · Cited by 8
Brilleman, S. L., Metcalfe, C. D., Peters, T. J., & Hollingworth, W. (2015) · Value in Health · doi:10.1016/j.jval.2015.07.009 · Cited by 8
Parsons, E. M., Hiserodt, M., & Otto, M. W. (2022) · Contemporary Clinical Trials · doi:10.1016/j.cct.2022.107018 · Cited by 7
Ellis, D. M., & Anderson, P. L. (2023) · JMIR Mental Health · doi:10.2196/43929 · Cited by 7
Kählke, F., Buntrock, C., Smit, F., Berger, T., Baumeister, H., & Ebert, D. D. (2023) · Depression and Anxiety · doi:10.1155/2023/7912017 · Cited by 9
Engelhardt, C. L., Meier, M., Keller, S., & Laireiter, A. (2024) · PLoS ONE · doi:10.1371/journal.pone.0299803 · Cited by 10
Wen, X., Gou, M., Chen, H., Kishimoto, T., Qian, M., Margraf, J., & Berger, T. (2024) · JMIR Mental Health · doi:10.2196/50535 · Cited by 6
Internet-Delivered Psychotherapy for Anxiety Disorders and Depression
Titov, N., Dear, B. F., & Andersson, G. (2014) · Focus · doi:10.1176/appi.focus.12.3.299 · Cited by 5
Self-citationSchröder, J., Dinse, H., Jahre, L. M., Skoda, E., Stettner, M., Kleinschnitz, C., Teufel, M., & Bäuerle, A. (2024) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2024.0088 · Cited by 5
Kondylakis, H., Hors-Fraile, S., Koumakis, L., Kouroubali, A., Notas, G., Rivero-Rodriguez, A., Sidiropoulos, P. I., Simos, P. G., & Katehakis, D. G. (2019) · IGI Global eBooks · doi:10.4018/978-1-7998-1680-5.ch006 · Cited by 4
Buhrman, M., Tillfors, M., Holländare, F., Lekström, E., Håkansson, A., & Boersma, K. (2023) · The Clinical Journal of Pain · doi:10.1097/ajp.0000000000001157 · Cited by 5
Seddik, A. H., Paulissen, J. H. J., Marapin, R. S., Fuhler, S., Johal, S., Rosenlund, M., Dunton, K., Postma, M. J., & Freriks, R. (2025) · Value in Health · doi:10.1016/j.jval.2025.02.009 · Cited by 4
Geiger, S., Aufderlandwehr, J., Esser, A. J., Schadendorf, T., Muehlbauer, T., Skoda, E., Teufel, M., & Bäuerle, A. (2024) · Frontiers in Sports and Active Living · doi:10.3389/fspor.2024.1416045 · Cited by 6
Internet-Based Therapies for Child and Adolescent Emotional and Behavioral Problems
Spence, S. H., March, S., Vigerland, S., & Serlachius, E. (2016) · Springer eBooks · doi:10.1007/978-3-319-06083-5_11 · Cited by 4
Hennemann, S., Farnsteiner, S., & Sander, L. (2017) · BMJ Open · doi:10.1136/bmjopen-2017-016696 · Cited by 4
The Internet and CBT: A New Clinical Application of an Effective Therapy
Gratzer, D., Khalid-Khan, F., & Balasingham, S. (2018) · InTech eBooks · doi:10.5772/intechopen.72146 · Cited by 6
Jansen, C., Bäuerle, A., Jahre, L. M., Kocol, D., Krakowczyk, J. B., Geiger, S., Dörrie, N., Skoda, E., & Teufel, M. (2024) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2023.0360 · Cited by 4
The Psychological Factors and Treatment of Cyberbullying
刘, 言. (2019) · Advances in Psychology · doi:10.12677/ap.2019.95097 · Cited by 4
The Cost‐effectiveness of Treatments for Anxiety Disorders
Mihalopoulos, C., Baxter, A. J., Whiteford, H., & Vos, T. (2014) · doi:10.1002/9781118775349.ch59 · Cited by 4
Schittenhelm, J. M., von Borell, C., Clément, C. C., Schüller, J. S., Stangier, U., & Hoyer, J. (2023) · Trials · doi:10.1186/s13063-023-07168-5 · Cited by 3
Luppa, M., Löbner, M., Pabst, A., Schlapke, C., Stein, J., & Riedel-Heller, S. G. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-036034 · Cited by 3
Digital Mental Health Interventions
Shelton, C. R., Kotsiou, A., & Hetzel‐Riggin, M. D. (2021) · Advances in human and social aspects of technology book series · doi:10.4018/978-1-7998-6453-0.ch008 · Cited by 3
Guided Internet Treatment of Anxiety Disorders in Adults
Andersson, G. (2014) · Wiley eBooks · doi:10.1002/9781118775349.ch61 · Cited by 3
Self-citationHedman‐Lagerlöf, M., Hedman‐Lagerlöf, E., Buhrman, M., & Axelsson, E. (2025) · Journal of Pain · doi:10.1016/j.jpain.2025.105375 · Cited by 4
Schittenhelm, J. M., von Rechenberg, R., Schäfer, L., Weber, L., Schüller, J. S., Stangier, U., & Hoyer, J. (2026) · Behaviour Research and Therapy · doi:10.1016/j.brat.2026.104983 · Cited by 2
Kondylakis, H., Hors-Fraile, S., Koumakis, L., Kouroubali, A., Notas, G., Rivero-Rodriguez, A., Sidiropoulos, P. I., Simos, P. G., & Katehakis, D. G. (2018) · International Journal of Reliable and Quality E-Healthcare · doi:10.4018/ijrqeh.2019010103 · Cited by 3
Preferences for Digital Mental Health Services in Urban China: A Discrete Choice Experiment
Xiang, D., Qian, Y., & Liang, D. (2025) · Applied Health Economics and Health Policy · doi:10.1007/s40258-025-01014-2 · Cited by 1
Kempen, F., Chandrakumar, R., Esser, S., Jahre, L. M., Teufel, M., & Bäuerle, A. (2026) · JMIR Formative Research · doi:10.2196/83065 · Cited by 1
Gratzer, D., Khalid-Khan, F., & Khalid‐Khan, S. (2015) · InTech eBooks · doi:10.5772/60816 · Cited by 1
Barriers to Adoptions of IoT-Based Solutions for Disease Screening
Hiwale, S. S., Ulman, S., & Subbaraman, K. (2018) · Advances in medical diagnosis, treatment, and care (AMDTC) book series · doi:10.4018/978-1-5225-7131-5.ch002 · Cited by 1
Improving the acceptability of internet-based cognitive-behavioral therapy among Black Americans.
Ellis, D. M., & Anderson, P. L. (2021) · Technology Mind and Behavior · doi:10.1037/tmb0000044 · Cited by 1
Le nuove tecnologie e la psicoterapia: approfondimento del trattamento del disturbo d'ansia sociale
Grassi, E., & Marsigli, N. (2021) · QUADERNI DI PSICOTERAPIA COGNITIVA · doi:10.3280/qpc47-2020oa11208 · Cited by 3
Crouse, J. J., Morley, K. C., Buckley, N. A., Dawson, A. H., Seth, D., Monds, L. A., Tickell, A. M., KAY‐LAMBKIN, F. J., & Chitty, K. M. (2021) · Bulletin of the Menninger Clinic · doi:10.1521/bumc.2021.85.2.123 · Cited by 1
Konseling Ringkas Berfokus Solusi Berbasis Online Dalam Penanganan Sosioemosional Mahasiswa
Agriani, B. I. (2023) · Jurnal Bikotetik (Bimbingan dan Konseling Teori dan Praktik) · doi:10.26740/bikotetik.v7n1.p32-40 · Cited by 1
Anxiety Disorders: Social Anxiety Disorder and Specific Phobia
McCabe, R. E., Hood, H. K., & Antony, M. M. (2015) · Wiley eBooks · doi:10.1002/9781118753378.ch54 · Cited by 1
Palma, P. D. C. (2017) · Digital Library of Theses and Dissertations (Universidade de São Paulo) · doi:10.11606/t.59.2017.tde-05092017-163256 · Cited by 1
Ellis, D. M., & Anderson, P. L. (2020) · Technology Mind and Behavior · doi:10.1037/tmb0000044.supp · Cited by 1
Katzman, M. A., Bleau, P., Blier, P., Chokka, P. R., Kjernisted, K. D., & Ameringen, M. V. (2021) · doi:10.32920/14638581.v1 · Cited by 1
Kortz, L. (2017) · Scholars Archive - University at Albany (University at Albany, State University of New York) · doi:10.54014/dkvq-a03j · Cited by 1
Benchmarks for Group Acceptance and Commitment Therapy: Tools for Social Work Professionals.
Washburn, M., Yu, M., & Rubin, A. (2022) · Research on Social Work Practice · doi:10.1177/10497315221105470
Guided Internet-Based Cognitive Behaviour Therapy for Chronic Pain
Buhrman, M. (2012) · KTH Publication Database DiVA (KTH Royal Institute of Technology)
Effekter av en internetbaserad stressbehandling
Tillmar, V. L., & Wikenholm, H. (2014)
Vad predicerar vårdpersonals intention och metodföljsamhet vid remittering till internetbehandling
Nilsson, G., & Dorve, E. (2012) · Lund University Publications Student Papers (Lund University)
Ivanova, E., Lindner, P., Dahlin, M., Ly, H. G., Vernmark, K., Andersson, G., & Carlbring, P. (2015) · DiVA (Stockholm University)
Self-citationvan Straten, A., Blom, K., Lancee, J., & Kaldo, V. (2016) · Springer eBooks · doi:10.1007/978-3-319-06083-5_8
Telepsychotherapy for the Treatment of Trichotillomania: A Randomized Controlled Trial
Lee, E. B. (2018) · Digital Commons - USU (Utah State University) · doi:10.13140/rg.2.2.35306.21448
Automatic structure estimation of predictive models for symptom developmentPreprint
Becker, D. (2018) · arXiv (Cornell University) · doi:10.48550/arxiv.1809.04494
Nielsen, E. (2020) · Scholarship@Western (Western University)
Lenton‐Brym, A. P. (2021) · doi:10.32920/ryerson.14649807.v1 · Cited by 1
Stoppok, P., Teufel, M., Jahre, L. M., Rometsch, C., Müßgens, D., Bingel, U., Skoda, E., & Bäuerle, A. (2022) · doi:10.2196/preprints.37682
Nielsen, E., & Minda, J. P. (2021) · PsyArXiv (OSF Preprints) · doi:10.31234/osf.io/pxbyu
Cárdenas, E. F., Kujawa, A., Letterie, M. C., & Humphreys, K. L. (2022) · Journal of Child and Family Studies · doi:10.1007/s10826-022-02330-0
A Cognitive Behaviour Therapy Chatbot (Otis) for Health Anxiety Management: Pilot Study (Preprint)Preprint
Goonesekera, Y., & Donkin, L. (2022) · doi:10.2196/preprints.37877
Internet-based treatment for Autistic Spectrum Disorder:An overview
Liu, S., Wang, Y., & Sun, Z. (2024) · Theoretical and Natural Science · doi:10.54254/2753-8818/46/20240666
Bouchlaghem, N., Delorme, R., & Trebossen, V. (2024) · Perfectionnement en Pédiatrie · doi:10.1016/j.perped.2024.10.004
Ovalles, A., Parsons, E. M., Steinberg, M., Ball, T. M., Edwards, R. R., Checko, E. R., Carl, J. R., Smits, J. A. J., & Otto, M. W. (2025) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2025.2564817
Friberg, M., & Lidén, A. (2014) · KTH Publication Database DiVA (KTH Royal Institute of Technology)
Sjöström, M. (2014) · KTH Publication Database DiVA (KTH Royal Institute of Technology)
Jalali, A., Ghasemianrad, M., Khazaie, H., Jalali, R., Chavoshani, F., Khalili, M., & Kazeminia, M. (2026) · SN Comprehensive Clinical Medicine · doi:10.1007/s42399-025-02235-1 · Cited by 2
From waitlists to well-being: An analytical approach to AI-supported mental healthcare
Cai, J., Likvornik, N. F., & Zychlinski, N. (2026) · IISE Transactions · doi:10.1080/24725854.2026.2679528 · Cited by 1
Wang, H., Song, B., Kan, C., & Zhang, Y. (2026) · Cognitive Therapy and Research · doi:10.1007/s10608-026-10770-x
Gatov, E., de Oliveira, C., Strudwick, G., Wiljer, D., Bhattacharyya, O. K., & Kurdyak, P. A. (2026) · The Canadian Journal of Psychiatry · doi:10.1177/07067437261477547
Afraid of the Therapist: The Value of Internet-Based Treatments for Social Anxiety
Lucyk, B. (2013) · Western Undergraduate Psychology Journal
Hesslow, T., & Nilsson, M. (2015) · KTH Publication Database DiVA (KTH Royal Institute of Technology)
Metadata
- Authors
- Hedman, E., Andersson, E., Ljótsson, B., Andersson, G., Rück, C., & Lindefors, N.
- Affiliations
- Karolinska Institutet (SE)
- Linköping University (SE)
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2011-11
- Volume
- 49
- Issue
- 11
- Pages
- 729-736
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W2047366764
- Cited by
- 183
- References
- 55
- Citations by year
- 2026: 6 · 2025: 4 · 2024: 8 · 2023: 10 · 2022: 13 · 2021: 17 · 2020: 8 · 2019: 9 · 2018: 12 · 2017: 12 · 2016: 15 · 2015: 17 · 2014: 24 · 2013: 19 · 2012: 8
- FWCI
- 22.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Stockholms Läns Landsting
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- social anxiety disorder, internet-based cognitive behavioral therapy, cost-effectiveness, social costs, productivity loss, economic burden, treatment costs
- MeSH terms
- Adolescent, Adult, Anxiety Disorders, Cost-Benefit Analysis, Female, Humans, Male, Middle Aged, Patient Compliance, Psychotherapy, Group, Quality of Life, Therapy, Computer-Assisted, Cognitive Behavioral Therapy, Health Care Costs, Internet, Patient Preference
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