Effectiveness of a culturally adapted cognitive behavioural therapy-based guided self-help (CACBT-GSH) intervention to reduce social anxiety and enhance self-esteem in adolescents: a randomized controlled trial from Pakistan
Abstract
Background: Social anxiety is common among adolescents in Pakistan and is associated with low self-esteem. Among the recommended treatments, cognitive behavioural therapy (CBT) is effective, and self-help approaches are encouraged. Aim: To determine the effectiveness of culturally adapted CBT-based guided self-help (CACBT-GSH) intervention, using a manual ‘Khushi aur Khatoon’, for treating social anxiety when added to treatment as usual (TAU) compared with TAU only. Method: A total of 76 adolescents with social anxiety aged 13–16 years from six schools in Multan, Pakistan were recruited into this randomized controlled trial. Participants were divided into intervention and control groups in a 1:1 ratio. Social anxiety, self-esteem and fear of negative evaluation were assessed through the Liebowtiz Social Anxiety Scale for children and adolescents, the Rosenberg Self-Esteem Scale and the Brief Fear of Negative Evaluation, respectively, at baseline and at the end of the study. Guided self-help using culturally adapted CBT (CACBT)-based self-help manual (eight sessions, one session per week) was provided to the intervention group. The effect of the CACBT-GSH intervention was analysed with ANCOVA. Results: There was a statistically significant difference between the intervention and the control groups in favour of intervention. Participants in the intervention group showed reduced symptoms of social anxiety (p < .001), fear of negative evaluation (p < .001) and enhanced self-esteem (p < .001). Conclusion: The study demonstrated the effectiveness of CACBT-based guided self-help intervention in treating social anxiety and addressing the symptoms associated with it.
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Several studies on ICBT with treatment programs adapted to specific cultures in China, Korea, and Pakistan yielded results supporting the effectiveness of ICBT.
“Recently, several studies on ICBT with treatment programs adapted to specific cultures have been conducted in China, Korea, and Pakistan, yielding results supporting the effectiveness of ICBT [14-16].”
From Feasibility of Guided Internet-Based Cognitive Behavioral Therapy for Panic Disorder and Social Anxiety Disorder in Japan: Pilot Single-Arm Trial (2024) · cites this paper as [14]
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“Recently, several studies on ICBT with treatment programs adapted to specific cultures have been conducted in China, Korea, and Pakistan, yielding results supporting the effectiveness of ICBT [14-16].”
Result
- Authors
- Amin, R., Iqbal, A., Naeem, F., & Irfan, M.
- Affiliations
- Bahria University (PK)
- Bahauddin Zakariya University (PK)
- Centre for Addiction and Mental Health (CA)
- Riphah International University (PK)
- Corresponding author
- Irfan, Muhammad
- Venue
- Behavioural and Cognitive Psychotherapy
- Publisher
- Cambridge University Press (CUP)
- Published
- 2020-05-26
- Volume
- 48
- Issue
- 5
- Pages
- 503-514
- ISSN
- 1352-4658 (ISSN-L)
- 1469-1833
- OpenAlex
- W3032282919
- Cited by
- 32
- References
- 76
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 5 · 2023: 11 · 2022: 4 · 2021: 1
- FWCI
- 3.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behavioural and Cognitive Psychotherapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- social anxiety, adolescents, guided self-help, self-esteem, fear of negative evaluation, school-based intervention, Pakistan
- MeSH terms
- Adolescent, Anxiety, Child, Fear, Humans, Pakistan, Self Concept, Cognitive Behavioral Therapy
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