Shyness 5: the clinical effectiveness of Internet-based clinician-assisted treatment of social phobia.
Abstract
Objective: The present study explores the clinical effectiveness of an Internet-based cognitive behavioural treatment program for social phobia (the Shyness program) administered by a psychiatric registrar as part of standard clinical treatment at an outpatient mental health service (the Anxiety Disorders Clinic, St Vincent's Hospital, Sydney). Method: Seventeen individuals with social phobia were assigned to this 8 week clinician-assisted program. All patients had access to online lessons, homework assignments, an online discussion forum with other patients, and regular emails from the clinician. Both completer and intention-to-treat models were used in data analyses. Results: Fourteen (82%) patients completed all six lessons within the 8 weeks, and 11/17 (65%) completed post-treatment questionnaires. Mean within-group effect sizes (Cohen's d) for the two social phobia measures were 1.06 and 0.77, based on completer and intention-to-treat analyses, respectively. Data indicate that the procedure was acceptable to patients. Conclusions: These results indicate that the procedure was clinically effective when operated as part of standard clinical treatment. These results provide further support for the potential clinical utility of the Shyness program.
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iCBT for anxiety and depressive disorders appears to be more acceptable to consumers.
“However, the data emerging from clinical trials and online surveys indicates iCBT for anxiety and depressive disorders appears to be more acceptable to consumers [22], [24], [25]”
From The acceptability of internet-based treatment and characteristics of an adult sample with obsessive compulsive disorder: An internet survey (2011) · cites this paper as [25]
Eighteen studies state that encouraging adherence is a task for the counselor.
“it is remarkable that 18 state that encouraging adherence is a task for the counselor [45-62]”
From Persuasive System Design Does Matter: a Systematic Review of Adherence to Web-based Interventions (2012) · cites this paper as [53]
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“The core components of the Shyness Programme have been described in detail previously (Titov et al., 2008c) and the programme has been evaluated in a number of trials (Aydos et al., 2009; Titov et al., 2008a,b,c).”
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“…than those reported by previous therapist-assisted CCBT studies (typically of self-referred participants) of a single disorder (e.g. social phobia), which have reported moderate to large mean within-group effects sizes of 0.8–1.0 (Aydos et al., 2009; Carlbring et al., 2005; Titov et al., 2008b).”
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“DISCUSSION Previous research on the clinical effectiveness of ICBT for SAD has demonstrated large short-term effects.(12) 13 The aim of the present study was to determine the sustainability of treatment effects in a naturalistic setting (ie, routine psychiatric care) and identify factors that might explain individual…”
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“…should have been included, from relatively small feasibility trials, such as those by Aydos et al. and Bragesj ¨ o et al. (Bragesj ¨ o et al., 2025; Aydos et al., 2009) to large-scale routine care studies such as the studies by Titov et al. and Dear et al. (Titov et al., 2017; Dear et al., 2024).”
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Internet-delivered treatments for generalized anxiety disorder
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“The Program was also shown to be effective when integrated into general clinical practice [32, 48].”
BackgroundSelf-guided interventions for Social Anxiety Disorder: a systematic review
Dittz, C. P., Lourenço, L. M., Swerts, L. S., Coelho, L. D. C., Gomes, D. A. G., & Lopes, R. D. C. T. (2024) · Estudos de Psicologia (Campinas) · doi:10.1590/1982-0275202441e220028
- Authors
- Aydos, L., Titov, N., & Andrews, G.
- Affiliations
- St Vincent's Hospital Sydney (AU)
- UNSW Sydney (AU)
- Corresponding author
- Andrews, Gavin
- Venue
- Australasian Psychiatry
- Publisher
- SAGE Publications
- Published
- 2009-12
- Volume
- 17
- Issue
- 6
- Pages
- 488-492
- ISSN
- 1039-8562 (ISSN-L)
- 1440-1665
- OpenAlex
- W2040285755
- Cited by
- 49
- References
- 20
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 5 · 2022: 1 · 2020: 1 · 2017: 3 · 2016: 7 · 2015: 3 · 2014: 5 · 2013: 6 · 2012: 8
- FWCI
- 6.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Australasian Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- 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 › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- social anxiety disorder, internet-based cognitive behavioral therapy, online therapy, treatment acceptability, clinical effectiveness, anxiety disorders
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