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Guided and unguided self-help for social anxiety disorder: randomised controlled trial
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Background: Internet-delivered self-help programmes with added therapist guidance have shown efficacy in social anxiety disorder, but unguided self-help has been insufficiently studied. Aims: To evaluate the efficacy of guided and unguided self-help for social anxiety disorder. Method: Participants followed a cognitive–behavioural self-help programme in the form of either pure bibliotherapy or an internet-based treatment with therapist guidance and online group discussions. A subsequent trial was conducted to evaluate treatment specificity. Participants (n = 235) were randomised to one of three conditions in the first trial, or one of four conditions in the second. Results: Pure bibliotherapy and the internet-based treatment were better than waiting list on measures of social anxiety, general anxiety, depression and quality of life. The internet-based therapy had the highest effect sizes, but directly comparable effects were noted for bibliotherapy augmented with online group discussions. Gains were well maintained a year later. Conclusions: Unguided self-help through bibliotherapy can produce enduring improvement for individuals with social anxiety disorder.
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“Guided iCBT has been found to be effective for numerous specific disorders such as panic disorder [4,5], generalized anxiety disorder [6,7], social anxiety disorder [8-10], posttraumatic stress disorder [11], specific phobia [12], major depression [3], stress [13], and somatic health problems such as irritable bowel syndrome [14].”
From Individually Tailored Internet-Based Treatment for Young Adults and Adults With Panic Attacks: Randomized Controlled Trial (2012) · cites this paper as [8]
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“Internet-delivered treatments for anxiety disorders have included interventions for panic disorder, SAD, SP, and posttraumatic stress and they have established findings that support their potential effectiveness and efficacy [43-47].”
From Low-intensity internet-delivered treatment for generalized anxiety symptoms in routine care: protocol for a randomized controlled trial (2014) · cites this paper as [45]
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Self-citationMoment-to-Moment Brain Signal Variability Reliably Predicts Psychiatric Treatment Outcome
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Self-citationPatient Expectations in Internet-Based Self-Help for Social Anxiety
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“…fi ndings comparing iCBT with bibliotherapy; in spite of the scant literature available on self-help treatment books, comparisons between iCBT and bibliotherapy for OCD (Wootton et al., 2013) and for social phobia (Furmark et al., 2009) exist and showed both modes of presentation to be equivalent.”
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Self-citation
Metadata
- Authors
- Furmark, T., Carlbring, P., Hedman, E., Sonnenstein, A., Clevberger, P., Bohman, B., Eriksson, A., Hållén, A., Frykman, M., Holmström, A., Sparthan, E., Tillfors, M., Ihrfelt, E. N., Spak, M., Eriksson, A., Ekselius, L., & Andersson, G.
- Affiliations
- Uppsala University (SE)
- Linköping University (SE)
- Örebro University (SE)
- Corresponding author
- Furmark, Tomas
- ORCID
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2009-11
- Volume
- 195
- Issue
- 5
- Pages
- 440-447
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2026629696
- Cited by
- 256
- References
- 37
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 10 · 2023: 13 · 2022: 14 · 2021: 17 · 2020: 13 · 2019: 12 · 2018: 13 · 2017: 14 · 2016: 24 · 2015: 19 · 2014: 18 · 2013: 20 · 2012: 22
- FWCI
- 20.38
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The British Journal of Psychiatry (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Funders
- Vetenskapsrådet
- 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, self-help, online therapy, bibliotherapy, online group discussion, therapist guidance, cognitive behavioral therapy, treatment specificity, maintenance of treatment effects, general anxiety, depression, quality of life
- MeSH terms
- Adult, Aged, Bibliotherapy, Female, Humans, Male, Middle Aged, Phobic Disorders, Psychiatric Status Rating Scales, Self Care, Shyness, Therapy, Computer-Assisted, Cognitive Behavioral Therapy, Treatment Outcome, Telemedicine, Internet, Young Adult
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