Cited by 256Digital Mental Health InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychological Treatments and Assessments

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Guided and unguided self-help for social anxiety disorder: randomised controlled trial

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Furmark, Tomas, Carlbring, Per, Hedman, Erik, Sonnenstein, Annika, Clevberger, Peder, Bohman, Benjamin, Eriksson, Anneli, Hållén, Agneta, Frykman, Mandus, Holmström, Annelie, Sparthan, Elisabeth, Tillfors, Maria, Ihrfelt, Elisabeth Nilsson, Spak, Maria, Eriksson, Anna, Ekselius, Lisa, Andersson, Gerhard·2009·British Journal of Psychiatry

DOI 10.1192/bjp.bp.108.060996

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Abstract

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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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: Furmark, Tomas
Carlbring, Per
Bohman, Benjamin
Frykman, Mandus
Tillfors, Maria
Ekselius, Lisa
Andersson, Gerhard
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
DOI: 10.1192/bjp.bp.108.060996
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: other-oa
www.cambridge.org/core/terms (unspecified, 2984 d)
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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Guided and unguided self-help for social anxiety disorder: randomised controlled trial

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