Evaluating a Web-Based Social Anxiety Intervention Among University Students: Randomized Controlled Trial

McCall, Hugh Cameron; Richardson, Chris G; Helgadottir, Fjola Dogg; Chen, Frances S

doi:10.2196/jmir.8630

Cited by 71Digital Mental Health InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychological Treatments and Assessments

Evaluating a Web-Based Social Anxiety Intervention Among University Students: Randomized Controlled Trial

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McCall, Hugh Cameron, Richardson, Chris G, Helgadottir, Fjola Dogg, Chen, Frances S·2018·Journal of Medical Internet Research

DOI 10.2196/jmir.8630PMC PMC5885061

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Abstract

BACKGROUND: Treatment rates for social anxiety, a prevalent and potentially debilitating condition, remain among the lowest of all major mental disorders today. Although computer-delivered interventions are well poised to surmount key barriers to the treatment of social anxiety, most are only marginally effective when delivered as stand-alone treatments. A new, Web-based cognitive behavioral therapy (CBT) intervention called Overcome Social Anxiety was recently created to address the limitations of prior computer-delivered interventions. Users of Overcome Social Anxiety are self-directed through various CBT modules incorporating cognitive restructuring and behavioral experiments. The intervention is personalized to each user's symptoms, and automatic email reminders and time limits are used to encourage adherence. OBJECTIVE: The purpose of this study was to conduct a randomized controlled trial to investigate the effectiveness of Overcome Social Anxiety in reducing social anxiety symptoms in a nonclinical sample of university students. As a secondary aim, we also investigated whether Overcome Social Anxiety would increase life satisfaction in this sample. METHODS: Following eligibility screening, participants were randomly assigned to a treatment condition or a wait-list control condition. Only those assigned to the treatment condition were given access to Overcome Social Anxiety; they were asked to complete the program within 4 months. The social interaction anxiety scale (SIAS), the fear of negative evaluation scale (FNE), and the quality of life enjoyment and satisfaction questionnaire-short form (Q-LES-Q-SF) were administered to participants from both conditions during baseline and 4-month follow-up lab visits. RESULTS: Over the course of the study, participants assigned to the treatment condition experienced a significant reduction in social anxiety (SIAS: P<.001, Cohen d=0.72; FNE: P<.001, Cohen d=0.82), whereas those assigned to the control condition did not (SIAS: P=.13, Cohen d=0.26; FNE: P=.40, Cohen d=0.14). Additionally, a direct comparison of the average change in social anxiety in the 2 conditions over the course of the study showed that those assigned to the treatment condition experienced significantly more improvement than those assigned to the control condition (SIAS: P=.03, Cohen d=0.56; FNE: P=.001, Cohen d=0.97). Although participants assigned to the treatment condition experienced a slight increase in life satisfaction, as measured by Q-LES-Q-SF scores, and those assigned to the control condition experienced a slight decrease, these changes were not statistically significant (treatment: P=.35, Cohen d=-0.18; control: P=.30, Cohen d=0.18). CONCLUSIONS: Our findings indicate that Overcome Social Anxiety is an effective intervention for treating symptoms of social anxiety and that it may have further utility in serving as a model for the development of new interventions. Additionally, our findings provide evidence that contemporary Web-based interventions can be sophisticated enough to benefit users even when delivered as stand-alone treatments, suggesting that further opportunities likely exist for the development of other Web-based mental health interventions. TRIAL REGISTRATION: ClinicalTrials.gov NCT02792127; https://clinicaltrials.gov/ct2/show/record/NCT02792127 (Archived by WebCite at http://www.webcitation.org/6xGSRh7MG).

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Online interventions can increase accessibility to mental health interventions remotely, overcoming limitations of distance and time.
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From Effectiveness of online mindfulness interventions on medical students’ mental health: a systematic review (2021) · cites this paper as [21]
The Introduction (Background; page unavailable) says computer-delivered therapy holds promise for increasing access and can reach people facing geographic barriers to in-person treatment. It does not specifically say that online delivery overcomes time limitations or discuss online mindfulness. (LLM, conf=0.87)
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Authors: McCall, H. C., Richardson, C. G., Helgadottir, F. D., & Chen, F. S.
Affiliations: University of British Columbia (CA)
Corresponding author: Chen, Frances S
ORCID: McCall, Hugh Cameron
Richardson, Chris G
Helgadottir, Fjola Dogg
Chen, Frances S
Venue: Journal of Medical Internet Research
Publisher: JMIR Publications Inc.
Published: 2018-03-21
Volume: 20
Issue: 3
Pages: e91
ISSN: 1438-8871 (ISSN-L)
DOI: 10.2196/jmir.8630
PMC: PMC5885061
OpenAlex: W2791698736
Cited by: 71
References: 38
Citations by year: 2026: 9 · 2025: 6 · 2024: 13 · 2023: 15 · 2022: 4 · 2021: 9 · 2020: 6 · 2019: 7 · 2018: 2
FWCI: 7.57
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
Locations: Journal of Medical Internet Research (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
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, online intervention, cognitive behavioral therapy, university students, non-clinical sample, life satisfaction, fear of negative evaluation, social interaction anxiety, medication adherence, email reminders, cognitive restructuring, behavioral experiments, treatment effectiveness, Social Interaction Anxiety Scale
MeSH terms: Adolescent, Adult, Anxiety, Female, Humans, Male, Middle Aged, Quality of Life, Students, Therapy, Computer-Assisted, Universities, Cognitive Behavioral Therapy, Internet, Young Adult

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Evaluating a Web-Based Social Anxiety Intervention Among University Students: Randomized Controlled Trial

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