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Group CBT for Social Anxiety Disorder: A Meta-Analysis

OBJECTIVE: A few meta-analyses have examined psychological treatments for a social anxiety disorder (SAD). This is the first meta-analysis that examines the effects of cognitive behavioural group therapies (CBGT) for SAD compared to control on symptoms of anxiety.

METHOD: After a systematic literature search in PubMed, Cochrane, PsychINFO and Embase was conducted; eleven studies were identified that met the inclusion criteria. The studies had to be randomized controlled studies in which individuals with a diagnosed SAD were treated with cognitive-behavioural group therapy (CBGT) and compared with a control group. The overall quality of the studies was moderate.

RESULTS: The pooled effect size indicated that the difference between intervention and control conditions was 0.53 (96% CI: 0.33-0.73), in favour of the intervention. This corresponds to a NNT 3.24. Heterogeneity was low to moderately high in all analyses. There was some indication of publication bias.

CONCLUSIONS: It was found that psychological group-treatments CBGT are more effective than control conditions in patients with SAD. Since heterogeneity between studies was high, more research comparing group psychotherapies for SAD to control is needed.

Wersebe, H., Sijbrandij, M., & Cuijpers, P. (January 01, 2013). Psychological group-treatments of social anxiety disorder: a meta-analysis. Plos One, 8, 11.)

Emotional Management Training CBT in Social Settings May Reduce Children’s Anxiety

A recent study published in the Journal of Research in Childhood Education, investigated the effect of using Cognitive Behavior Therapy (CBT) in a social setting on children’s anxiety levels. Typically, children with anxiety have the most difficulty with evaluating and managing emotions, which may lead to poor peer relationships and maladaptive coping strategies. Because anxiety disorders are the most common mental health conditions in children, research on early intervention is warranted. Emotional Management Training (EMT) is a form of CBT that helps children learn to regulate anxious emotions. Participants in the current study were primarily recruited from a New York City mental health clinic and included 58 children, ages 5-14, diagnosed with anxiety disorders. The program included social and therapeutic group activities, as well as CBT skills to help children manage anxious emotions. Specifically, the EMT CBT intervention consisted of psychoeducation about emotional and physical anxiety symptoms, relaxation and meditation therapy, cognitive restructuring, and exposure activities. Results demonstrated overall improvement in anxiety symptoms measured by the Multidimensional Anxiety Scale for Children, program satisfaction surveys, self-reports, and therapist and parent reports. These findings suggest that EMT may be a helpful alternative for anxious children in social settings.

Kearny, R., Pawlukewicz, J., & Guardino, M. (2014). Children with anxiety disorders: Use of a cognitive behavioral therapy model within a social milieu. Journal of Research in Childhood Education, 28, 59-68. doi: 10.1080/02568543.2013.850130

CBT Reduces Shame in Individuals with Social Anxiety Disorder

According to a recent study published in Plos One, cognitive behavior therapy (CBT) may help reduce experiences of shame (specifically associated with how individuals judge themselves) among patients diagnosed with social anxiety disorder (SAD.) Participants (n= 161) in the current study were initially evaluated for experiences of shame, guilt, depression, and social anxiety. Participants diagnosed with SAD (n=67) were assigned to a CBT treatment condition; the remaining participants (n=94) were assigned to two samples of healthy controls. According to results, shame, social anxiety, and depressive symptoms were each associated in participants with SAD. Further, shame was shown to be elevated among SAD patients compared to the main healthy control. Following treatment, shame significantly reduced among participants with SAD. These findings suggest that shame and social anxiety are associated, that socially anxious patients may be more likely to experience shame than patients without social anxiety, and that CBT treatment can help reduce shame among individuals with SAD.

Hedman, E., Strom, P., Stunkel, A., & Mortberg, E. (April 19, 2013). Shame and Guilt in Social Anxiety Disorder: Effects of Cognitive Behavior Therapy and Association with Social Anxiety and Depressive Symptoms. Plos One, 8, 4.

CBT Demonstrates Long-Term Effectiveness for Adults with Anxiety

According to a new study published in Behaviour Research and Therapy, research has demonstrated that cognitive behavior therapy (CBT) has long-term effectiveness for adults with anxiety disorders. The current study sought to examine the immediate and long-term effectiveness of CBT treatment within a naturalistic, outpatient setting. Participants (n=181) included individuals with the primary diagnoses of OCD, GAD, social phobia, panic disorder with agoraphobia, and specific phobia who had received at least 3 (and on average 14) CBT sessions with a therapist, using CBT interventions exclusively, in an outpatient, fee-for-service setting. At post-treatment, 113 participants (62%) were identified as “responders” or “remitters” (i.e., much or very much improved). Of these, 87 participants (77%) maintained their status as “responders” or” remitters” at one-year follow up. These findings suggest CBT outcomes for anxiety disorders among clinic patients are effective in both the short- and long-term.

DiMauro, J., Tolin, D. F., Domingues, J., & Fernandez, G. (2013). Long-term effectiveness of CBT for anxiety disorders in an adult outpatient clinic sample: A follow-up study. Behaviour Research and Therapy, 51, 2, 82-86.

Japan: Social Anxiety Disorder shows positive response to group CBT

A study in BMC Psychiatry reported that the use of cognitive behavioral therapy (CBT) for Social Anxiety Disorder (SAD) was well established in Europe and North America but little was known about its effectiveness in non-Western cultures.

A pilot study of group CBT for SAD was conducted in Japan (groups of 3 or 4; average number of sessions per group was 15). The CBT methods included psychoeducation regarding anxiety, experiments to reduce safety behaviors, cognitive restructuring for dysfunctional assumptions, and others. Where needed, co-administration of antidepressants and benzodiazepines was allowed.

The researchers found a significant reduction in symptoms pre- to post-treatment, and concluded that group CBT “can bring about a similar degree of symptom reduction among Japanese patients with SAD as among Western patients.”

Study authors: J. Chen, Y. Nakano, T. Ietzugu, S. Ogawa, et al.

CBT cutting down on the sweat in patients with hyperhidrosis

Hyperhidrosis, a condition that causes excessive sweating, is brought on by a combination of the body’s temperature regulating system and emotional factors. The way emotional triggers affect this condition had never been studied in depth.

A recent study at the Mayo Clinic in Minnesota showed that Cognitive Behavioral Therapy (CBT) helps not only with the general anxieties that trigger sweating, but also with social anxiety brought on by hyperhidroses itself and therefore can further reduce the unwanted sweating.