Cognitive behavioral group treatment for social phobia: Comparison with a credible placebo control

Heimberg, Richard G.; Dodge, Cynthia S.; Hope, Debra A.; Kennedy, Charles Rann; Zollo, Linda J.; Becker, Robert E.

doi:10.1007/bf01173521

Cited by 452 publications

(294 citation statements)

References 41 publications

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“…CSRs range from 0 (not at all severe) to 8 (extremely severe/distressing), with a CSR of 4 (moderate impairment) generally considered the cutoff for clinical significance (Heimberg et al, 1990).…”

Section: Brief Fear Of Negative Evaluation Scale (Bfne;mentioning

confidence: 99%

Assessing Client Progress Session by Session in the Treatment of Social Anxiety Disorder: The Social Anxiety Session Change Index

Hayes

Miller

Hope

et al. 2008

Cognitive and Behavioral Practice

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Frequent assessment during therapy can improve treatments and provide accountability. However, clinicians often do not monitor progress because of the time it takes to administer and score assessments. In response, the Social Anxiety Session Change Index (SASCI) was developed. The SASCI is a short, easily administered rating of subjective improvement that asks clients with social anxiety disorder how much they have changed since the beginning of therapy. Change on the SASCI was related to change in fear of negative evaluation, a core aspect of social anxiety, and to clinician-rated improvement, but not to ratings of anxiety sensitivity or depression. Because it is brief and easily interpretable, the SASCI can be used in a variety of clinical settings to monitor change across therapy. The SASCI is presented along with examples of how the information gathered from frequent administration can inform clinical practice. Barlow, Hayes, and Nelson (1984) highlight three key reasons why clinicians should measure their clients' change across therapy: to improve treatment, to enhance clinical science, and to provide accountability. In short, these authors posit that assessing change during treatment allows modifications in the treatment procedure to enhance results; gives scientist-practitioners a better understanding of effective treatment techniques; and provides evidence of treatment effectiveness to insurance companies and other third-party payers. Research has shown that tracking clients' progress can improve outcome (see Lambert et al., 2003). A brief weekly progress update would allow for an efficient and sensitive method to NIH Public Access Author ManuscriptCogn Behav Pract. Author manuscript; available in PMC 2014 July 27. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript assess client improvement or relapse from week to week. Changes from the previous week could be used as a tool in session to either investigate what worked well over the week, or to make adjustments if needed. Further, researchers could utilize a session-by-session measure as a way to understand the elements and processes of treatment that lead to change. In addition, therapists have reported that they are interested in using such data to improve their services (e.g., Bickman et al., 2000). However, one of the primary difficulties in utilizing regular assessments in clinical settings is the time required to administer, score, and interpret frequent assessments. In our own work with social anxiety disorder, we found the need for an efficient instrument for ongoing assessment of change, but nothing was available. In response, we developed a brief measure of subjective change that can be administered, interpreted, and utilized in busy clinical practices and research settings.Traditionally, treatment research has focused on changes in symptoms from pretreatment to posttreatment (Kazdin, 2003). Whereas this approach provides a global account of the efficacy of the treatment, it neglects important intermediate steps ...

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Section: Brief Fear Of Negative Evaluation Scale (Bfne;mentioning

confidence: 99%

Assessing Client Progress Session by Session in the Treatment of Social Anxiety Disorder: The Social Anxiety Session Change Index

Hayes

Miller

Hope

et al. 2008

Cognitive and Behavioral Practice

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“…Techniques such as exposure, social skills training, and cognitive restructuring are used. [1][2][3][4] One of the most efficient methods for treating phobias is exposure, [5][6][7] which can be in vivo or imagined (in vitro). In vivo exposure is superior to imagination, but it is costly and timeconsuming, and situational elements are difficult to control.…”

Section: Introductionmentioning

confidence: 99%

Virtual reality exposure using three-dimensional images for the treatment of social phobia

Gebara

Barros-Neto

Gertsenchtein

et al. 2015

Rev. Bras. Psiquiatr.

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Objective: To test a potential treatment for social phobia, which provides exposure to phobia-inducing situations via computer-generated, three-dimensional images, using an open clinical trial design. Methods: Twenty-one patients with a DSM-IV diagnosis of social phobia took part in the trial. Treatment consisted of up to 12 sessions of exposure to relevant images, each session lasting 50 minutes. Results: Improvements in social anxiety were seen in all scales and instruments used, including at follow-up 6 months after the end of treatment. The average number of sessions was seven, as the participants habituated rapidly to the process. Only one participant dropped out. Conclusion: This study provides evidence that exposure to computer-generated three-dimensional images is relatively inexpensive, leads to greater treatment adherence, and can reduce social anxiety. Further studies are needed to corroborate these findings.

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“…Os estudos controlados avaliados apontam para a eficácia das intervenções cognitivas e comportamentais (tais como EXP e TTC), sozinhas ou associadas a outras técni-cas (relaxamento e treino em respiração), na redução dos sintomas do TAS [17][18][19] quando comparadas a outros tipos de abordagens psicoterápicas ou a grupo controle [21][22][23][24][25][26][28][29][30][31][32][33][34]41,43 . Tais achados são confi rmados por Acarturk et al 52 em estudo meta-analítico recente que afi rmou também que essa efi cácia tende a se manter e, em alguns casos, até melhorar nas medidas de follow-up.…”

Section: Discussionunclassified

“…19 12 TCC TCC em grupo 25 TSE 24 EXP = exposição; RC = reestruturação cognitiva; TA = terapia associativa; TCC = terapia cognitivo-comportamental; TCog =terapia cognitiva; THS = treino em habilidades sociais; TS= terapia de suporte; TSE = terapia de suporte educacional.…”

Section: Tcc Comparada a Outros Tipos De Psicoterapiasunclassified

Eficácia do tratamento cognitivo e/ou comportamental para o transtorno de ansiedade social

Mululo

Menezes

Fontenelle

et al. 2009

Rev. psiquiatr. Rio Gd. Sul

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ResumoObjetivo: Avaliar a efi cácia do tratamento cognitivo e/ou comportamental no transtorno de ansiedade social quando comparado a outras intervenções terapêuticas, incluindo farmacoterapia. Método: Realizamos análise sistemática de todos os ensaios clínicos controlados randomizados envolvendo terapia cognitiva e/ou comportamental versus outras formas de tratamento, publicados até março de 2009, indexados nas seguintes bases de dados: MEDLINE, PsycINFO, Registro Cochrane de Ensaios Controlados, LILACS e ISI/Web of Science. Resultados: Os estudos avaliados não demonstraram diferenças signifi cativas entre a terapia cognitiva e/ou comportamental e a farmacoterapia. Esses tratamentos combinados não apresentaram maior efi cácia do que as intervenções isoladamente. Quando comparada ao grupo controle, a terapia cognitiva e/ou comportamental é efi caz na redução dos sintomas de ansiedade social, tanto no seu formato padrão quanto nas novas formas de intervenção. A exceção foi o treino em habilidades sociais, que, isoladamente, não se mostrou efi caz. A terapia cognitiva e/ou comportamental também demonstrou ser superior aos outros tipos de psicoterapias. Conclusão: A terapia cognitiva e/ou comportamental mostrou-se efi caz na redução da ansiedade social em pacientes com transtorno de ansiedade social. No entanto, a heterogeneidade dos estudos avaliados, seja no que diz respeito a aspectos envolvendo o tratamento (duração do tratamento e protocolos utilizados) ou os pacientes avaliados (gravidade e forma de recrutamento), difi cultaram a comparação dos resultados. Novos estudos de tratamento cognitivo e/ou comportamental e novas revisões envolvendo essas abordagens são necessários para melhor avaliação de nossos achados. Descritores: Fobia social, terapia cognitiva, terapia comportamental, transtorno de ansiedade social, revisão. AbstractObjective: To ascertain whether cognitive and/or behavioral treatment of patients with social anxiety disorder is superior in terms of effi cacy than other types of therapeutic interventions, including pharmacotherapy. Method: Systematic analysis of all randomized clinical trials on cognitive and/or behavioral therapy vs. other forms of treatment, published until March 2009, indexed in the following databases: MEDLINE, PsycINFO, Cochrane Controlled Trials Register, LILACS and ISI Web of Science. Results: The reported results do not suggest signifi cant differences in the effi cacy of cognitive and/or behavioral therapy and pharmacotherapy. Such treatments combined did not show higher effi cacy than interventions alone. Compared with the control group, cognitive and/or behavioral therapy was superior in reducing social anxiety disorder, either in the classic model or in the newest propositions. The only exception was the social skills training, which was not effective for patients with social anxiety disorder. Cognitive and/or behavioral therapy was also superior to other psychotherapeutic interventions. Conclusion: Cognitive and/or behavioral therapy is an effective treatment for pati...

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Cognitive behavioral group treatment for social phobia: Comparison with a credible placebo control

Cited by 452 publications

References 41 publications

Assessing Client Progress Session by Session in the Treatment of Social Anxiety Disorder: The Social Anxiety Session Change Index

Assessing Client Progress Session by Session in the Treatment of Social Anxiety Disorder: The Social Anxiety Session Change Index

Virtual reality exposure using three-dimensional images for the treatment of social phobia

Eficácia do tratamento cognitivo e/ou comportamental para o transtorno de ansiedade social

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