Effectiveness of Unguided Internet-Based Cognitive Behavioral Therapy for Subthreshold Social Anxiety Disorder in Adolescents and Young Adults: Multicenter Randomized Controlled Trial

Abstract

Background: Social anxiety disorder (SAD) is a common mental disorder in adolescents and young adults. Early intervention and support could help prevent the development of full-blown SAD. Considering that adolescents with social anxiety symptoms do not prefer face-to-face sessions due to their fear of communicating with therapists, an internet-based cognitive behavioral therapy (ICBT) was implemented.Objective: This study aimed to examine the effectiveness of complete self-help ICBT for subthreshold SAD in high school and college students with no history of mental disorders.Methods: A multicenter randomized controlled trial (RCT) designed to demonstrate the objective was conducted from December 2022 to October 2023. Participants were students enrolled at six universities and one high school. The intervention was a complete self-help ICBT and consisted of 10 text-based sessions that taught cognitive behavioral therapy (CBT) techniques for social anxiety in youth and young adults. The comparison was a no-treatment condition (control group), which was randomly assigned in a 1:1 ratio by a computer program. Two psychological scales were used to assess the severity of social anxiety, and one each to measure symptoms of depression, general anxiety, and quality of life (QoL).