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Imagery-based CBT for Social Anxiety Disorder: Piloting a Treatment Augmentation Protocol

Not Applicable
Completed
Conditions
Social Anxiety Disorder
Interventions
Other: Imagery-based CBT
Other: Verbal-linguistic CBT
Registration Number
NCT02659436
Lead Sponsor
St. Joseph's Healthcare Hamilton
Brief Summary

The purpose of this pilot study is to explore whether there is a differential impact of verbal versus imagery-based cognitive behavioural therapy (CBT) as a treatment augmentation strategy for individuals with social anxiety disorder (SAD). Clients who have not demonstrated clinically significant change following group CBT for SAD will receive four additional sessions of either verbal-based CBT or imagery-based CBT. We hypothesize that that individuals who receive imagery-based CBT will experience even stronger improvements and be more satisfied with their treatment than individuals who received traditional verbal-linguistic CBT.

Detailed Description

Social Anxiety Disorder (SAD) is a debilitating disorder, marked by significant functional impairment and high personal distress for those who suffer. Psychological treatment for SAD has traditionally been verbal-linguistic cognitive behavioural therapy (CBT). However, a significant number of individuals who complete CBT for SAD do not achieve full response and continue to struggle with significant residual symptoms. One innovation that has received attention recently in the literature is using imagery-based CBT as a way to augment treatment outcome in SAD. Results from a pilot and benchmarking study suggest that participants who received imagery-based CBT were more likely to complete treatment than those who received traditional CBT and treatment outcome was strong for both groups, but stronger in the imagery-based CBT group.

However, before re-training hundreds of practitioners in using a completely novel treatment approach, it is important to see if a brief augmentation of traditional CBT programs is effective in producing further change for individuals with residual symptoms after group CBT. It is possible that individuals just require a few more sessions of the same verbal-linguistic CBT to consolidate treatment gains or work on lingering triggers of anxiety. It is also possible that more of the same is not as valuable as offering therapy using a different modality, such as imagery. Therefore, we propose to evaluate a brief imagery-based augmentation of traditional group CBT to explore its effects on further symptom reduction.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
9
Inclusion Criteria
  • Completed eight out of twelve sessions of standard verbal-linguistic group cognitive behavioural therapy for social anxiety disorder
  • Presented with a Social Phobia Inventory (SPIN) score of greater than 19 post-treatment
  • Interested in further treatment
Exclusion Criteria
  • Has another mental health concern of greater importance than social anxiety disorder

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Imagery-based CBTImagery-based CBTParticipants will receive 4 sessions of imagery-based cognitive work and behavioural experiments delivered in an individual therapy format.
Verbal-linguistic CBTVerbal-linguistic CBTParticipants will receive 4 sessions of verbal cognitive restructuring and exposure therapy delivered in an individual therapy format.
Primary Outcome Measures
NameTimeMethod
Social Phobia InventoryThis will be administered at the end of the 4 session protocol which will take place approximately 4 -6 weeks after entry into the study.

Measures social anxiety symptoms

Secondary Outcome Measures
NameTimeMethod
Vividness of Visual Imagery QuestionnaireThis will be administered at the end of the 4 session protocol which will take place approximately 4 -6 weeks after entry into the study.

Measures the ability to visualize several visual images

Treatment Satisfaction ScaleThis will be administered at the end of the 4 session protocol which will take place approximately 4 -6 weeks after entry into the study.

Measures the participant's satisfaction with their treatment

Homework Adherence ScaleThis will be administered at the end of the 4 session protocol which will take place approximately 4 -6 weeks after entry into the study.

Measures the quality of homework completion

Illness Intrusiveness Rating ScaleThis will be administered at the end of the 4 session protocol which will take place approximately 4 -6 weeks after entry into the study.

Measures how much anxiety interferes with functioning

Brief Fear of Negative Evaluation ScaleThis will be administered at the end of the 4 session protocol which will take place approximately 4 -6 weeks after entry into the study.

Measures fears about being negatively evaluated by others

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