Abstract
Most studies examining processes of change in psychological therapy for social anxiety disorder (SAD) have analysed data from randomised controlled trials in research settings. To assess whether these findings are representative of routine clinical practice, we analysed audit data from two samples of patients who received Cognitive Therapy for SAD (total N = 271). Three process variables (self-focused attention, negative social cognitions, and depressed mood) were examined using multilevel structural equation models. Significant indirect effects were observed for all three variables in both samples, with negative social cognitions showing the strongest percent mediation effect. 'Reversed' relationships, where social anxiety predicted subsequent process variable scores, were also supported. The findings suggest the processes of change in this treatment may be similar between research trials and routine care.
Highlights
Most studies examining processes of change in psychological therapy for social anxiety disorder (SAD) have analysed data from randomised controlled trials in research settings
Significant indirect effect estimates were observed for all three of the process variables assessed, indicating that self-focused attention, negative social cognitions, and depressed mood all mediated the effect of time on social anxiety
The reversed models, which swapped the social anxiety and process variables but re‐ tained the time-lag component, were significant for the three process variables assessed. These findings suggest that lower social anxiety scores were associated with subsequent reduced self-focused attention, reduced negative social cognitions, and im‐ proved mood at the following assessment
Summary
Most studies examining processes of change in psychological therapy for social anxiety disorder (SAD) have analysed data from randomised controlled trials in research settings. Method: To assess whether these findings are representative of routine clinical practice, we analysed audit data from two samples of patients who received Cognitive Therapy for SAD (total N = 271). Three process variables (self-focused attention, negative social cognitions, and depressed mood) were examined using multilevel structural equation models. Results: Significant indirect effects were observed for all three variables in both samples, with negative social cognitions showing the strongest percent mediation effect. ‘Reversed’ relationships, where social anxiety predicted subsequent process variable scores, were supported. Conclusion: The findings suggest the processes of change in this treatment may be similar between research trials and routine care
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