Cognitive Behavioral Training Reduces Socially Anxious Classroom Behavior in Primary School Students

Gino Casale,Daniel Haarhoff

doi:10.3389/feduc.2022.746094

Abstract

Many students show symptoms of social anxiety. Cognitive behavioral training (CBT) has been shown to be effective in reducing symptom behavior in therapeutic and school contexts, but there are hardly any single-case studies that examine the individual effectiveness in school settings. Furthermore, the extent to which differential responsivity effects are exhibited by students has not been examined yet. This single-case study with AB design investigates the effects of a CBT on the socially anxious classroom behavior of students with severe symptoms of social anxiety. Two female and two male students (9–10 years old) of an inclusive primary school in Germany participated in the CBT over a period of twelve weeks. Socially anxious behaviors were measured daily with Direct Behavior Rating-Multi Item Scales. Visual analyses, overlap indices, and regression models show a substantial behavioral improvement for all students during the intervention. However, there are differences between the students in terms of which specific behaviors were improved and whether the behavioral improvements took place immediately after the implementation of the intervention or continuously from measurement to measurement in the B phase. The results highlight the relevance of specific and individualized behavioral goals for CBT in school, although the effects should be replicated in experimental studies.

Highlights

Social anxiety is among the most prevalent emotional and behavioral disorders in school-aged children and youth with relatively early ages of onset and high rates of comorbidity with many others internalizing behavioral problems (Merikangas et al, 2010)
Schools offer a suitable setting for Cognitive behavioral training (CBT) for students with social anxiety, since the school context provides an excellent opportunity to generalize and practice the newlydeveloped skills in the children’s everyday environment, and intervention effects have been found to be larger in school contexts (Scaini et al, 2016)
In an attempt to fill this research gap, we examined the effectiveness of a CBT in reducing socially anxious classroom behavior in students with severe symptoms of social anxiety

Summary

Introduction

Social anxiety is among the most prevalent emotional and behavioral disorders in school-aged children and youth with relatively early ages of onset and high rates of comorbidity with many others internalizing behavioral problems (Merikangas et al, 2010). Schools offer a suitable setting for CBT for students with social anxiety, since the school context provides an excellent opportunity to generalize and practice the newlydeveloped skills in the children’s everyday environment (see e.g., Domitrovich et al, 2010), and intervention effects have been found to be larger in school contexts (Scaini et al, 2016) Despite this potential of CBT, there is still a lack of controlled single-case studies that test patterns of individual students’ responsiveness to CBT, especially with a focus on students who are not formally diagnosed with social anxiety disorders, but who exhibit severe clinical symptoms of social anxiety. The single-case experimental research approach offers the opportunity to control for the manipulation of an independent variable and to examine the functional relationship between the independent and dependent variable more closely, as is uncommon in traditional case studies, for example

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