Abstract
Social anxiety disorder (SAD) is common. It usually starts in adolescence, and without treatment can disrupt key developmental milestones. Existing generic treatments are less effective for young people with SAD than with other anxiety disorders, but an adaptation of an effective adult therapy (CT-SAD-A) has shown promising results for adolescents. The aim of this study was to conduct a qualitative exploration to contribute towards the evaluation of CT-SAD-A for adoption into Child and Adolescent Mental Health Services (CAMHS). We used interpretative phenomenological analysis (IPA) to analyse the transcripts of interviews with a sample of six young people, six parents and seven clinicians who were learning the treatment. Three cross-cutting themes were identified: (i) endorsing the treatment; (ii) finding therapy to be collaborative and active; challenging but helpful; and (iii) navigating change in a complex setting. Young people and parents found the treatment to be useful and acceptable, although simultaneously challenging. This was echoed by the clinicians, with particular reference to integrating CT-SAD-A within community CAMHS settings. The acceptability of the treatment with young people, their parents and clinicians suggests further work is warranted in order to support its development and implementation within CAMHS settings.
Highlights
Social anxiety disorder (SAD) is characterised by an intense fear of social situations
The analysis reported here focuses on expectations and experiences of the treatment from the perspective of young people, parents, and clinicians
The specific role of the therapist in establishing a collaborative relationship around the treatment seemed to be important to the young people. This is generally evident in the language used to report on these activities, which tended to highlight the collective voice: ‘We looked at my umm behaviours and stuff that linked to it and the things that I found the most umm, like, scary to do and after we went through them, we decided on things we could do that could like, get over them and we coz - we were - it’s quite easy to go to like shops and cafes and stuff and we just gradually built it up to things that I found the worst.’ [Julia – underlining added to highlight collective voice]
Summary
Social anxiety disorder (SAD) is characterised by an intense fear of social situations. SAD has the lowest natural recovery rate of all anxiety disorders (Bruce et al, 2005) It usually starts in adolescence, and without treatment may disrupt key developmental milestones (e.g. educational achievement; Katzelnick and Greist, 2001). It is important for these treatments to be deliverable within the NHS, in a way that clinicians, young people and their families find useful. It usually starts in adolescence, and without treatment can disrupt key developmental milestones. Young people and parents found the treatment to be useful and acceptable, simultaneously challenging. This was echoed by the clinicians, with particular reference to integrating CT-SAD-A within community CAMHS settings. Conclusions: The acceptability of the treatment with young people, their parents and clinicians suggests further work is warranted in order to support its development and implementation within CAMHS settings
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