Abstract
Cognitive behavioral therapy (CBT) is generally considered to be the most effective psychological treatment for social anxiety disorder (SAD). Nevertheless, many patients with SAD are still symptomatic after treatment. The present pilot study aimed to examine integrating CBT, with a focus on cognitive and behavioral techniques, and psychodrama, which focuses more on experiential techniques into a combined treatment (CBPT) for social anxious patients in a group format. This new intervention for SAD is described session-by-session. Five adult female patients diagnosed with social anxiety disorder participated in a twelve-session CBPT in a group format. Pretest and posttest scores of social anxiety, avoidance, spontaneity, cost and probability estimates of negative social events, depression, and quality of life were compared, as were weekly assessments of fear of negative evaluation. Results demonstrated a significant reduction of the fear of negative evaluation and social anxiety symptoms. It is noteworthy that also the scores of the probability and cost estimates decreased. However, there were no significant differences between pre and post measures in any of other measures. The current study suggests that group CBPT might be an effective treatment for SAD. However, our sample size was small and this was an uncontrolled study. Therefore, it is necessary to test this intervention in a randomized controlled trial with follow-up assessments.
Highlights
Cognitive behavioral therapy (CBT) is generally considered to be the most effective psychological treatment for social anxiety disorder (SAD)
The current study suggests that group CBPT might be an effective treatment for SAD
CBPT balances a focus on cognition and behavior through CBT techniques, and emotion during psychodrama techniques in action
Summary
Six patients with a primary diagnosis of social anxiety disorder were included in this study; all were diagnosed with the Structured Clinical Interview for DSM 4th ed (SCIDI, Farsi Version; First, Spitzer, Gibbon, & Williams, 2012). One participant dropped out of the study because she found a full-time job before the first session, and was not included in the analysis. An Iranian ethical committee (reference number IR.UMSHA.REC.1394.521) approved the protocol on February 27, 2016, and all patients gave their written informed consent prior to their inclusion in the study. This study is a preparatory pilot for an RCT that included the CBPT protocol as an arm. Inclusion criteria were SAD as a primary diagnosis, age between 18 and 65 years, ability to read and understand the questionnaires and the interview. Unwillingness to stabilize medication for the duration of the study was an exclusion criterion as well
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