Internet-Based Cognitive Behavior Therapy for Social Anxiety Disorder

Abstract

Social anxiety disorder (SAD) is characterized by a marked and persistent fear of being scrutinized by others in social situations. It is highly prevalent and follows a chronic course for many affected if untreated. Treatment with cognitive behavior therapy (CBT) has been shown to be highly effective for SAD with responder rates of 50–75 %. For more than a decade, Internet-based CBT (ICBT) has been researched and evidence has been provided by four independent research groups. In essence, most forms of ICBT for SAD can generally be described as therapist-guided Internet-based self-help CBT where a named therapist guides the client through the treatment. The treatments are manualized and highly structured comprising 5–15 modules or lessons, which are the equivalent of sessions in face-to-face CBT. The existing treatments for SAD all have vital features in common including that they are based in CBT, comprise the same interventions as have been shown to be effective in face-to-face CBT, have large amount of psychoeducational material, and use asynchronous text messages as the main communication between patient and therapist. ICBT for SAD has been proven to be effective in at least 16 randomized trials and found to be non-inferior to face-to-face CBT. A few studies suggest that ICBT is a cost-effective treatment. Since SAD is known to appear at an early age in most cases, one central future challenge is to increase the body of knowledge on ICBT for children and adolescents. For adults, ICBT for SAD is clearly an effective treatment and a promising option for increasing accessibility to evidence-based psychological treatment.