Trial-Based Cognitive Therapy: Efficacy of a New CBT Approach for Treating Social Anxiety Disorder with Comorbid Depression

Abstract

The present study aims to evaluate the efficacy of Trial-Based Cognitive Therapy (TBCT), a new cognitive-behavioral therapy approach, for generalized social anxiety disorder (GSAD) in a population with high rates of comorbid disorders, especially depression. This two-arm randomized clinical trial included 39 adults (TBCT = 18; waitlist group = 21) diagnosed with GSAD. The TBCT group received 16 weekly sessions of individual TBCT. Symptom severity was assessed at pre- and post-treatment. Participants in the TBCT group showed reduction in social anxiety, social avoidance, and depression, all associated with a large effect size. No differences between pre- and post-treatment scores were observed in the waitlist condition. Results also showed that comorbidity significantly moderated treatment efficacy. Patients with comorbid conditions showed greater reductions in social anxiety symptoms across treatment than those with SAD only. In summary, TBCT was effective in reducing social anxiety and depressive symptoms, particularly for patients with comorbidity.