Optimizing cognitive-behavioral therapy for social anxiety disorder and understanding the mechanisms of change: Study protocol for a randomized factorial trial
Background: Social anxiety disorder (SAD) is characterized by a marked fear of negative evaluation in social situations and significant impairments. Even with the most effective treatments, remission rates are around 50%. An important reason for the limited effectiveness of treatments is the lack of...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-12-01
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| Series: | Internet Interventions |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214782921001202 |
| _version_ | 1818461710037549056 |
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| author | Rodrigo C.T. Lopes Dajana Šipka Tobias Krieger Jan Philipp Klein Thomas Berger |
| author_facet | Rodrigo C.T. Lopes Dajana Šipka Tobias Krieger Jan Philipp Klein Thomas Berger |
| author_sort | Rodrigo C.T. Lopes |
| collection | DOAJ |
| description | Background: Social anxiety disorder (SAD) is characterized by a marked fear of negative evaluation in social situations and significant impairments. Even with the most effective treatments, remission rates are around 50%. An important reason for the limited effectiveness of treatments is the lack of evidence-based explanation of how treatments work and what their active ingredients might be. An approach to unpack the active ingredients and mechanisms of treatment is the factorial design. Objectives: The study is a factorial trial aiming (1) to examine the main effects and interactions for the four main treatment components of internet-based cognitive-behavioral therapy (ICBT) for SAD (i.e., psychoeducation, cognitive restructuring, attentional training, and exposure) and (2) to examine whether and which change mechanisms mediate the relationship between treatment components and symptom reduction. Methods: A total of 464 adults diagnosed with SAD will be randomized to one of 16 conditions containing combinations of the treatment components. The primary endpoint is SAD symptomatology at eight weeks. Secondary endpoints include symptoms of depression and anxiety, quality of life, and negative effects. Hypothesized change mechanisms are the increase of knowledge about SAD, the decrease of dysfunctional cognitions, the decrease of self-focused attention, and the decrease of avoidance and safety behaviors. Discussion: A better understanding of the differential efficacy of treatment components and mechanisms of treatment underlying ICBT for SAD might inform clinicians and researchers to plan more potent and scalable treatments. Trial registration: clinicaltrials.gov (NCT04879641) on June, 11th 2021. https://clinicaltrials.gov/ct2/show/NCT04879641. |
| first_indexed | 2024-12-14T23:50:28Z |
| format | Article |
| id | doaj.art-5c1ee12f377f440ab64d0a3f927d2fcf |
| institution | Directory Open Access Journal |
| issn | 2214-7829 |
| language | English |
| last_indexed | 2024-12-14T23:50:28Z |
| publishDate | 2021-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Internet Interventions |
| spelling | doaj.art-5c1ee12f377f440ab64d0a3f927d2fcf2022-12-21T22:43:16ZengElsevierInternet Interventions2214-78292021-12-0126100480Optimizing cognitive-behavioral therapy for social anxiety disorder and understanding the mechanisms of change: Study protocol for a randomized factorial trialRodrigo C.T. Lopes0Dajana Šipka1Tobias Krieger2Jan Philipp Klein3Thomas Berger4Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse, 8, 3012 Bern, Switzerland; Corresponding author at: Universität Bern, Institut für Psychologie, Klinische Psychologie und Psychotherapie, Fabrikstrasse 8, 3012 Bern, Switzerland.Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse, 8, 3012 Bern, SwitzerlandDepartment of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse, 8, 3012 Bern, SwitzerlandDepartment of Psychiatry, Psychosomatics and Psychotherapy, Luebeck University, Luebeck, GermanyDepartment of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse, 8, 3012 Bern, SwitzerlandBackground: Social anxiety disorder (SAD) is characterized by a marked fear of negative evaluation in social situations and significant impairments. Even with the most effective treatments, remission rates are around 50%. An important reason for the limited effectiveness of treatments is the lack of evidence-based explanation of how treatments work and what their active ingredients might be. An approach to unpack the active ingredients and mechanisms of treatment is the factorial design. Objectives: The study is a factorial trial aiming (1) to examine the main effects and interactions for the four main treatment components of internet-based cognitive-behavioral therapy (ICBT) for SAD (i.e., psychoeducation, cognitive restructuring, attentional training, and exposure) and (2) to examine whether and which change mechanisms mediate the relationship between treatment components and symptom reduction. Methods: A total of 464 adults diagnosed with SAD will be randomized to one of 16 conditions containing combinations of the treatment components. The primary endpoint is SAD symptomatology at eight weeks. Secondary endpoints include symptoms of depression and anxiety, quality of life, and negative effects. Hypothesized change mechanisms are the increase of knowledge about SAD, the decrease of dysfunctional cognitions, the decrease of self-focused attention, and the decrease of avoidance and safety behaviors. Discussion: A better understanding of the differential efficacy of treatment components and mechanisms of treatment underlying ICBT for SAD might inform clinicians and researchers to plan more potent and scalable treatments. Trial registration: clinicaltrials.gov (NCT04879641) on June, 11th 2021. https://clinicaltrials.gov/ct2/show/NCT04879641.http://www.sciencedirect.com/science/article/pii/S2214782921001202Internet-based cognitive-behavioral therapySocial anxietyFactorial designMechanisms of change |
| spellingShingle | Rodrigo C.T. Lopes Dajana Šipka Tobias Krieger Jan Philipp Klein Thomas Berger Optimizing cognitive-behavioral therapy for social anxiety disorder and understanding the mechanisms of change: Study protocol for a randomized factorial trial Internet Interventions Internet-based cognitive-behavioral therapy Social anxiety Factorial design Mechanisms of change |
| title | Optimizing cognitive-behavioral therapy for social anxiety disorder and understanding the mechanisms of change: Study protocol for a randomized factorial trial |
| title_full | Optimizing cognitive-behavioral therapy for social anxiety disorder and understanding the mechanisms of change: Study protocol for a randomized factorial trial |
| title_fullStr | Optimizing cognitive-behavioral therapy for social anxiety disorder and understanding the mechanisms of change: Study protocol for a randomized factorial trial |
| title_full_unstemmed | Optimizing cognitive-behavioral therapy for social anxiety disorder and understanding the mechanisms of change: Study protocol for a randomized factorial trial |
| title_short | Optimizing cognitive-behavioral therapy for social anxiety disorder and understanding the mechanisms of change: Study protocol for a randomized factorial trial |
| title_sort | optimizing cognitive behavioral therapy for social anxiety disorder and understanding the mechanisms of change study protocol for a randomized factorial trial |
| topic | Internet-based cognitive-behavioral therapy Social anxiety Factorial design Mechanisms of change |
| url | http://www.sciencedirect.com/science/article/pii/S2214782921001202 |
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