This Way Up - Social Phobia Course

Description:

The This Way Up Social Phobia course consists of 6 online lessons based on the principles of Cognitive Behavioural Therapy (CBT), as well as homework activities and phone/email contact with your clinician if you complete the supervised version. The lessons present the story of a young man who suffers from social phobia, and as the course progresses he learns more about it and develops the skills to overcome his fears. The lessons build on one another and focus on psychoeducation, the development of exposure strategies, changing negative thoughts, and information about preventing a relapse. Each lesson takes about 20 minutes along with an additional 3-4 hours per week for homework over the month period.

Service URL:

https://thiswayup.org.au/clinic/courses/courses-we-offer/social-phobia/

Agency Responsible:

This Way Up, Clinical Research Unit for Anxiety and Depression (CRUfAD), St Vincent's Hospital, Sydney and the University of NSW.

Details

Format:

Website.

Intervention Type:

Psychological – CBT.

Course Length:

Long (more than 5 modules). 6 lessons over 3 months

Support Option:

Clinical support. Via phone/email contact with your own clinician, self-directed course also available

Target Audience

Primary Category:

Social anxiety.

Target Audience:

Adult.

Language:

English.

Access

Fee:

Fee-based. The course costs $59

Access:

Closed: Fee required. You need to be referred by your clinician to register for the supervised course. A self-directed version is also available

Contact Details:

Through an online form at: https://thiswayup.org.au/about/contact-us/

Research evidence

Research Trials:

10

Research RCTs:

4

Outcome Summary:

The efficacy of the Social Phobia Course has been tested in four randomised controlled trials (RCTS). In the first two of these trials, the course resulted in significant reductions in measures of social phobia compared to waitlist controls, with large respective mean within and between-group effect sizes on the Social Interaction Anxiety Scale (SIAS) and Social Phobia Scale (SPS) (d = 1.15 and 0.95, and 1.18 and 1.20). Further, secondary measures of depressive symptoms, psychological distress and disability have also been shown to be reduced. Six-month follow-up of 59% of treatment group participants in these two studies found that the improvements of the Social Phobia Course  had continued. Social phobia measures displayed significant differences between pre-test, post-test and follow-up, with secondary measures displaying significant differences between pre-test and post-test, and pre-test and follow-up. A third RCT comparing the course with a self-help version and waitlist control showed that it resulted in greater improvements in social phobia, disability and avoidance behaviours compared to the self-help and control conditions. Within-group effect sizes on social phobia measures were large, and the mean between-group effect size compared to controls and self-help were d = 1.04 and 0.66 respectively. Moreover, in the most recent RCT, the Social Phobia Course resulted in significant reductions of social phobia as measured by the Liebowitz Social Anxiety Scale (LSAS) compared to wait list controls, with a moderate effect size.  Therefore, there is good evidence from RCTs in support of the Social Phobia Course.

Additional studies have also shown that while more effective with telephone support, the pure self-help version of the course has strong efficacy, is clinically effective and satisfying for participants regardless of whether support is through a clinician or forum, and reduces symptoms of comorbid anxiety and depression. A recent trial comparing the course to the course plus self-guided motivational enhancement strategies found no evidence of symptom benefit from the addition of motivational strategies. Another recent trial comparing the course to face to face therapy found that both groups experienced significant improvements on social phobia symptoms and disability measures. There were no significant differences in outcome between the Social Phobia Course and face-to-face groups, but there was a substantial difference in clinician time required; 18 min per patient for the Social Phobia Course group and 240 min per patient for the face-to-face group. Two studies have been carried out testing the effectiveness of the This Way Up Social Phobia Course in clinical samples with N=368 and N=192. Participants saw significant improvements in symptoms of social anxiety with large effect sizes (d=0.99 and d=1.09) as well as significant reductions in distress and depression. 

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Research paper citations

Evidence evaluation studies:

Titov, N., Andrews, G., Schwencke, G., Drobny, J. & Einstein, D. (2008) Shyness 1: Distance treatment of social phobia over the internet. Australian and New Zealand Journal of Psychiatry, 42 (7), 585-594.

 

Titov, N., Andrews, G. & Schwencke, G. (2008). Shyness 2: Treating social phobia online: replication and extension. Australian and New Zealand Journal of Psychiatry, 42 (7), 595-605.

 

Titov, N., Andrews, G., Choi, I., Schwencke, G & Mahoney, A. (2008). Shyness 3: Randomized controlled trial of guided versus unguided internet-based CBT for social phobia. Australian and New Zealand Journal of Psychiatry, 42 (12), 1030-1040.

 

Titov, N., Andrews, G., Johnston, L., Schwencke, G. & Choi, I. (2009). Shyness programme: Longer term benefits, cost-effectiveness, and acceptability. Australian and New Zealand Journal of Psychiatry, 43 (1), 36-44.

 

Titov, N., Andrews, G., Choi, I., Schwencke, G., & Johnston, L. (2009). Randomized controlled trial of web-based treatment of social phobia without clinician guidance. Australian and New Zealand Journal of Psychiatry, 43, 913-919.

 

Aydos, L., Titov, N., & Andrews, G. (2009). Shyness 5: the clinical effectiveness of Internet-based clinician-assisted treatment of social phobia. Australian and New Zealand Journal of Psychiatry, 17(6), 488-492.

 

Titov, N., Andrews, G., Schwencke, G., Solley, K., Johnston, L., & Robinson, E. (2009). An RCT comparing two types of support on severity of symptoms for people completing Internet-based cognitive behaviour therapy for social phobia. Australian and New Zealand Journal of Psychiatry, 43, 920-926.

 

Titov, N., Gibson, M., Andrews, G., & McEvoy, P. (2009). Internet treatment for social phobia reduces comorbidity. Australian and New Zealand Journal of Psychiatry, 43, 754-759.

 

Titov, N., Andrews, G., Schwencke, G., Robinson, E., Peters, L., & Spence, J. (2010). Randomized controlled trial of Internet cognitive behavioural treatment for social phobia with and without motivational enhancement strategies. The Australian and New Zealand Journal of Psychiatry, 44(10), 938-945.

 

Andrews, G., Davies, M., & Titov, N. (2011). Effectiveness randomized controlled trial of face to face versus Internet cognitive behaviour therapy for social phobia. The Australian and New Zealand Journal of Psychiatry, 45: 337.

 

Bell, C.J., Colhoun, H.C., Carter, F.A., Frampton, C.M. (2012)  Effectiveness of computerised cognitive behaviour therapy for anxiety disorders in secondary care.  The Australian and New Zealand Journal of Psychiatry, 46(7): 630-640.

 

Williams, A. D., O'Moore, K., Mason, E., & Andrews, G. (2014). The effectiveness of internet cognitive behaviour therapy (iCBT) for social anxiety disorder across two routine practice pathways. Internet Interventions, 1(4), 225-229.

 

Additional references:

Hilvert-Bruce, Z., Rossouw, P.J., Wong, N., Sunderland, M., Andrews, G. (2012)  Adherence as a determinant of effectiveness of internet cognitive behavioural therapy for anxiety and depressive disorders.  Behaviour Research and Therapy, 50, 463-468.