Published 18 May 2021 at 12.13
Science. In a new study, researchers have shown that internet-mediated cognitive behavioral therapy is an effective and very inexpensive treatment for social anxiety in young people. The study was published in the journal JAMA Psychiatry.
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Social anxiety, formerly known as social phobia, usually debuts in childhood and involves a strong and persistent fear of being examined or negatively assessed in social contexts or performance situations.
Fear usually leads to anxious situations being avoided or completely avoided, which results in impaired everyday function. The reduction can lead to inability to perform in school, social isolation from peers or inability to participate in leisure activities.
As one of the most common anxiety disorders among young people, it affects about 5-10 percent of the young population and without effective treatment, there is a risk that the condition becomes chronic and can lead to other serious mental illness in adulthood.
Although cognitive behavioral therapy (CBT) is an evidence-based treatment for social anxiety in young people, access to treatment is limited. The lack of therapists, distance to accessible clinics and the problems as such are some reasons for the low availability.
Now researchers at the Center for Psychiatric Research at Karolinska Institutet and Child and Adolescent Psychiatry (BUP) in Region Stockholm have developed and evaluated a ten-week Internet-mediated CBT program for young people with social anxiety.
The study, which was conducted during the years 2017–2020, includes 103 children and young people aged 10-17, and their parents. Participants were randomized to internet CBT or an active control group, internet support treatment. Both included ten treatment chapters via a website with weekly support from a psychologist, as well as three short video conversations with the psychologist during the treatment period. The children's parents were offered five parallel chapters and a psychologist contact via the website.
The results show that Internet CBT was significantly more effective than supportive care in reducing social anxiety and comorbid symptoms such as depressive symptoms. The general ability to function in everyday life also increased. The results were reflected in both psychologists 'and children's and their parents' estimates of the child's symptoms.
According to the researchers, the digital format can increase the chances that evidence-based treatment reaches more young people with social anxiety.
– Offering treatment digitally means that children and parents do not have to take time off from school and work to go to a reception. We also believe that the step to seeking care can be lower digitally, as people with social anxiety may have difficulty meeting new people or being in new situations, says the study's lead author Martina Nordh, psychologist and researcher at Karolinska Institutet and BUP Stockholm, in a dispatch
The therapists only needed to spend about a quarter of the time it normally takes to carry out a standard CBT treatment for social anxiety.
– With a reduced total treatment time, each therapist can receive more patients and this can shorten waiting times. CBT in a digital format thus saves costs for health care and resources can be redistributed to those who need more intensive treatment, says the study's lead researcher Eva Serlachius, child and adolescent psychiatrist and adjunct professor at Karolinska Institutet and BUP Stockholm.
The researchers have now started a collaboration with BUP Internet treatment in the Stockholm Region, where they plan to implement and disseminate the program via the national platform for Support and treatment.