Category: Adult Anxiety - Social
Background and aim: It has been established that cognitive behavioral therapy (CBT) based on the Clark and Wells (1995) model is an effective treatment for social anxiety disorder (SAD). The purpose of this study was to develop a smartphone-based CBT on public speaking anxiety and to examine its efficacy for adults with SAD in the community. Method: Sixty individuals with SAD diagnosed through SCID-I were randomly assigned to smartphone-based CBT or to a control group. The Korean version of Social Phobia Scale, Speech Anxiety Scale, Self-focused Attention, Speech Anxiety Thoughts Inventory, and Subtle Avoidance Frequency Examination were administered online at pre- and post-treatment to all participants. A total of 28 participants who completed the 4 modules and 26 in the waiting list control group were in the analyses. The smartphone-based CBT implemented key features of the face-to-face treatment including cognitive restructuring, video feedback, attention training, and exposure, which targeted to reduce negative self-image, self-focused attention and safety behaviors. Therapist support was delivered through messenger application. Results and conclusion: Repeated measure ANOVAs indicated that participants in the smartphone-based CBT group improved significantly on all measures compared to the control group. The treatment group showed large effect sizes ranging from 1.38 to 2.53. It was also shown that the changes in the negative cognitive biases and safety behaviors mediated the changes in the social anxiety symptoms. The findings suggest that the smartphone-based CBT can be a promising, cost-effective way of delivering CBT for SAD.