Category: Treatment - CBT


A Multisite Systems Intervention for Unemployed Persons with Social Anxiety Disorder

Saturday, November 18
10:15 AM - 11:45 AM
Location: Aqua Salon E & F, Level 3, Aqua Level

Keywords: Social Anxiety | Exposure | Randomized Controlled Trial
Presentation Type: Symposium

This is a multisite study investigates the effects of work-related cognitive behavioral therapy (WCBT) upon employment and mental health in a largely minority and low-income group of unemployed individuals with social anxiety disorder. WCBT is designed to enhance employment success among unemployed persons whose job attainment efforts have been undermined by social anxiety disorder (SAD). SAD has substantial negative impacts on occupational functioning (Stein & Kean, 2000), financial dependence (Schneier et al., 1992), and income (Patel et al., 2002). We have shown that SAD is the strongest psychiatric predictor of sustained reliance on welfare among mothers (Tolman et al., 2009) and other research indicates that SAD is the largest mental health predictor of protracted unemployment among members of a health maintenance organization (Moitra et al., 2011). WCBT is an 8-session work-related group CBT for SAD that is delivered by vocational services professionals in a vocational service center order to enhance intervention sustainability. In our previously published report (Himle et al., 2014), WCBT significantly improved social anxiety, generalized anxiety, depression, job search behaviors and job search self-confidence compared to a vocational services as usual (VAU) control condition. These results were achieved in a homeless, primarily African American sample of urban-based job-seekers with high levels of psychiatric comorbidity and limited education and employment histories.

The present multicenter study examines a refined version of WCBT where intervention training and WCBT delivery are computer-assisted. The current RCT includes a larger sample of diverse job seekers from two regions in the U.S. and examines the effects of WCBT over the long term. This presentation presents outcome data on pilot studies of the refined version of WCBT conducted in both study sites and includes discussion of the challenges and benefits of implementing a multisite RCT in community-based vocational service centers with WCBT groups led by vocational professionals. Information on the early-stage system effects of WCBT on participating vocational service centers is also presented. 

Joseph A. Himle

University of Michigan


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A Multisite Systems Intervention for Unemployed Persons with Social Anxiety Disorder

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