Early Intervention and Disorder-specific Group Cognitive Behavioral Therapy for Socially Anxious Adolescents

Journal of Child and Family Studies, vol. 34, pp. 3337–3353

Abstract

Abstract Social anxiety disorder (SAD) is a persistent yet under-treated disorder with low remission rates. Given that adolescence is the most common period for the onset of SAD, it is crucial to intervene at this developmental phase before severe consequences develop. Hence, the present study employed an early intervention approach, recruiting via schools and implementing an evidence-based social anxiety disorder-specific intervention for adolescents (ages 11–17, N = 41). The adolescents had clinical levels of SAD but had not yet sought treatment. We delivered Skills for Academic and Social Success, a 12-week group CBT intervention focusing on in vivo exposure exercises and social skills training in addition to cognitive restructuring. To explore the potential of blended care we offered access to a supplemental CBT-based mHealth platform with psychoeducation, activities, and chat options and tested whether treatment outcome was influenced by mHealth usage. Using a double-baseline within-subject design, we found significant improvement with large effects in clinician-rated social anxiety disorder (child: d = −2.57, parent: d = −1.79). The intervention yielded a combined remission rate of 59% post-treatment based on averaged reports from clinical interviews with adolescents and parents (ADIS-C/P). Effects increased at the 5-month follow-up with a combined remission rate of 73%. We also found significant improvements in generalized anxiety disorder, self-reported measures of depression, public speaking anxiety, negative and positive cognitions, and self-perception. Taking all results together, treatment outcome was not improved by mHealth usage. Our findings highlight the potential benefits of early intervention programs with a social skills focus, as well as the important role schools can play in the detection of SAD.

Authors 5

1. Sara L. M. Velthuizen corresponding Aachen Faculty of Social and Behavioral Sciences Institute of Psychology Unit Developmental and Educational Psychology

   Leiden University

   Affiliation as printed

   Faculty of Social and Behavioral Sciences, Institute of Psychology, Unit Developmental and Educational Psychology, Leiden University, P.O. Box 9555, Leiden, 2300 RB, The Netherlands

2. Anne C. Miers Aachen Faculty of Social and Behavioral Sciences Institute of Psychology Unit Developmental and Educational Psychology

   Leiden University

   Affiliation as printed

   Faculty of Social and Behavioral Sciences, Institute of Psychology, Unit Developmental and Educational Psychology, Leiden University, P.O. Box 9555, Leiden, 2300 RB, The Netherlands

3. Esther van den Bos Aachen Faculty of Social and Behavioral Sciences Institute of Psychology Unit Developmental and Educational Psychology

   Leiden University

   Affiliation as printed

   Faculty of Social and Behavioral Sciences, Institute of Psychology, Unit Developmental and Educational Psychology, Leiden University, P.O. Box 9555, Leiden, 2300 RB, The Netherlands

4. Annelieke Hagen Aachen Faculty of Social and Behavioral Sciences Institute of Psychology Unit Developmental and Educational Psychology

   Leiden University

   Affiliation as printed

   Faculty of Social and Behavioral Sciences, Institute of Psychology, Unit Developmental and Educational Psychology, Leiden University, P.O. Box 9555, Leiden, 2300 RB, The Netherlands

5. P. Michiel Westenberg Aachen Faculty of Social and Behavioral Sciences Institute of Psychology Unit Developmental and Educational Psychology

   Leiden University

   Affiliation as printed

   Faculty of Social and Behavioral Sciences, Institute of Psychology, Unit Developmental and Educational Psychology, Leiden University, P.O. Box 9555, Leiden, 2300 RB, The Netherlands