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Abstract
Social anxiety disorder is the third most common psychiatric disorder and can lead to substantial interference and suffering. Research on interventions for social anxiety disorder has demonstrated the efficacy of cognitive-behavioral therapy (CBT). However, access to appropriate, empirically supported care in rural areas is often limited due to a number of barriers, including shortage of health-care specialists in rural areas and distance from services. One approach to overcoming such barriers is to utilize new technologies that may help increase access to care. Telehealth-delivered psychotherapy may be particularly useful in addressing this problem, and a growing body of evidence has documented the utility of telehealth-delivered medical health-care.
The present study examined the efficacy and feasibility of CBT for social anxiety disorder delivered through videoconferencing. Participants with a primary diagnosis of social anxiety disorder were randomly assigned to receive either 16 sessions of individual CBT via videoconferencing or to a wait-list control group for a 16-week waiting period. Clinician-rated and self-report measures of social anxiety and a self-report measure of depression were administered at pre-treatment and post-treatment. Participants who received treatment demonstrated significant decreases on clinician-rated measures of social anxiety from pre-treatment to post-treatment on both within-groups analyses and compared to participants in the wait-list control group. Participants in the treatment group demonstrated a significant decrease on self-report measures of social anxiety and depression from pre-treatment to post-treatment, though not significantly different from individuals in the wait-list group. In addition to treatment outcome, the current study also examined feasibility, including treatment credibility (in general and specifically delivered via videoconferencing), treatment satisfaction (in general and specifically delivered via videoconferencing), homework compliance, and telepresence among participants in the telehealth-delivered treatment group. Treatment credibility and satisfaction, both in general and specifically delivered via videoconferencing, was high. Participants rated their degree of telepresence as moderate-to-high, with some noted variability. Limitations and implications of these findings, as well as future directions for research, are discussed.
