Social anxiety disorder (SAD), a psychiatric disorder characterized by persistent and intense fear of one or more social situations that are avoided or endured with marked distress, is the third most common psychiatric disorder and can lead to substantial interference and suffering. Research on interventions for SAD has demonstrated the efficacy of cognitive-behavioral therapy (CBT). Despite the substantial empirical support of CBT for SAD, lack of access to the best psychosocial treatments represents a significant public health problem. In particular, 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. A growing body of evidence has documented the utility of telehealth-delivered medical health-care, particularly telepsychiatry. Social anxiety disorder is an ideal disorder to test the feasibility of such a treatment modality, given the interpersonal focus of the disorder and that efficacious treatments have been identified. Therefore, the proposed study will examine the efficacy and acceptability of CBT for social anxiety disorder delivered via a telehealth format. Participants will undergo a comprehensive diagnostic interview and baseline assessment. Participants with a primary diagnosis of social anxiety disorder will be randomly assigned to either receive telehealth-delivered CBT (TH) or a waitlist (WL) control group. Following treatment, participants will complete a posttreatment assessment and diagnostic interview. If treatment can be successfully delivered in a telehealth format for individuals with SAD, then the same format should be efficacious for the other anxiety disorders, for which highly effective exposure-based treatments are also available.
Telehealth-delivered psychotherapy may be particularly useful to address disparities in access to care, a significant public health problem, by increasing the availability of treatment. If treatment can be successfully delivered in a telehealth format for individuals with SAD, this will help establish the feasibility of utilizing telehealth technology to deliver evidence-based mental health services and, thus, increasing access to care. Establishing the feasibility of telehealth-delivered treatment with SAD would also suggest that the same format should be similarly efficacious for other anxiety disorders, given the similarities of exposure-based treatments.
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|Weiss, Brandon J; Hope, Debra A (2011) A preliminary investigation of worry content in sexual minorities. J Anxiety Disord 25:244-50|