Cognitive behavioral therapy is an efficacious treatment of social anxiety disorder, however less is known about how therapy leads to change. To better understand how treatment leads to meaningful changes for clients, which will ultimately lead to improvements in existing treatments, it is essential that research examines multiple aspects of change with a focus on how these various change agents interact to produce clinically significant change. Therefore, the overall goal of this research projects is to test aspects of a multidimensional model of change within cognitive behavioral therapy for social anxiety disorder. Specifically, this research aims to examine the role and interaction of two proposed mechanisms of change (decentering and emotional processing) longitudinally across the course of Cognitive Behavioral Group Therapy (CBGT) for social anxiety disorder. The study aims to examine the extent to which decentering, or the ability to observe thoughts and feelings as objective events in the mind, increases over the course of CBGT and whether this increase In decentering is related in decreases in symptoms of anxiety and increases in quality of life. Futher, this study will examine the interaction between decentering and emotional processing and whether it is a combination of these mechanisms that leads to the lowest levels of anxiety and highest levels of quality of life at the end of therapy. The results of this study will serve as a preliminary test of a multidimensional model of change that proposes that it is a combination of these factors that leads to therapeutic change. This preliminary test of the multidimensional model of change will help determine the direction df future investigations into therapeutic change mechanisms and intervention development for the treatment of anxiety disorders.

Public Health Relevance

This work has the potential to Inform current treatment practice to maximize the therapeutic benefit for clients with social anxiety disorder. If the hypotheses are supported than strategies to promote decentering and emotional processing, would likely lead to improved clinical outcomes. This may ultimately reduce the number of sessions needed to treat this disorder by maximizing the effectiveness of treatment components.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Transition Award (R00)
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Special Emphasis Panel (NSS)
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Chavez, Mark
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University of Massachusetts Boston
Schools of Arts and Sciences
United States
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Hayes-Skelton, Sarah A; Lee, Carol S (2018) Changes in Decentering Across Cognitive Behavioral Group Therapy for Social Anxiety Disorder. Behav Ther 49:809-822
Hayes-Skelton, Sarah A; Calloway, Amber; Roemer, Lizabeth et al. (2015) Decentering as a potential common mechanism across two therapies for generalized anxiety disorder. J Consult Clin Psychol 83:395-404
Paulus, Daniel J; Wadsworth, Lauren Page; Hayes-Skelton, Sarah A (2015) Mental Health Literacy for Anxiety Disorders: How perceptions of symptom severity might relate to recognition of psychological distress. J Public Ment Health 14:94-106
Hayes-Skelton, Sarah A; Roemer, Lizabeth; Orsillo, Susan M et al. (2013) A contemporary view of applied relaxation for generalized anxiety disorder. Cogn Behav Ther 42:292-302
Hayes-Skelton, Sarah A; Roemer, Lizabeth; Orsillo, Susan M (2013) A randomized clinical trial comparing an acceptance-based behavior therapy to applied relaxation for generalized anxiety disorder. J Consult Clin Psychol 81:761-73
Hayes-Skelton, Sarah; Graham, Jessica (2013) Decentering as a common link among mindfulness, cognitive reappraisal, and social anxiety. Behav Cogn Psychother 41:317-28
Graham, Jessica R; Sorenson, Shannon; Hayes-Skelton, Sarah A (2013) Enhancing the Cultural Sensitivity of Cognitive Behavioral Interventions for Anxiety in Diverse Populations. Behav Ther (N Y N Y) 36:101-108
Hayes-Skelton, Sarah A; Usmani, Aisha; Lee, Jonathan K et al. (2012) A Fresh Look at Potential Mechanisms of Change in Applied Relaxation for Generalized Anxiety Disorder: A Case Series. Cogn Behav Pract 19:451-462