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Guided and unguided self-help for social anxiety disorder: randomised controlled trial

  • Tomas Furmark (a1), Per Carlbring (a2), Erik Hedman (a3), Annika Sonnenstein (a1), Peder Clevberger (a1), Benjamin Bohman (a1), Anneli Eriksson (a1), Agneta Hållén (a1), Mandus Frykman (a1), Annelie Holmström (a1), Elisabeth Sparthan (a1), Maria Tillfors (a4), Elisabeth Nilsson Ihrfelt (a1), Maria Spak (a1), Anna Eriksson (a1), Lisa Ekselius (a5) and Gerhard Andersson (a6)...
Abstract
Background

Internet-delivered self-help programmes with added therapist guidance have shown efficacy in social anxiety disorder, but unguided self-help has been insufficiently studied.

Aims

To evaluate the efficacy of guided and unguided self-help for social anxiety disorder.

Method

Participants followed a cognitive–behavioural self-help programme in the form of either pure bibliotherapy or an internet-based treatment with therapist guidance and online group discussions. A subsequent trial was conducted to evaluate treatment specificity. Participants (n = 235) were randomised to one of three conditions in the first trial, or one of four conditions in the second.

Results

Pure bibliotherapy and the internet-based treatment were better than waiting list on measures of social anxiety, general anxiety, depression and quality of life. The internet-based therapy had the highest effect sizes, but directly comparable effects were noted for bibliotherapy augmented with online group discussions. Gains were well maintained a year later.

Conclusions

Unguided self-help through bibliotherapy can produce enduring improvement for individuals with social anxiety disorder.

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Copyright
Corresponding author
Dr Tomas Furmark, Department of Psychology, Uppsala University, Box 1225, SE–751 42 Uppsala, Sweden. Email: tomas.furmark@psyk.uu.se
Footnotes
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Declaration of interest

T.F., A.H., E.S., P.Ca. and G.A. receive royalties for authoring the self-help book used for bibliotherapy.

Footnotes
References
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Guided and unguided self-help for social anxiety disorder: randomised controlled trial

  • Tomas Furmark (a1), Per Carlbring (a2), Erik Hedman (a3), Annika Sonnenstein (a1), Peder Clevberger (a1), Benjamin Bohman (a1), Anneli Eriksson (a1), Agneta Hållén (a1), Mandus Frykman (a1), Annelie Holmström (a1), Elisabeth Sparthan (a1), Maria Tillfors (a4), Elisabeth Nilsson Ihrfelt (a1), Maria Spak (a1), Anna Eriksson (a1), Lisa Ekselius (a5) and Gerhard Andersson (a6)...
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