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Imagery-based CBT for Social Anxiety Disorder: Piloting a Treatment Augmentation Protocol

NCT ID: NCT02659436

Last Updated: 2016-12-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

9 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-01-31

Study Completion Date

2016-12-31

Brief Summary

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The purpose of this pilot study is to explore whether there is a differential impact of verbal versus imagery-based cognitive behavioural therapy (CBT) as a treatment augmentation strategy for individuals with social anxiety disorder (SAD). Clients who have not demonstrated clinically significant change following group CBT for SAD will receive four additional sessions of either verbal-based CBT or imagery-based CBT. We hypothesize that that individuals who receive imagery-based CBT will experience even stronger improvements and be more satisfied with their treatment than individuals who received traditional verbal-linguistic CBT.

Detailed Description

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Social Anxiety Disorder (SAD) is a debilitating disorder, marked by significant functional impairment and high personal distress for those who suffer. Psychological treatment for SAD has traditionally been verbal-linguistic cognitive behavioural therapy (CBT). However, a significant number of individuals who complete CBT for SAD do not achieve full response and continue to struggle with significant residual symptoms. One innovation that has received attention recently in the literature is using imagery-based CBT as a way to augment treatment outcome in SAD. Results from a pilot and benchmarking study suggest that participants who received imagery-based CBT were more likely to complete treatment than those who received traditional CBT and treatment outcome was strong for both groups, but stronger in the imagery-based CBT group.

However, before re-training hundreds of practitioners in using a completely novel treatment approach, it is important to see if a brief augmentation of traditional CBT programs is effective in producing further change for individuals with residual symptoms after group CBT. It is possible that individuals just require a few more sessions of the same verbal-linguistic CBT to consolidate treatment gains or work on lingering triggers of anxiety. It is also possible that more of the same is not as valuable as offering therapy using a different modality, such as imagery. Therefore, we propose to evaluate a brief imagery-based augmentation of traditional group CBT to explore its effects on further symptom reduction.

Conditions

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Social Anxiety Disorder

Keywords

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Cognitive Behavioural Therapy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Verbal-linguistic CBT

Participants will receive 4 sessions of verbal cognitive restructuring and exposure therapy delivered in an individual therapy format.

Group Type ACTIVE_COMPARATOR

Verbal-linguistic CBT

Intervention Type OTHER

Participants will receive 4 sessions of individual therapy focused on traditional cognitive restructuring and exposure therapy.

Imagery-based CBT

Participants will receive 4 sessions of imagery-based cognitive work and behavioural experiments delivered in an individual therapy format.

Group Type EXPERIMENTAL

Imagery-based CBT

Intervention Type OTHER

Participants will receive 4 sessions of individual therapy focused on imagery-based cognitive work and behavioural experiments.

Interventions

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Verbal-linguistic CBT

Participants will receive 4 sessions of individual therapy focused on traditional cognitive restructuring and exposure therapy.

Intervention Type OTHER

Imagery-based CBT

Participants will receive 4 sessions of individual therapy focused on imagery-based cognitive work and behavioural experiments.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Completed eight out of twelve sessions of standard verbal-linguistic group cognitive behavioural therapy for social anxiety disorder
* Presented with a Social Phobia Inventory (SPIN) score of greater than 19 post-treatment
* Interested in further treatment

Exclusion Criteria

* Has another mental health concern of greater importance than social anxiety disorder
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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St. Joseph's Healthcare Hamilton

OTHER

Sponsor Role lead

Responsible Party

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Karen Rowa

Associate Professor and Psychologist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Karen Rowa, Ph. D

Role: PRINCIPAL_INVESTIGATOR

St. Joseph's Healthcare Hamilton

References

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American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th edition). Washington, DC: APA.

Reference Type BACKGROUND

Antony MM, Roth D, Swinson RP, Huta V, Devins GM. Illness intrusiveness in individuals with panic disorder, obsessive-compulsive disorder, or social phobia. J Nerv Ment Dis. 1998 May;186(5):311-5. doi: 10.1097/00005053-199805000-00008.

Reference Type BACKGROUND
PMID: 9612449 (View on PubMed)

Bieling, P.J., Rowa, K., Antony, M.M., Summerfeldt, L.J., & Swinson, R.P. (2001). Factor structure of the Illness Intrusiveness Ratings Scale in patients diagnosed with anxiety disorders. Journal of Psychopathology and Behavioral Assessment, 23, 223-230. doi: 10.1023/A:1012723318964

Reference Type BACKGROUND

Carleton RN, Collimore KC, Asmundson GJ. Social anxiety and fear of negative evaluation: construct validity of the BFNE-II. J Anxiety Disord. 2007;21(1):131-41. doi: 10.1016/j.janxdis.2006.03.010. Epub 2006 May 3.

Reference Type BACKGROUND
PMID: 16675196 (View on PubMed)

Devins GM. Illness intrusiveness and the psychosocial impact of lifestyle disruptions in chronic life-threatening disease. Adv Ren Replace Ther. 1994 Oct;1(3):251-63. doi: 10.1016/s1073-4449(12)80007-0.

Reference Type BACKGROUND
PMID: 7614328 (View on PubMed)

Devins GM, Dion R, Pelletier LG, Shapiro CM, Abbey S, Raiz LR, Binik YM, McGowan P, Kutner NG, Beanlands H, Edworthy SM. Structure of lifestyle disruptions in chronic disease: a confirmatory factor analysis of the Illness Intrusiveness Ratings Scale. Med Care. 2001 Oct;39(10):1097-104. doi: 10.1097/00005650-200110000-00007.

Reference Type BACKGROUND
PMID: 11567172 (View on PubMed)

Hackmann A, Clark DM, McManus F. Recurrent images and early memories in social phobia. Behav Res Ther. 2000 Jun;38(6):601-10. doi: 10.1016/s0005-7967(99)00161-8.

Reference Type BACKGROUND
PMID: 10846808 (View on PubMed)

Hirsch CR, Clark DM, Mathews A, Williams R. Self-images play a causal role in social phobia. Behav Res Ther. 2003 Aug;41(8):909-21. doi: 10.1016/s0005-7967(02)00103-1.

Reference Type BACKGROUND
PMID: 12880646 (View on PubMed)

Holmes EA, Lang TJ, Shah DM. Developing interpretation bias modification as a "cognitive vaccine" for depressed mood: imagining positive events makes you feel better than thinking about them verbally. J Abnorm Psychol. 2009 Feb;118(1):76-88. doi: 10.1037/a0012590.

Reference Type BACKGROUND
PMID: 19222316 (View on PubMed)

Leary, M. R. (1983). A brief version of the Fear of Negative Evaluation Scale. Personality and Social Psychology Bulletin, 9, 371-376. doi: 10.1177/0146167283093007

Reference Type BACKGROUND

McEvoy PM, Saulsman LM. Imagery-enhanced cognitive behavioural group therapy for social anxiety disorder: a pilot study. Behav Res Ther. 2014 Apr;55:1-6. doi: 10.1016/j.brat.2014.01.006. Epub 2014 Feb 7.

Reference Type BACKGROUND
PMID: 24561919 (View on PubMed)

McEvoy PM, Erceg-Hurn DM, Saulsman LM, Thibodeau MA. Imagery enhancements increase the effectiveness of cognitive behavioural group therapy for social anxiety disorder: a benchmarking study. Behav Res Ther. 2015 Feb;65:42-51. doi: 10.1016/j.brat.2014.12.011. Epub 2014 Dec 27.

Reference Type BACKGROUND
PMID: 25569339 (View on PubMed)

Moscovitch DA, Gavric DL, Merrifield C, Bielak T, Moscovitch M. Retrieval properties of negative vs. positive mental images and autobiographical memories in social anxiety: outcomes with a new measure. Behav Res Ther. 2011 Aug;49(8):505-17. doi: 10.1016/j.brat.2011.05.009. Epub 2011 May 26.

Reference Type BACKGROUND
PMID: 21683343 (View on PubMed)

Other Identifiers

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0986

Identifier Type: -

Identifier Source: org_study_id