In a recent article (Effectiveness of Internet-based Cognitive-Behavior Therapy for Social Anxiety Disorder in Clinical Psychiatry – http://dx.doi.org/10.1037/a0039198), the authors reported the results of a study on the effectiveness of the Cognitive Behavioral Cognitive Therapy Protocol via Internet (Internet Cognitive Behavoral Therapy – ICBT) for the treatment of social anxiety disorder in patients belonging to psychiatry services.
As known, the social phobia It is a very common and highly disabling disorder; It tends to a chronic course and often represents the cause of depressive disorders and pathological addictions.
There Cognitive behavioral therapyalbeit with some shadow, has long demonstrated its effectiveness in the treatment of this disabling disorder. This has led to develop several protocols, including the one subject to study of this article.
The purpose of the study was to investigate the effectiveness of the ICBT in dealing with the social phobia in a group of patients who are related to the psychiatry service. A second goal was to evaluate whether the adherence to the treatment was associated with a symptomatological improvement; Finally, given the longitudinal nature of the study, to see if the increase in the experience of therapists in this protocol produced an improvement in the results.
This study involved a sample of 654 patients relating to the national psychiatric service. The inclusion criteria were satisfying the criteria of the DSM IV, do not undertake other types of therapy during the trial, take on any drug therapy, if present, in a stable way for at least four weeks, know how to read and write, have an age over 16 years, have access to a computer, do not present other psychiatric problems. Several questionnaires were administered to the patients, including the Liebowitz Social Anxiety Self Report.
The basic principle of ICBT is that the protocol, based on the Clark and Wells model, does not de facto de facto from a vis á vis therapy. Over the years (this study began in 2009 and finished in 2013), the number of sessions has gone from 15 to 12 but without substantially modifying the intervention.
As supposed, the basic principles of the treatment were the psychoeducationthe cognitive renovation and theexposure in vivo gradual. Patients were provided materials and working sheets via the Internet. In the average, each patient sent 14.84 messages to the therapist, who on average replied with 15.33 messages.
The results show that ICBT is effective in reducing i Social phobic symptoms both at the end of the trial and at the follow -up at 6 months.
One of the most important clinical implications of this study is that ICBT seems to have an effectiveness similar to that of the standard CBT and, therefore, given the difficulty of accessing patients with social phobia to treatment, this protocol could prove advantageous. In conclusion, however, it is also necessary to underline several weaknesses of the study, such as the absence of a control group.
These are clearly experiences of the Anglo-Saxon world, and in Italy we are still far from applying this type of interventions. One wonders, however, if all this skepticism has a sense of existing, given the increasingly overwhelming results that report the trials of effectiveness of Internet-based therapy.
