A Systems Level Intervention for Unemployed Persons With Social Anxiety Disorder
Condition: Social Anxiety Disorder
MeSH terms: Anxiety Disorders; Phobia, Social
Study type: Interventional
Phase: Phase 2/Phase 3

Summary: 
      The goal of the proposed research is to design and develop a culturally appropriate,
      vocationally focused, sustainable, cognitive-behavioral intervention for unemployed,
      economically disadvantaged, urban-dwelling persons whose job attainment efforts have been
      undermined by the presence of social anxiety disorder.
    

Detailed description: 
      The goal of the proposed research is to gather information from Jewish Vocational Service
      consumers and employees about the association between social anxiety disorder and
      unemployment. A recent nationally representative epidemiological study places the lifetime
      prevalence of DSM-IV SocAD at 12.1% (Kessler et al., 2005). Social anxiety disorder is
      associated with notable impairments in social functioning (Kessler, 2003; Stein and Kean,
      2000). A large majority of people with social anxiety disorder report significant impairment
      in occupational functioning (Stein, et al., 2000; Turner et al., 1986). Specific impairments
      include turning down job offers and promotions (Stein, Torgrud, & Walker, 2000), reduced
      productivity and job performance (Wittchen, et al., 2000), lowered educational attainment &
      early school dropout (Stein & Kean, 2000), increased unemployment (Heimberg et al.,1990a),
      financial dependence (Scheier et al, 1992), and reduced income (Magee et al., 1996). Social
      anxiety disorder likely interferes with job attainment due to job interview avoidance,
      excessive anxious arousal during job interviews, and limited social networks to provide job
      leads. Our longitudinal study of mothers receiving welfare found that the diagnosis of social
      anxiety disorder was the strongest psychiatric predictor of reliance on welfare for support
      over time. We have also completed a study that identifies social anxiety disorder as the only
      psychiatric disorder that significantly interferes with attaining work among individuals who
      participated in an internationally tested, best-practice, vocational services intervention
      program. We have begun to screen individuals for the presence of social anxiety at Jewish
      Vocational Service in Detroit, Michigan, where the primary clientele are economically
      disadvantaged, African Americans who are seeking work. Our screening efforts confirm the
      association between suspected social anxiety disorder and unemployment in this population.
      This project will build upon these findings and will interview JVS consumers and employees to
      gain more insight and knowledge into the relationship between social anxiety disorder and
      unemployment. It will also inform future research on the design and development of a
      culturally appropriate, vocationally focused, sustainable, cognitive-behavioral intervention
      for unemployed, economically disadvantaged, urban-dwelling persons whose job attainment
      efforts have been undermined by the presence of social anxiety disorder.
    

Intervention name(s): Cognitive Behavioral Therapy Group; Vocational Services as Usual
Intervention type(s): Behavioral; Other
Intervention description(s): This is a cognitive behavioral therapy group designed for homeless, unemployed people utelizing vocational rehabilitation services. The group is administered on a bi-weekly basis for four weeks, totalling eight sessions.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment