Study of an Internet-delivered Treatment Based on Experiential Dynamic Psychotherapy for Social Anxiety Disorder

Study Overview
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Brief Summary
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The aim of this randomized, controlled study is to examine an internet delivered, self-help program for social anxiety based on psychodynamic therapy. The study will compare three conditions: the psychodynamic program with therapist support, without therapist support and a waitlist control.

Official Title
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Study of an Internet-delivered Treatment Based on Experiential Dynamic Psychotherapy for Social Anxiety Disorder

Conditions
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Social Anxiety Disorder

Intervention / Treatment
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* Behavioral: Experimental: Internet delivered self-help program with therapist support
* Behavioral: Internet delivered self-help program without therapist support


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 years old or older Fulfill the DSM-5 criteria for social anxiety disorder (Score > 60 on the self-assessment instrument LSAS-SR) Have access to a computer/smartphone/tablet with internet connection Be able to read and write Swedish. Exclusion Criteria: Suicidal (within the previous month, assessed with the self-assessment instrument C-SSRS) Partaking in psychological treatment Ongoing treatment with psychopharmacological drugs with dose adjustments within the nearest month or planned dose adjustments. The following self-reported diagnoses are excluded: Autism spectrum disorder Serious depression (Score ≥ 20 on the PHQ9) Indications of psychosis or bipolar disorder (type 1 or 2).

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Internet delivered self-help program with therapist support<br>The intervention consists of 8 therapist-supported self-help modules delivered over 8 weeks on a secure online platform. Modules consist of texts and video followed by exercises which they send to their therapist and receive feedback within a few days. The treatment is based on principles from affect-focused psychodynamic psychotherapy. | Behavioral: Experimental: Internet delivered self-help program with therapist support<br>* During 8 weeks of treatment participants are taught how emotional conflicts may underlie and perpetuate symptoms of social anxiety. They are also taught how to observe their own anxiety and emotional avoidance (i.e. defenses) and how to gradually approach previously warded off feelings. The final part of the program contains material on how one may express previously warded off emotions to improve important relationships. The treatment program consists of text, videos and a series of experiential exercises which a therapist gives feedback on.<br>|
| Active Comparator: Internet delivered self-help program without therapist support<br>The intervention consists of 8 self-help modules delivered over 8 weeks on a secure online platform. Modules consist of texts and video followed by exercises which the participants are encouraged to try. The treatment is based on principles from affect-focused psychodynamic psychotherapy. | Behavioral: Internet delivered self-help program without therapist support<br>* During 8 weeks of treatment participants are taught how emotional conflicts may underlie and perpetuate symptoms of social anxiety. They are also taught how to observe their own anxiety and emotional avoidance (i.e. defenses) and how to gradually approach previously warded off feelings. The final part of the program contains material on how one may express previously warded off emotions to improve important relationships. The treatment program consists of text, videos and a series of experiential exercises.<br>|
| No Intervention: Waitlist<br>Participants will receive no intervention for 8 weeks. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Liebowitz Social Anxiety Scale, Self-Report, (LSAS-SR) | The LSAS-SR features 48 items assessing social anxiety symptoms. | Change from baseline to post-treatment (8 week) and follow up (6, 12 and 24 months after treatment) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Generalised Anxiety Disorder 7- item scale (GAD-7) | The GAD-7 features seven items for assessing anxiety and screening for generalized anxiety disorder. | Change from baseline to post-treatment (8 week) and follow up (6, 12 and 24 months after treatment) | 
| Patient Health Questionnaire 9-item scale (PHQ-9) | The PHQ-9 features nine items for assessing depression in a clinical context and screening of depression in the general population | Change from baseline to post-treatment (8 week) and follow up (6, 12 and 24 months after treatment) | 
| Brunnsviken Brief Quality of Life Scale (BBQ) | The BBQ features 12 items concerning 6 areas of life rated on importance and satisfaction. | Change from baseline to post-treatment (8 week) and follow up (6, 12 and 24 months after treatment) |