CBT for Social Anxiety Disorder Delivered by School Counselors

Study Overview
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Brief Summary
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This 5-year study addresses the unmet needs of adolescents with social phobia through the testing of a 12-week cognitive-behavioral, school-based group intervention delivered by trained school counselors compared to a nonspecific school counseling program. A secondary goal is to provide further examination of the efficacy of the CBT program delivered by school counselors as compared to the same program delivered by psychologists.

Detailed Description
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The investigators have tested SASS, a school-based group CBT intervention for social phobia, and found it to be effective when delivered by psychologists (Masia Warner et al., 2005; Masia Warner et al., 2007). The proposed dissemination study extends this work through a controlled trial of SASS delivered by school counselors. The investigators will randomize 126 adolescents with social anxiety disorder, ages 14 through 17, to one of 3 treatments: 1) SASS delivered by school counselors (SC-SASS), 2) SASS delivered by psychologists (Expert-SASS), or 3) a manualized adolescent group counseling program specifically designed for school counselors, called Skills for Living (SFL). A comprehensive evaluation will include diagnosis, illness severity, scale ratings of social anxiety and depression, clinical global improvement, overall functioning, and school-relevant indices of function. Outcomes will be assessed at baseline, mid-point (after 6 weeks of intervention), post-treatment, and 6 months following intervention completion.

Official Title
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CBT for Social Anxiety Disorder Delivered by School Counselors

Conditions
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Social Anxiety Disorder

Intervention / Treatment
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* Behavioral: Skills for Academic and Social Success
* Behavioral: Skills for Life


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis. DSM-IV primary diagnosis (most severe) of social anxiety disorder (as determined by the ADIS-PC) Age and Sex. Boys and Girls, 14 through 19 years Grade. 9th, 10th, 11th, or 12th English speaking. Adolescent Exclusion Criteria: Current diagnosis of substance use or conduct disorder Concurrent mental disorder of greater severity than social anxiety disorder Current psychotic symptoms Current suicidal ideation Pervasive developmental disorder, or a significant medical disorder (e.g., substantially impairs functioning, school attendance, or the ability to engage in treatment) Current psychological or pharmacological treatment

Ages Eligible for Study
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Minimum Age: 14 Years
Maximum Age: 17 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: Factorial Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Expert-led CBT<br>Expert SASS is the Skills for Academic and Social Success protocol delivered by a postdoctoral fellows. | Behavioral: Skills for Academic and Social Success<br>* 12-week cognitive-behavioral, school-based group intervention<br>|
| Experimental: School Counselor-led CBT<br>School Counselor SASS is the Skills for Academic and Social Success protocol delivered by School Counselors. Intervention: Behavioral: Skills for Social and Academic Success | Behavioral: Skills for Academic and Social Success<br>* 12-week cognitive-behavioral, school-based group intervention<br>|
| Active Comparator: Skills for Life<br>SFL is the Skills for Life Protocol delivered by school counselors. Intervention: Behavioral: Skills for Life | Behavioral: Skills for Life<br>* SFL is the Skills for Life Protocol delivered by school counselors.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Diagnostic severity of social anxiety disorder (ADIS CSR score) | ADIS CSR Ratings are taken at baseline, immediately following treatment, and at a 6-month followup. | 2 week and 6-month follow-up | 
| Change in Treatment response/non-response (a CGI-I of Improved or better, ratings of 1-3, 3 = Improved) | CGI-I assesses improvement from baseline immediately following treatment and at a 6-month followup assessment. | 2 week and 6-month follow-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Diagnostic status: presence or absence of social anxiety disorder |  | 2 week and 6-month follow-up | 
| Change in Overall and school functioning: spare-time, peer relations, home life, school attendance, grades, and LSAS-CA school items total score |  | 2 week and 6-month follow-up | 
| Change in Adolescent and parent ratings of social anxiety scale scores (self and parent SPAI-C), and adolescent ratings of depression (BDI-II) |  | 2 week and 6-month follow-up |