Social Anxiety Disorder (SAD) is widely recognized as one of the most common anxiety disorders, impacting approximately 12% of the population. This disorder is marked by excessive fear of how individuals are perceived in social situations, often perpetuated by self-focused attention and negative self-image according to Clark and Wells’ influential model. Cognitive Therapy for SAD (CT-SAD) is the standard frontline treatment in the NHS, combining cognitive behavioral therapy principles to challenge negative self-perceptions over a 14-week course that includes behavioral experiments.
As healthcare transitions towards digitization, an internet-based version of CT-SAD (iCT-SAD) has been developed to allow for remote treatment, requiring less therapist guidance and time. However, the effectiveness of in-person therapist interactions versus remote treatments like iCT-SAD, particularly in the context of behavioral experiments such as video feedback, remains a topic of debate.
Wild and colleagues conducted studies comparing the effects of CT-SAD and iCT-SAD, analyzing video feedback data from two separate trials in the UK and Hong Kong. Results showed that both interventions resulted in significant improvements in self-perception of anxiety, occurrence of feared beliefs, LSAS anxiety ratings, and overall performance. While CT-SAD showed slightly greater improvement in self-ratings, both methods demonstrated promising results, with most patients experiencing positive outcomes.
These findings suggest that video feedback within iCT-SAD can effectively challenge and reduce negative self-perceptions associated with SAD. The results were consistent across the UK and Hong Kong studies, indicating the potential cross-cultural efficacy of this intervention. However, limitations in controlling for therapist guidance, data collection timing, and long-term effects emphasize the need for further research.
The strengths of this study lie in its contribution to understanding specific elements of SAD treatment, providing valuable insights for clinical application. The use of self-report questionnaires allowed for quantitative analysis of self-perception outcomes, supporting the effectiveness of video feedback in reducing social anxiety. This research has implications for the future development of remote interventions for SAD, highlighting the potential benefits and considerations for utilizing video feedback in digital formats.
