Cognitive behaviour therapy for social anxiety disorder: a systematic review and meta-analysis investigating different treatment formats

Abstract

Objective: Cognitive behaviour therapy (CBT) for social anxiety disorder (SAD) can be delivered through several modalities, including individually-administered CBT (ICBT), group-based CBT (GCBT), and CBT delivered remotely (RCBT). We synthesised the current literature on ICBT, GCBT, and RCBT approaches in adults with SAD, and compared their relative effectiveness using a meta-analytic approach. Method: This review included randomised controlled trials comparing a disorder specific CBT monotherapy (ICBT, GCBT, or RCBT) to a non-active control group in adults with diagnosed SAD. Eligible studies were searched through PsycINFO, Scopus, and EMBASE databases to April 2023. A total of 37 studies met the inclusion criteria (with 55 between-group comparisons; N = 3234). Between-group effect sizes were conducted using random effects models. Results: Analyses indicated that RCBT (k = 23; g = 0.90; 95% CI = 0.74–1.06) and ICBT (k = 17; g = 0.95; 95% CI = 0.66–1.23) demonstrated large effects, while GCBT demonstrated medium effects (k = 15; g = 0.71; 95% CI = 0.49–0.94). The groups, however, did not differ significantly (Q2 = 2.17, p >.05). Conclusions: This study builds on the existing literature demonstrating the efficacy of these treatment approaches.