Examining two of the ingredients of Cognitive therapy for adolescent social anxiety disorder: Back-translation from a treatment trial
Year: 2025
Type: article
Abstract: Cognitive Therapy for Social Anxiety Disorder (CT-SAD) based on the Clark & Wells model is a complex intervention comprised of a series of therapeutic elements. Two of the key ingredients are the self-focused attention and safety behaviour experiment and video feedback . The present study examined the effects of these two therapeutic procedures in adolescents with SAD, as well as common themes of the young people's social fears and negative self-images. 35 participants with a diagnosis of SAD completed internet-delivered CT-SAD as part of a randomised controlled trial. We conducted a series of paired samples t-tests to evaluate the effects of the self-focused attention and safety behaviour experiment and video feedback . We applied Latent Dirichlet Allocation to identify latent topics based on participants' description of their social fears and negative self-images that were elicited during the course of these therapy procedures. Participants reported lower anxiety and more positive self-appraisals when focusing externally and dropping safety behaviours, compared to when focusing internally and using safety behaviours ( ps < 0.0025). After they watched the videos compared to before, they reported more positive appraisals of their appearance and performance ( ps < 0.0025). The differences in these outcomes were significantly larger when they focused internally and used safety behaviours, compared to focusing externally and dropping safety behaviours ( ps < 0.0025). Topic modelling identified six social fear topics and five negative self-image topics. Self-focused attention, safety behaviours, and negative self-imagery are modifiable with the ‘self-focused attention and safety behaviour experiment’ and ‘video feedback’ as part of internet delivered CT-SAD. • Self-focused attention and safety behaviour experiment and video feedback are two key procedures in CT-SAD. • We examined effects of these procedures on anxiety and self-perceptions in youth receiving an online version of CT-SAD. • Both procedures were associated with large effects on anxiety and self-appraisals, pointing to their value in therapy. • Common themes in social fears were worries about verbal communication and in negative self-images were about eye contact.
Authors: Eleanor Leigh, David Clark, Kenny Chiu
Institutions: University of Oxford, University of East Anglia
Language: English
Subfield: Experimental and Cognitive Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: hybrid
Estimated APC paid: $3,140
OpenAlex ID: W4407603112