ABSTRACT
There are many barriers to the delivery of evidence-based treatment, including geographical location, cost, and stigma. Self-help may address some of these factors but there is a paucity of research on the efficacy of self-help for many problems, including social anxiety. The present research evaluated the efficacy of a mindfulness and acceptance-based self-help approach for the treatment of social anxiety. Individuals seeking help for social anxiety or shyness were recruited from the community. Participants (N = 117) were randomly assigned to a book (n = 58) or wait-list control condition (n = 59) on a 1:1 ratio. Hierarchical linear modelling results supported the efficacy of the self-help condition with between-group effect sizes on social anxiety outcomes ranging from .74 to .79. Significant change was also observed on self-compassion, mindfulness, acceptance, and depression. Some variables, including social anxiety and acceptance, were assessed weekly for those in the book condition. Additional participants (n = 35) were recruited for the book condition increasing the sample size to 93 for the latent change score modelling analyses. A unidirectional model was supported: increases in acceptance were associated with subsequent decreases in social anxiety. Overall these results support the use of a mindfulness and acceptance-based self-help approach for social anxiety.
Subject(s)
Anxiety/therapy , Mindfulness , Adult , Depression/therapy , Empathy , Female , Health Behavior , Humans , Male , Treatment OutcomeABSTRACT
BACKGROUND: Self-focused attention (SFA) and safety behaviors are two variables implicated in the maintenance of social anxiety disorder (SAD). DESIGN: The present study examined SFA and safety behaviors across two therapies for SAD, cognitive behavioral group therapy (CBGT) and mindfulness and acceptance-based group therapy (MAGT). METHOD: Participants with symptoms meeting criteria for SAD (N = 137) were randomly assigned to the 12-week-treatment groups (n = 53 for each condition) or a waitlist control (n = 31). Variables were assessed at baseline, midtreatment, posttreatment, and a 3-month follow-up. RESULTS: Both treatment conditions reported significantly lower SFA and safety behaviors compared to control, but did not differ from one another at posttreatment. Mediation analyses supported the following models: (1) safety behaviors mediating the relationship between SFA and social anxiety, and (2) SFA mediating the relationship between safety behaviors and social anxiety. These models were supported for both treatment groups. CONCLUSIONS: Both treatments may have the potential to reduce the SFA and safety behaviors that serve to maintain SAD.
Subject(s)
Attention , Cognitive Behavioral Therapy/methods , Phobia, Social/therapy , Psychotherapy, Group/methods , Self Concept , Social Behavior , Acceptance and Commitment Therapy/methods , Adolescent , Adult , Canada , Female , Follow-Up Studies , Humans , Male , Middle Aged , Mindfulness/methods , Phobia, Social/psychology , Treatment Outcome , Young AdultABSTRACT
The present study investigated mechanisms of change for two group treatments for social anxiety disorder (SAD): cognitive behavioral group therapy (CBGT) and mindfulness and acceptance-based group therapy (MAGT). Participants were treatment completers (n = 37 for MAGT, n = 32 for CBGT) from a randomized clinical trial. Cognitive reappraisal was the hypothesized mechanism of change for CBGT. Mindfulness and acceptance were hypothesized mechanisms of change for MAGT. Latent difference score (LDS) analysis results demonstrate that cognitive reappraisal coupling (in which cognitive reappraisal is negatively associated with the subsequent rate of change in social anxiety) had a greater impact on social anxiety for CBGT than MAGT. The LDS bidirectional mindfulness model (mindfulness predicts subsequent change in social anxiety; social anxiety predicts subsequent change in mindfulness) was supported for both treatments. Results for acceptance were less clear. Cognitive reappraisal may be a more important mechanism of change for CBGT than MAGT, whereas mindfulness may be an important mechanism of change for both treatments.
Subject(s)
Acceptance and Commitment Therapy/methods , Anxiety/therapy , Cognitive Behavioral Therapy/methods , Mindfulness/methods , Models, Psychological , Phobic Disorders/therapy , Psychotherapy, Group/methods , Adult , Anxiety/psychology , Cognition/physiology , Female , Humans , Male , Phobic Disorders/psychology , Treatment OutcomeABSTRACT
UNLABELLED: Recent research has supported the use of mindfulness and acceptance-based interventions for Social Anxiety Disorder (SAD). OBJECTIVE: The purpose of the present study was to compare mindfulness and acceptance-based group therapy (MAGT) with cognitive behavioral group therapy (CBGT) with respect to outcome. It was hypothesized that MAGT and CBGT would both be superior to a control group but not significantly different from one another. METHOD: Individuals (N = 137, mean age = 34 years, 54% female, 62% White, 20% Asian) diagnosed with SAD were randomly assigned to MAGT (n = 53), CBGT (n = 53) or a waitlist control group (n = 31). The primary outcome was social anxiety symptom severity assessed at baseline, treatment midpoint, treatment completion, and 3-month follow-up. Secondary outcomes were cognitive reappraisal, mindfulness, acceptance, and rumination. Depression, valued living, and group cohesion were also assessed. RESULTS: As hypothesized, MAGT and CBGT were both more effective than the control group but not significantly different from one another on social anxiety reduction and most other variables assessed. CONCLUSIONS: The present research provides additional support for the use of mindfulness and acceptance-based treatments for SAD, and future research should examine the processes by which these treatments lead to change.