The effectiveness of cognitive behavioural therapy for social anxiety disorder in routine clinical practice.

Numerous randomized controlled trials have shown cognitive behaviour therapy (CBT) to be effective in treating social anxiety disorder (SAD). Yet, less is known about the effectiveness of CBT for SAD conducted by psychotherapists in training in routine clinical practice. In this study, 231 patients with SAD were treated with CBT under routine conditions and were examined at pre- and post-treatment as well as at 6 and 12 months follow-up. We applied self-reports to assess symptoms of SAD (defined as primary outcome), depression and psychological distress (defined as secondary outcome). We conducted both completer and intent-to-treat analyses and also assessed the reliability of change with the reliable change index. Results revealed significant reductions in symptoms of SAD between pre- and post-assessments, with effect sizes ranging from d = 0.9 to 1.2. Depending on the SAD specific questionnaire applied, 47.8% to 73.5% of the sample showed a reliable positive change, whereas 1.9% to 3.8% showed a reliable negative change. Depressive symptoms and psychological distress also decreased significantly from pre- to post-assessment, with large effect sizes. Significant treatment gains regarding both primary and secondary outcomes were further observed at 6 and 12 months follow-up. The current findings based on a large sample of patients suggest that psychotherapists in CBT training working under routine conditions can effectively treat symptoms of SAD, depression and psychological distress.

Introduction and evaluation of a clinical compulsory elective course on domestic violence.

Goal: Knowledge about domestic violence (DV) in medicine is often lacking, even though health professionals are often the first point of contact for victims of DV. A clinical compulsory elective course for medical students on DV was introduced to increase competences and knowledge on DV. The course is based on the didactic concept of the IMPRODOVA training platform [https://training.improdova.eu/en/] and was first piloted at the Medical School at the University of Muenster in summer 2020. The course was evaluated to assess whether it is suitable to increase knowledge and competences on DV. Accordingly, the following research questions were assessed: What competences and knowledge do students have about DV in general and how do students' competences and knowledge about DV change after participating in the course? Methods: Knowledge assessment on DV in general was based on two surveys conducted at the German universities of Muenster and Luebeck in 2020 and 2021. 54 medical students from Muenster (n=37) and Luebeck (n=17) participated. Muenster medical students were asked to complete a questionnaire within a two-week time period prior participation in the clinical compulsory elective course on DV. Luebeck medical students who had registered for a workshop on DV participated in the same survey prior to the webinar. 28 of the medical students in Muenster underwent in addition a post course assessment. The surveys were created using Questback's online survey research tool EFS using a 5-Point-Likert-Scale. Participation was voluntary and anonymous. The results are reported descriptively and differences between pre- and post-surveys were assessed by t-tests and effect sizes. Results: Knowledge assessment indicated that medical students had severe gaps in knowledge related to DV. Completion of an elective course has contributed to a significant learning and competence progress of the students in all DV subject areas. Conclusion: The newly established course is suitable to increase knowledge and competences on DV in medical students and should be included mandatory into the medical curriculum.