The British Journal of Psychiatry (2007) 191: 246-252. doi: 10.1192/bjp.bp.106.028167
© 2007 The Royal College of Psychiatrists
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Treatment of social phobia through pure self-help and therapist-augmented self-help

Ronald M. Rapee, PhD

Department of Psychology, Macquarie University, Sydney

Maree J. Abbott, PhD

Department of Psychology, University of Sydney

Andrew J. Baillie, MPsychol, PhD

Department of Psychology, Macquarie University, Sydney

Jonathan E. Gaston, MClinPsych

Macquarie University Anxiety Research Unit, Macquarie University, Sydney, New South Wales, Australia

Correspondence: Dr Ronald M. Rapee, Department of Psychology, Macquarie University, Sydney, NSW 2109, Australia. Email: Ron.Rapee{at}mq.edu.au

Declaration of interest R.M.R. authored the book used for bibliotherapy and receives royalties.

Background Self-help for social phobia has not received controlled empirical evaluation.

Aims To evaluate the efficacy of pure self-help through written materials for severe social phobia and self-help augmented by five group sessions with a therapist. These conditions were compared with a waiting-list control and standard, therapist-led group therapy.

Method Participants with severe generalised social phobia (n=224) were randomised to one of four conditions. Assessment included diagnoses, symptoms and life interference at pretreatment, 12 weeks and at 24 weeks.

Results A larger percentage of patients no longer had a diagnosis of social phobia at post-intervention in the pure self-help group than in the waiting-list group, although this percentage decreased slightly over the next 3 months. Symptoms of social anxiety and life interference did not differ significantly between these groups. Augmented self-help was better than waiting list on all measures and did not differ significantly from group treatment.

Conclusions Self-help augmented by therapist assistance shows promise as a less resource-intensive method for the management of social phobia. Pure self-help shows limited efficacy for this disorder.


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