4 - (SYM 17) The Efficacy of Blended Therapy Utilizing Internet- and Mobile-based Interventions for Social Anxiety Disorder

Abstract Body
Social anxiety disorder (SAD) is a highly prevalent mental disorder associated with enormous stress and suffering. While cognitive behavioral therapy (CBT) is the first-line treatment for SAD, its accessibility is often constrained by long waiting times. Additionally, effective CBT methods, particularly behavioral exposure, are sometimes not implemented in practice. A possible solution is to utilize new technologies like internet- and mobile-based interventions (IMIs) and virtual reality (VR). The present study aims to investigate whether blended therapy, utilizing an IMI with VR and only a few therapeutic appointments, can reduce the severity of SAD symptomology.

Patients with SAD (N = 32) were randomly assigned to two different groups: an intervention group getting blended therapy utilizing an IMI with self-guided VR (n = 16), and an active control group receiving the same number of appointments on relaxation and stress reduction (n = 16). Self-reported SAD symptoms were assessed via a questionnaire assessing social anxiety and social competence deficits (SASKO) before, during, and after treatment, and six weeks following the end of the treatment, allowing group-based comparisons at multiple time points (see preregistration: ISRCTN18013983 and the published study protocol at https://doi.org/10.1186/s13063-022-06320-x). Additionally, remission was assessed at the six-week follow-up assessment via a clinical interview conducted by licensed psychotherapists.

A mixed-effects model with multiple imputations for missing data was utilized for analying the data. The results showed a significant effect of time, but no significant effect of group, and no significant interaction between group and time. Regarding remission, significantly fewer patients in the experimental group were still diagnosed with SAD at follow-up.

The results of this study showed blended therapy utilizing an IMI with self-guided VR to be efficient in reducing symptoms of SAD in those affected. However, only the clinically evaluated remission was superior to an active control group. These findings suggest differences between self-report and clinical evaluations. Despite mixed results, IMIs may provide a low-barrier intervention and could be used to increase access to therapy and reduce waiting times. Overall, this study aims to shed light on blended therapy and inform psychotherapists about the potential of self-guided digital therapeutic applications.