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Symposium

Anxiety Disorders
Symposium

Symposium17 - Global Innovations in Cognitive Behavioral Therapy for Social Anxiety Disorder: Efficiency, Cultural Adaptation, and Immersive Delivery

Friday, June 26, 2026
2:00 PM - 3:30 PM PDT
Location: Golden Gate C3, B2 Level
CE: 1.5

Keywords: Social Anxiety, CBT, Dissemination
Level of Familiarity: Basic to Moderate
Recommended Readings: Clark DM, Wild J, Warnock-Parkes E, Stott R, Grey N, Thew G, Ehlers A. More than doubling the clinical benefit of each hour of therapist time: a randomised controlled trial of internet cognitive therapy for social anxiety disorder. Psychological Medicine. 2023;53(11):5022-5032.,   Thew GR, Kwok APL, Lissillour Chan MH, Powell CLYM, Wild J, Leung PWL, Clark DM. Internet-delivered cognitive therapy for social anxiety disorder in Hong Kong: A randomized controlled trial. Internet Interventions. 2022;28:100539.,   Yoshinaga N, Thew GR, Hayashi Y, Tanoue H, Nakai M, Clark DM. Translated and culturally adapted internet-delivered cognitive therapy for social anxiety disorder in Japanese clinical settings: study protocol for a randomised controlled trial. Trials. 2024;25(1):492.,   Steele KR, Upton E, Holden M, Regan A, Coleshill MJ, Li S, Joubert AE, Mahoney AEJ, Millard M, Newby JM. Intensive 7-day internet-delivered cognitive behavioural therapy for social anxiety disorder: A randomized controlled trial. Journal of Anxiety Disorders. 2025;115:103073.,   Hildebrand AS, Planert J, Roesmann K, Machulska A, Neubert M, Klucken T. Fear not: Combining digital and virtual reality interventions for the treatment of social anxiety disorder - a randomized controlled trial. Behaviour Research and Therapy. 2025;188:104731.

This symposium showcases scalable and equitable cognitive-behavioral interventions for social anxiety disorder (SAD), considering efficiency, cross-cultural dissemination, and immersive technology.

Graham R. Thew (University of Oxford) and Patrick W.L. Leung (The Chinese University of Hong Kong) open with evidence that internet-delivered cognitive therapy for SAD (iCT-SAD), based on the Clark and Wells (1995) model, can achieve outcomes comparable to face-to-face CT-SAD while using considerably less therapist time—demonstrating substantially greater therapist efficiency. They further present the successful replication of the English-language iCT-SAD program in Hong Kong and outline a new coach-supported treatment format that may support wider implementation and access across settings and cultures.

Naoki Yoshinaga (University of Miyazaki) focuses on Japan’s translation and cultural adaptation of iCT-SAD (Japanese iCT-SAD), reporting the process of translation, adaptation, pilot testing, and a randomized controlled trial combining Japanese iCT-SAD with treatment as usual. He also introduces a successful treatment case involving a client with hikikomori (prolonged social withdrawal) and comorbid social anxiety, illustrating the potential of iCT-SAD for reaching socially isolated populations.

Jill M. Newby (UNSW Sydney at the Black Dog Institute) presents the first randomized controlled trial of an intensive, seven-day, clinician-guided internet-delivered cognitive behavioral therapy (iCBT) program for SAD. Adults randomized to intensive iCBT versus a waitlist showed large improvements in social anxiety and functional impairment at post-treatment and one-month follow-up, with high adherence and satisfaction. These findings support the feasibility and acceptability of brief, concentrated treatment “bursts” that can reduce waiting times and overcome barriers to weekly therapy.

Anne S. Hildebrand (University of Bielefeld) reports on a randomized controlled trial combining digital CBT with virtual-reality (VR)–supported behavioral experiments and exposure. While both conditions showed similar self-reported improvements, remission rates at follow-up were higher in the VR-enhanced intervention, underscoring the potential of immersive, low-barrier tools to accelerate real-world behavioral change and increase access where in vivo exposure is difficult.

Together, the presentations represent important progress in line with the WCCBT 2026 “Health for All” ethos: (a) improving treatment efficiency without sacrificing outcomes; (b) transporting and translating interventions across cultures and languages; (c) exploring delivery through coach-supported models; and (d) augmenting treatment with brief, intensive treatment adjuncts and VR to overcome cognitive and practical barriers. David M. Clark (University of Oxford) will serve as discussant to reflect on these themes and extend the dialogue.

Learning Objectives:

  • Develop a greater understanding of recent advances in the use of technology to deliver evidence-based treatment for SAD
  • Discuss global perspectives on cultural adaptation and immersive technologies in the treatment of SAD.
  • Consider ways to make more effective use of technology to enhance clinical practice for SAD
  • Access clinical materials, resources, and training videos on cognitive therapy for SAD
  • Compare processes for treatment development and adaptation across different global contexts

Presentations:

  • 2:06 PM - 2:27 PM PDT
    (SYM 17) Improving Efficiency, Access and Ease of Implementation for Evidence-based Treatments: Findings from Internet-based Cognitive Therapy for Social Anxiety Disorder in Hong Kong

    Speaker: Graham R. Thew, D. Phil. (he/him/his) – University of Oxford, UK

    Co-Author: Patrick Leung, PhD (he/him/his) – Chinese University of Hong Kong

  • 2:27 PM - 2:48 PM PDT
    (SYM 17) Adapting Internet-delivered Cognitive Therapy for Social Anxiety Disorder (iCT-SAD) for Japan: From Translation to Clinical Evaluation

    Speaker: Naoki Yoshinaga, Ph.D. (he/him/his) – University of Miyazaki

  • 2:48 PM - 3:09 PM PDT
    (SYM 17) A Randomised Wait List Controlled Trial Exploring the Efficacy of an Intensive 7-day Online CBT Program for Social Anxiety Disorder

    Speaker: Jill M. Newby, Ph.D. (she/her/hers) – UNSW Sydney at the Black Dog Institute

    Co-Author: Kayla Steele, PhD (she/her/hers) – UNSW and Black Dog Institute

    Co-Author: Emily L. Upton, PsyM – UNSW Sydney, The Black Dog Institute

    Co-Author: Monique Holden, Other – Black Dog Institute

    Co-Author: Amy Regan, M.Psych(Clinical) (she/her/hers) – Black Dog Institute

    Co-Author: Matthew Coleshill, PhD (he/him/his) – Black Dog Institute

    Co-Author: Sophie Li, Ph.D. – Black Dog Institute, UNSW Sydney

    Co-Author: Amy Joubert, Ph.D. – Clinical Research Unit for Anxiety and Depression (CRUfAD), St. Vincent’s Hospital

    Co-Author: Alison Mahoney, Ph.D. – Clinical Research Unit for Anxiety and Depression, St Vincents Hospital

    Co-Author: Michael Millard, MBBS (he/him/his) – Clinical Research Unit for Anxiety and Depression

  • 3:09 PM - 3:30 PM PDT
    (SYM 17) The Efficacy of Blended Therapy Utilizing Internet- and Mobile-based Interventions for Social Anxiety Disorder

    Speaker: Anne S. Hildebrand, M.Sc. – University Medical Center OWL, University of Bielefeld

    Co-Author: Anne S. Hildebrand, M.Sc. – University Medical Center OWL, University of Bielefeld

    Co-Author: Jari Planert, M.Sc. – University of Siegen

    Co-Author: Kati Roesmann, Prof. Dr. – University of Osnabrück

    Co-Author: Alla Machulska, Dr. – University of Siegen

    Co-Author: Marie Neubert, Dr. – University of Siegen

    Co-Author: Tim Klucken, Prof. Dr. – University of Siegen