The effectiveness of guided internet-based cognitive behavioral therapy for social anxiety disorder in a routine care setting

Social anxiety disorder (SAD) is a common mental disorder with high persistence when untreated. As access to effective treatment is limited, guided internet-based cognitive behavioral therapy (ICBT) has been proposed as an effective alternative to face-to-face treatment. In a new study, that was published today, we examined the effectiveness of a 14-week therapist-guided ICBT program for patients with SAD undergoing routine care. From 2014 to 2017, 169 patients were included in the study, of which 145 started the treatment. The sample was all general practitioner-referred and had a lower educational level and higher rate of work absence compared to similar effectiveness studies. Regarding social anxiety symptoms, we identified significant within-group effect sizes (post-treatment: d=1.00–1.10; six-month follow-up: d=1.03–1.55). We also found significant effects on secondary depression symptoms (d=0.67). Clinically significant improvement was reported by 66.2% of the participants, and 16.6% had a significant deterioration. Clinical implications of the current study are that guided ICBT for SAD is an effective treatment for the majority of the patients undergoing routine care. Future studies should explore interventions targeting non-responders and deteriorated patients.


  • The effectiveness of guided ICBT for 169 patients with social anxiety disorder was studied in routine care.
  • All patients were GP- referred and had a low educational level and high rate of work absence compared to other studies.
  • Significant within-group effect sizes were identified at post treatment and follow-up for primary and secondary symptoms.
  • Clinically significant improvement (66.2%) and deterioration (16.6%) are reported.
  • Non-responding and deteriorated patients needs to be addressed in future studies.

Read the full paper:
Nordgreen, T., Gjestad, R., Andersson, G., Carlbring, P., & Havik, O. E. (2018). The effectiveness of guided internet-based cognitive behavioral therapy for social anxiety disorder in a routine care setting. Internet Interventions, 13, 24-29. doi:10.1016/j.invent.2018.05.003

[lightbox link=”” thumb=”×735.jpg” width=”1024″ align=”center” title=”” frame=”true” icon=”image” caption=”N = 169. M = module. SPS = Social Phobia Scale. SIAS = Social Interaction Anxiety Scale. MADRS-SR = The Montgomery Åsberg Depression Rating Scale–Self Report.”]