Group cognitive therapy for social anxiety disorder among adolescents treated at routine adolescent psychiatric services: preliminary effects and implementation model.

PURPOSE: Social Anxiety Disorder (SAD) typically onsets in adolescence. Few studies have targeted delivery of evidence-based interventions for SAD in mental health services for adolescents. In specific, no prior studies have examined group cognitive therapy (CT) for SAD in adolescent services delivered by method-trained staff. We implemented group CT in psychiatric outpatient units to assess its feasibility and effectiveness in routine services.

MATERIALS AND METHODS: In the context of a region-wide implementation program launched by Helsinki University Hospital (HUH), eleven psychiatric nurses and psychologists were trained to deliver group CT for SAD at its outpatient clinics. None of them had prior psychotherapy training. A two-day training workshop and monthly group supervision were arranged. Clinicians treated 13-to-18-year-old adolescents with primary SAD. Dropout rate, completer/dropout analysis, and effects of group CT on SAD symptoms and general psychological distress were assessed.

RESULTS: Of adolescents referred to group CT, 75% completed the intervention. Magnitude of pre-to-post change in SAD symptoms was large (d = 0.85), comparable to findings from studies of group CBT/CT for SAD in adult services. General psychological distress of adolescents decreased somewhat, however, only 20% showed reliable change. The program was maintained in the HUH outpatient clinical services over an 8-year period.

CONCLUSIONS: Group-adapted CT for SAD based on the cognitive model of SAD appears feasible for young people. It was transferable to clinical units using a cross-regional implementation model. Our results support further controlled research of group CT for SAD delivered by method-trained staff of routine services.