Behaviour research and therapy · 2026
Three-day intensive group cognitive behavioral therapy for social anxiety in Chinese college students: A randomized controlled trial with an exploratory analysis of underlying mechanisms.
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Cui Liechuan, Tang Xinfeng
Аннотация
BACKGROUND: Social anxiety is highly prevalent among Chinese youth. While traditional group cognitive behavioral therapy (CBT) has demonstrated efficacy, its extended duration and high attrition rates may limit accessibility. In this randomized controlled trial, we developed and evaluated the short- and long-term efficacy of a three-day intensive group CBT protocol and explored a potential serial mediation pathway involving maladaptive social beliefs and fear of negative evaluation.
METHODS: Seventy-one participants with elevated social anxiety (Liebowitz Social Anxiety Scale - Self Report [LSAS-SR] ≥ 38) were randomly assigned to an intensive intervention group (n = 35) or a waitlist control group (n = 36). The intervention was delivered as an intensive group program over three consecutive days (total duration: 18 h), with participants engaging in 6 h of intervention activities per day. The program comprised four core modules: psychoeducation, cognitive restructuring, behavioral experiments, and assertiveness training. We used linear mixed models and calculated Cohen's d to evaluate the intervention effects. To further explore the underlying mechanisms, we conducted a mediation analysis including both the intervention and control groups (n = 71), focusing on the mediating roles of maladaptive social beliefs and fear of negative evaluation in the reduction of social anxiety.
RESULTS: Compared to controls, participants in the intervention group demonstrated significantly greater reductions in social anxiety symptoms (LSAS-SR and DSM-5 Social Anxiety Disorder Severity Scale), maladaptive social beliefs, and fear of negative evaluation at post-treatment, one-month, three-month and six-month follow-up. Serial mediation analysis revealed that the intervention alleviated social anxiety by first reducing maladaptive social beliefs (e.g., overestimation of social costs), which in turn decreased fear of negative evaluation. The intervention group also showed a low attrition rate (2.9%; n = 1).
CONCLUSION: This three-day intensive group CBT effectively alleviates social anxiety through mechanisms consistent with cognitive behavioral models, thereby offering a complementary approach to conventional intervention formats.
METHODS: Seventy-one participants with elevated social anxiety (Liebowitz Social Anxiety Scale - Self Report [LSAS-SR] ≥ 38) were randomly assigned to an intensive intervention group (n = 35) or a waitlist control group (n = 36). The intervention was delivered as an intensive group program over three consecutive days (total duration: 18 h), with participants engaging in 6 h of intervention activities per day. The program comprised four core modules: psychoeducation, cognitive restructuring, behavioral experiments, and assertiveness training. We used linear mixed models and calculated Cohen's d to evaluate the intervention effects. To further explore the underlying mechanisms, we conducted a mediation analysis including both the intervention and control groups (n = 71), focusing on the mediating roles of maladaptive social beliefs and fear of negative evaluation in the reduction of social anxiety.
RESULTS: Compared to controls, participants in the intervention group demonstrated significantly greater reductions in social anxiety symptoms (LSAS-SR and DSM-5 Social Anxiety Disorder Severity Scale), maladaptive social beliefs, and fear of negative evaluation at post-treatment, one-month, three-month and six-month follow-up. Serial mediation analysis revealed that the intervention alleviated social anxiety by first reducing maladaptive social beliefs (e.g., overestimation of social costs), which in turn decreased fear of negative evaluation. The intervention group also showed a low attrition rate (2.9%; n = 1).
CONCLUSION: This three-day intensive group CBT effectively alleviates social anxiety through mechanisms consistent with cognitive behavioral models, thereby offering a complementary approach to conventional intervention formats.