Group Exposure Therapy for Social Anxiety

(OASIS Trial)

Overseen By Joanna Arch, PhD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Colorado, Boulder

Disqualifiers: Severe depression, Suicide risk, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 6

200 Participants Needed

Trial Summary

What is the purpose of this trial?

The purpose of the study is to investigate the effects of four versions of a workshop for social anxiety and public speaking stress. All participants are current University of Colorado Boulder undergraduate students. Participation in this research study lasts for approximately 8 weeks, and includes a pre-workshop questionnaire, 3 weekly workshop sessions (ranging from 2 to 3 hours each, including a 5-minute post-session questionnaire), a post-workshop questionnaire, and a 1-month follow-up questionnaire.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the study coordinators.

What data supports the effectiveness of the treatment Group Exposure Therapy for Social Anxiety?

Research shows that self-compassion training, which is part of the treatment, can help reduce social anxiety symptoms. Studies found that enhancing self-compassion before exposure therapy can improve engagement in therapy and that self-compassion techniques can lead to significant decreases in social anxiety. ^{1 2 3 4 5}

Is Group Exposure Therapy for Social Anxiety safe for humans?

The research does not specifically address safety concerns, but Group Exposure Therapy and related self-compassion techniques have been studied in socially anxious individuals without reported safety issues, suggesting they are generally safe for humans. ^{1 2 3 6 7}

How does Group Exposure Therapy for Social Anxiety differ from other treatments for social anxiety?

This treatment is unique because it combines group exposure therapy with self-compassion and peer support, which helps individuals engage more effectively with their fears by fostering a sense of common humanity and reducing self-criticism. ^{1 2 3 4 5}

Eligibility Criteria

This trial is for University of Colorado Boulder undergraduates who experience social anxiety or stress related to public speaking. Participants will engage in an 8-week study involving questionnaires and weekly workshops.

Inclusion Criteria

Current undergraduate students at CU

Able to read and write fluently in English

Experiencing elevated social anxiety symptoms indicated by a SPIN score ≥ 19

Exclusion Criteria

Score in the moderate-high range for suicide risk as indicated by the CSSRS, report a suicide attempt in the past 12 months, or report current, ongoing suicidal ideation along with a past (lifetime) suicide attempt

I am currently experiencing severe depression.

Current students of the PI or clients or current students of the doctoral student co-facilitators

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2 weeks

Pre-Workshop Assessment

Participants complete a pre-workshop questionnaire to assess baseline measures

1 week

1 visit (in-person or virtual)

Workshop Sessions

Participants attend 3 weekly workshop sessions focusing on exposure therapy for social anxiety and public speaking fears

3 weeks

3 visits (in-person)

Post-Workshop Assessment

Participants complete a post-workshop questionnaire to assess immediate outcomes

1 week

1 visit (in-person or virtual)

Follow-up

Participants are monitored for safety and effectiveness after the workshop sessions, including a 1-month follow-up questionnaire

4 weeks

1 visit (in-person or virtual)

Treatment Details

Interventions

• Group Exposure for Social Anxiety
• Peer and Self-Compassion Enhanced Group Exposure Therapy for Social Anxiety
• Peer-Enhanced Group Exposure Therapy for Social Anxiety
• Self-Compassion Enhanced Group Exposure Therapy for Social Anxiety

Trial Overview The study tests four types of group exposure therapy workshops aimed at reducing social anxiety, each with a different focus: self-compassion, peer support, or both. The effectiveness will be measured through questionnaires before and after the workshops and one month later.

Participant Groups

Group I: Peer enhanced Experimental Treatment 1 Intervention

Group exposure therapy for social anxiety and public speaking fears facilitated by a pair of doctoral student and undergraduate student co-facilitators who will explicitly use appropriate self-disclosure to establish the co-facilitators as individuals with lived experiences of social anxiety and public speaking fears.

Group II: Fully enhanced Experimental Treatment 1 Intervention

Group exposure therapy for social anxiety and public speaking fears plus self-compassion exercises aimed at inducing a sense of common humanity, facilitated by a pair of doctoral student and undergraduate student co-facilitators who will explicitly use appropriate self-disclosure to establish the co-facilitators as individuals with lived experiences of social anxiety and public speaking fears.

Group III: Compassion Enhanced Experimental Treatment 1 Intervention

Group exposure therapy for social anxiety and public speaking fears plus self-compassion exercises aimed at inducing a sense of common humanity.

Group IV: Exposure Only Active Control 1 Intervention

Group exposure therapy for social anxiety and public speaking fears.

Who Is Running the Clinical Trial?

University of Colorado, Boulder

Lead Sponsor

Trials

128

Recruited

29,600+

Findings from Research

Enhancing self-compassion through a common humanity-focused intervention significantly increased engagement in exposure therapy among socially anxious individuals, with participants remaining longer in the exposure session compared to those who did not receive the intervention.

The study, involving 63 socially anxious undergraduates, found that participants who practiced common humanity showed improved positive self-responses during exposure, suggesting that this approach may effectively support individuals facing anxiety-provoking situations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluating the efficacy of common humanity-enhanced exposure for socially anxious young adults. Slivjak, ET., Pedersen, EJ., Arch, JJ.[2022]

Both self-compassion and cognitive restructuring interventions significantly reduced social anxiety in individuals over a 2-week period, with effects lasting up to 5 weeks after treatment, indicating their efficacy.

Approximately 20% of participants in each group experienced clinically significant improvements in their social anxiety symptoms, suggesting that both approaches can be beneficial for those struggling with high levels of social anxiety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of a brief online self-compassion versus cognitive restructuring intervention on trait social anxiety. Stevenson, J., Mattiske, JK., Nixon, RDV.[2020]

A randomized controlled trial with 63 adults suffering from social anxiety disorder showed that a self-guided self-compassion training program significantly improved self-compassion and reduced SAD symptoms compared to a waitlist control group.

While self-compassion training was effective, it did not show superior results compared to an applied relaxation training program, indicating that both methods may be beneficial for managing social anxiety symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Self-compassion training for individuals with social anxiety disorder: a preliminary randomized controlled trial. Teale Sapach, MJN., Carleton, RN.[2023]

Brief cognitive behavior group therapy (bCBGT) significantly improved symptoms of social anxiety disorder (SAD) in a study of 50 medical students, showing large effect sizes at both post-treatment and two-month follow-up assessments.

bCBGT was found to be statistically superior to a credible placebo therapy (psychoeducational-supportive therapy) in reducing social anxiety symptoms, indicating its efficacy as a treatment option.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Brief cognitive behavior group therapy for social anxiety among medical students: A randomized placebo-controlled trial. Samantaray, NN., Nath, B., Behera, N., et al.[2021]

A group psychotherapy program for 70 clients with social anxiety disorder (SAD) over 8 weeks significantly reduced social anxiety symptoms, as measured by the Liebowitz Social Anxiety Scale, indicating its efficacy.

Participants showed a decrease in immature and neurotic defense mechanisms while demonstrating a trend towards increased use of mature defense mechanisms, suggesting improvements in coping strategies and self-acceptance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[The influence of self-improving based group psychotherapy in defense mechanisms for the clients with social anxiety disorder]. Feng, Y., Xiao, R., Qiu, CJ., et al.[2009]

Imagery-enhanced group cognitive behavior therapy (CBT) for social anxiety disorder (SAD) showed large within-group effect sizes (around 2.05 to 2.19) in both the original Australian clinic and an independent Canadian clinic, indicating its effectiveness in reducing social interaction anxiety.

However, the comparison between the two clinics revealed a very small and non-significant effect size (d=0.09), suggesting that while the therapy is effective within groups, the generalization of its effects across different settings and clinicians may be limited.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Transportability of imagery-enhanced CBT for social anxiety disorder. McEvoy, PM., Erceg-Hurn, DM., Barber, KC., et al.[2019]

Individuals with social anxiety disorder (SAD) showed similar levels of self-compassion and emotional regulation as those with high social anxiety, but had higher levels of depression, indicating that depression may complicate the relationship between self-compassion and social anxiety.

Higher self-compassion was linked to lower social interaction anxiety, with emotional regulation acting as a mediator, although this mediation was influenced by the presence of depression, highlighting the importance of compassionate self-responses in managing social anxiety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Self-compassion and social anxiety: The mediating effect of emotion regulation strategies and the influence of depressed mood. McBride, NL., Bates, GW., Elphinstone, B., et al.[2022]

References

1. Netherlands pubmed.ncbi.nlm.nih.gov

Evaluating the efficacy of common humanity-enhanced exposure for socially anxious young adults. [2022]

2. England pubmed.ncbi.nlm.nih.gov

The effect of a brief online self-compassion versus cognitive restructuring intervention on trait social anxiety. [2020]

3. England pubmed.ncbi.nlm.nih.gov

Self-compassion training for individuals with social anxiety disorder: a preliminary randomized controlled trial. [2023]

4. Netherlands pubmed.ncbi.nlm.nih.gov

Brief cognitive behavior group therapy for social anxiety among medical students: A randomized placebo-controlled trial. [2021]

5. China pubmed.ncbi.nlm.nih.gov

[The influence of self-improving based group psychotherapy in defense mechanisms for the clients with social anxiety disorder]. [2009]

6. England pubmed.ncbi.nlm.nih.gov

Transportability of imagery-enhanced CBT for social anxiety disorder. [2019]

7. England pubmed.ncbi.nlm.nih.gov

Self-compassion and social anxiety: The mediating effect of emotion regulation strategies and the influence of depressed mood. [2022]