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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how different versions of group exposure therapy can assist people with social anxiety and public speaking stress. Participants will engage in one of four therapy workshops, each featuring unique elements such as self-compassion exercises or peer-led sessions. This trial suits University of Colorado Boulder undergraduates who find social situations or public speaking particularly stressful and seek help. As an unphased trial, it offers participants a unique opportunity to contribute to innovative therapy approaches and potentially enhance their own coping skills.

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.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research shows that group exposure therapy, including versions with added compassion and peer support, is generally safe for treating social anxiety. In a previous study, exercises focusing on self-compassion—being kind to oneself and feeling connected to others—helped reduce anxiety and improve stress responses. This method had positive effects without major negative reactions.

Exposure therapy, which involves gradually facing fears in a controlled setting, effectively lowers anxiety levels and is well-tolerated, with few side effects reported. The peer-enhanced version, where facilitators share their own experiences with anxiety, aims to create a supportive and understanding environment. Although specific safety data on these enhanced methods remain limited, the proven safety of exposure therapy suggests that these group sessions are likely safe and manageable for participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these treatments for social anxiety because they use a unique blend of traditional exposure therapy with innovative enhancements like peer involvement and self-compassion exercises. Unlike standard treatments that often focus solely on exposure to feared situations, these therapies incorporate self-compassion techniques to help individuals recognize their shared humanity, potentially reducing feelings of isolation. The inclusion of co-facilitators who share their own experiences with social anxiety adds an authentic, relatable element that may enhance the therapeutic process. By combining these elements, these treatments aim to foster a more supportive and empathetic environment, potentially leading to improved outcomes for individuals struggling with social anxiety and public speaking fears.

What evidence suggests that this trial's treatments could be effective for social anxiety?

Research shows that group exposure therapy, one of the treatments in this trial, effectively addresses social anxiety. Studies have found that it reduces anxiety in social situations and public speaking. In this trial, some participants will receive group exposure therapy with added self-compassion exercises, which involve being kind to oneself, potentially enhancing these benefits. One study found that self-compassion reduced anxiety and increased positive feelings. Another treatment arm in this trial involves peer-enhanced therapy, where facilitators share their own experiences, potentially creating a supportive environment. Overall, these methods have shown promise in reducing symptoms of social anxiety. ^{1 2 3 4 6}

Are You a Good Fit for This Trial?

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

Able to read and write fluently in English

Current undergraduate students at CU

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 for a Trial Participant

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)

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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 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]

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]

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]

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]

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]

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT06673407

Group Exposure Workshops for Socially Anxious ... The purpose of the study is to investigate the effects of four versions of a workshop for social anxiety and public speaking stress.

2. withpower.com withpower.com/trial/phase-anxiety-disorders-5-2024-f6c9c

Group Exposure Therapy for Social Anxiety (OASIS Trial) The purpose of the study is to investigate the effects of four versions of a workshop for social anxiety and public speaking stress.

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11589380/

Augmenting self-guided virtual-reality exposure therapy for ... Results. PSA improved by the end of treatment and overall social anxiety improved one month after the VRET across both groups. The VRET-plus- ...

4. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0887618522000159

Evaluating the efficacy of common humanity-enhanced ... This is the first experimental study to explicitly target cultivating a sense of common humanity among groups of socially anxious adults using multiple ...

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11351419/

A Narrative Review of Compassion Focused Therapy on ... CFT was used for diverse PMH outcomes, and the effects were overall positive. Self-compassion and compassion were the most frequently evaluated outcomes.

6. clinicaltrials.gov clinicaltrials.gov/study/NCT04850989

Efficacy of Virtual Reality Exposure Therapy Scripts for ... The purpose of this study is to test the efficacy virtual reality videos to facilitate exposure therapy in social anxiety disorder (SAD).