Evidence map›Paper›PMID 35835726›Full record

Trial reportPsychological medicine2023

More than doubling the clinical benefit of each hour of therapist time: a randomised controlled trial of internet cognitive therapy for social anxiety disorder.

David M Clark, Jennifer Wild, Emma Warnock-Parkes, Richard Stott, Nick Grey, Graham Thew, Anke Ehlers

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Psychological medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 2 pooled it
14.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

39 citing papers in PubMed, 2 syntheses or guidelines pooled it, 85 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

David M ClarkDepartment of Experimental Psychology, University of Oxford, Oxford, UK.ORCID 0000-0002-8173-6022
Jennifer WildDepartment of Experimental Psychology, University of Oxford, Oxford, UK.ORCID 0000-0001-5463-1711
Emma Warnock-ParkesDepartment of Experimental Psychology, University of Oxford, Oxford, UK.ORCID 0000-0001-6867-6451
Richard StottDepartment of Psychology, Institute of Psychiatry, Psychology and Neuroscience, Kings College, London, UK.ORCID 0000-0003-2533-5504
Nick GreySussex Partnership NHS Foundation Trust, Worthing, West Sussex, UK.
Graham ThewDepartment of Experimental Psychology, University of Oxford, Oxford, UK.ORCID 0000-0003-2851-1315
Anke EhlersDepartment of Experimental Psychology, University of Oxford, Oxford, UK.ORCID 0000-0002-8742-0192
University of Oxford · GBKing's College London · GBSussex Partnership NHS Foundation Trust · GB

Funding

Wellcome Trust 069777Wellcome Trust 200796/Z/16/Z
6 · The paper itself

Abstract

backgroundCognitive therapy for social anxiety disorder (CT-SAD) is recommended by NICE (2013) as a first-line intervention. Take up in routine services is limited by the need for up to 14 ninety-min face-to-face sessions, some of which are out of the office. An internet-based version of the treatment (iCT-SAD) with remote therapist support may achieve similar outcomes with less therapist time.

methods102 patients with social anxiety disorder were randomised to iCT-SAD, CT-SAD, or waitlist (WAIT) control, each for 14 weeks. WAIT patients were randomised to the treatments after wait. Assessments were at pre-treatment/wait, midtreatment/wait, posttreatment/wait, and follow-ups 3 & 12 months after treatment. The pre-registered (ISRCTN 95 458 747) primary outcome was the social anxiety disorder composite, which combines 6 independent assessor and patient self-report scales of social anxiety. Secondary outcomes included disability, general anxiety, depression and a behaviour test.

resultsCT-SAD and iCT-SAD were both superior to WAIT on all measures. iCT-SAD did not differ from CT-SAD on the primary outcome at post-treatment or follow-up. Total therapist time in iCT-SAD was 6.45 h. CT-SAD required 15.8 h for the same reduction in social anxiety. Mediation analysis indicated that change in process variables specified in cognitive models accounted for 60% of the improvements associated with either treatment. Unlike the primary outcome, there was a significant but small difference in favour of CT-SAD on the behaviour test.

conclusionsWhen compared to conventional face-to-face therapy, iCT-SAD can more than double the amount of symptom change associated with each therapist hour.

Indexed as

Cognitive Behavioral TherapyPhobia, SocialTherapy, Computer-AssistedAnxietyHumansInternetTreatment OutcomeCognitive behaviour therapyIAPTinternet therapysocial anxiety

Identifiers

PMID35835726
PMCPMC10476054
OpenAlexW4285491857

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.