Active Components in Internet-Based Cognitive-Behavioral Therapy for Social Anxiety Disorder: A Randomized Full Factorial Trial.

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

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

The role of internet-based therapies in adolescents' quality of life: a systematic review and meta-analysis.BMC psychology · 2026
Pooled it
Efficacy of digital interventions in social anxiety disorder: a systematic review and Bayesian network meta-analysis.Frontiers in psychiatry · 2026
Pooled it
Group sports games for social anxiety in university students: a randomized controlled trial revealing gender-specific efficacy.BMC psychology · 2025
Trial
404: Personal data not found - Anonymous vs. account-based internet self-help for social anxiety in a partially randomized patient preference trial.Internet interventions · 2026
Article
Comparative efficacy of digital health interventions for depression and anxiety symptoms in adolescents and young adults: a systematic review and bayesian network meta-analysis.Child and adolescent psychiatry and mental health · 2026
Article
Innovations to improve outcomes and uptake of psychotherapies for mental disorders: a state-of-the-art review.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2026
Article
A Freely Accessible, Anonymous Online Treatment for Social Anxiety: Protocol for a Partially Randomized Patient Preference Trial.JMIR research protocols · 2025
Article

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

5 authors.

Dajana ŠipkaDepartment of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland.

Rodrigo LopesDepartment of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland.

Tobias KriegerDepartment of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland.

Jan Philipp KleinDepartment of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany.

Thomas BergerDepartment of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMany studies have demonstrated that social anxiety disorder (SAD) can be effectively treated with psychotherapy, particularly cognitive-behavioral therapy (CBT), including internet-based CBT (ICBT). Despite evidence-based treatments, many individuals do not sufficiently benefit from them. Identifying the active components could help improve the effectiveness of SAD treatment. This study tested the effects of four treatment components (psychoeducation, cognitive restructuring, attention training, and exposure) within ICBT for SAD to investigate its active components.

methodsThis randomized full factorial trial consisted of four factors (i.e., treatment components) and 16 conditions. A total of 464 adults with a diagnosed SAD were recruited from the community. The primary outcome was SAD symptoms at 8 weeks (post-assessment). Secondary outcomes included SAD diagnosis, SAD symptoms at follow-up (4 months after post), depression and anxiety symptoms, quality of life, client satisfaction, and adverse effects.

resultsConditions including psychoeducation and exposure were significantly more effective in reducing SAD symptoms at post compared to conditions without these components. Conditions including cognitive restructuring and attention training did not show superiority over conditions without them at post. However, all treatment conditions significantly reduced symptoms compared to the condition without a treatment component. At follow-up, the superiority of psychoeducation and exposure was not significant anymore due to the version without the respective components catching up.

conclusionThe findings suggest that while all treatment components of ICBT for SAD are beneficial compared to no treatment, psychoeducation and exposure include specific active components that significantly improve treatment outcomes more quickly in ICBT for SAD.

introductionMany studies have demonstrated that social anxiety disorder (SAD) can be effectively treated with psychotherapy, particularly cognitive-behavioral therapy (CBT), including internet-based CBT (ICBT). Despite evidence-based treatments, many individuals do not sufficiently benefit from them. Identifying the active components could help improve the effectiveness of SAD treatment. This study tested the effects of four treatment components (psychoeducation, cognitive restructuring, attention training, and exposure) within ICBT for SAD to investigate its active components.

methodsThis randomized full factorial trial consisted of four factors (i.e., treatment components) and 16 conditions. A total of 464 adults with a diagnosed SAD were recruited from the community. The primary outcome was SAD symptoms at 8 weeks (post-assessment). Secondary outcomes included SAD diagnosis, SAD symptoms at follow-up (4 months after post), depression and anxiety symptoms, quality of life, client satisfaction, and adverse effects.

resultsConditions including psychoeducation and exposure were significantly more effective in reducing SAD symptoms at post compared to conditions without these components. Conditions including cognitive restructuring and attention training did not show superiority over conditions without them at post. However, all treatment conditions significantly reduced symptoms compared to the condition without a treatment component. At follow-up, the superiority of psychoeducation and exposure was not significant anymore due to the version without the respective components catching up.

conclusionThe findings suggest that while all treatment components of ICBT for SAD are beneficial compared to no treatment, psychoeducation and exposure include specific active components that significantly improve treatment outcomes more quickly in ICBT for SAD.

Indexed as

Cognitive Behavioral TherapyInternet-Based InterventionPhobia, SocialAdultFemaleHumansInternetMaleMiddle AgedQuality of LifeTreatment OutcomeYoung AdultAnxiety disordersCognitive-behavioral psychotherapyFactorial designInternet-based treatmentSocial anxiety disorder