Researchers from the Karolinska Institute in Stockholm, Sweden evaluated the long-term effects of internet-based cognitive behavioral therapy (CBT) for social anxiety disorder. Several trials had demonstrated its effectiveness in the short term, but long term impact was unclear.   

This was a 5-year follow-up study of 80 people with SAD who had undergone Internet-based CBT. The assessment comprised a diagnostic interview and self-report questionnaires.

The main outcome measure was the Liebowitz Social Anxiety Scale-Self-Report (LSAS-SR). Additional measures of social anxiety were the Social Interaction Anxiety Scale (SIAS) and the Social Phobia Scale (SPS).

Attrition rates were low: 89% (71/80) of the participants completed the diagnostic interview and 80% (64/80) responded to the questionnaires.

Results were strong.  Improvements gained at the 1-year follow-up were sustained 5 years after completed treatment.

Mixed-effect models analysis showed a significant effect of time on the three social anxiety measures, LSAS-SR, SIAS, and SPS (F(3,98-102) = 16.05 - 29.20, P < .001) indicating improvement.

From baseline to 5-year follow-up, participants' mean scores on the LSAS-SR were reduced from 71.3 to 40.3. The effect sizes of the LSAS-SR were large (Cohen's d range 1.30 - 1.40, 95% conf. level)

The investigators concluded that internet-based CBT for SAD is a treatment that can result in large and enduring effects.

Citation:  Hedman E, Furmark T, Carlbring P, Ljótsson B, Rück C, Lindefors N, Andersson G. A 5-Year follow-up of internet-based cognitive behavior therapy for social anxiety disorder. Journal of Medical Internet Research. 2011 Jun 15;13 (2):e39. [email protected]