Change search
ReferencesLink to record
Permanent link

Direct link
Stepped Care Versus Direct Face-to-Face Cognitive Behavior Therapy for Social Anxiety Disorder and Panic Disorder: A Randomized Effectiveness Trial
Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology. Haukeland University Hospital, Norway; University of Bergen, Norway; Karolinska Institutet, Sweden.
Show others and affiliations
2016 (English)In: Behavior Therapy, ISSN 0005-7894, E-ISSN 1878-1888, Vol. 47, no 2, 166-183 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to assess the effectiveness of a cognitive behavioral therapy(CBT) stepped care model (psychoeducation, guided Internet treatment, and face-to-face CBT) compared with direct face-to-face (FtF) CBT. Patients with panic disorder or social anxiety disorder were randomized to either stepped care (n = 85) or direct FtF CBT (n = 88). Recovery was defined as meeting two of the following three criteria: loss of diagnosis, below cut-off for self-reported symptoms, and functional improvement. No significant differences in intention-to-treat recovery rates were identified between stepped care (40.0%) and direct FtF CBT (43.2%). The majority of the patients who recovered in the stepped care did so at the less therapist-demanding steps (26/34, 76.5%). Moderate to large within-groups effect sizes were identified at posttreatment and 1-year follow-up. The attrition rates were high: 41.2% in the stepped care condition and 27.3% in the direct FtF CBT condition. These findings indicate that the outcome of a stepped care model for anxiety disorders is comparable to that of direct FtF CBT. The rates of improvement at the two less therapist-demanding steps indicate that stepped care models might be useful for increasing patients’ access to evidence-based psychological treatments for anxiety disorders. However, attrition in the stepped care condition was high, and research regarding the factors that can improve adherence should be prioritized.

Place, publisher, year, edition, pages
2016. Vol. 47, no 2, 166-183 p.
Keyword [en]
stepped care, effectiveness, social anxiety disorder, panic disorder
National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:su:diva-126033DOI: 10.1016/j.beth.2015.10.004ISI: 000372665700003ScopusID: 000372665700003OAI: oai:DiVA.org:su-126033DiVA: diva2:896947
Available from: 2016-01-22 Created: 2016-01-22 Last updated: 2016-06-22Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textScopus

Search in DiVA

By author/editor
Öst, Lars-GöranCarlbring, Per
By organisation
Clinical psychology
In the same journal
Behavior Therapy
Psychology

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 76 hits
ReferencesLink to record
Permanent link

Direct link