Self-help Treatment For Social Anxiety Can Ease Burden

With mental health conditions such as anxiety growing in prevalence across the globe, there is a critical need for more innovative, cost-effective and accessible treatments. According to the Australian Bureau of Statistics (1997 National Survey of Health and Wellbeing) social phobia affects more than 200,000 Australians every year. Of these people, 80 per cent do not seek treatment. The results of Macquarie's recently trialed self-help treatment for social anxiety disorder is therefore promising news for both anxiety sufferers and mental health services.

Recently published in the British Journal of Psychiatry, the study investigated the efficacy of pure self-help through written materials for severe social phobia and self-help augmented by five group sessions with a therapist. These conditions were compared with a waiting-list control and standard, therapist-led group therapy.

According to psychology Professor Ron Rapee, who led the team of Macquarie researchers, such methods may provide a template for a highly resource-effective method of treatment delivery.

"Mental health services around the world are limited in their reach and scope," explains Rapee. "In addition, a large proportion of people with anxiety disorders including social phobia do not seek help from traditional mental health services, rather they prefer to deal with difficulties themselves. For these people in particular, self-help might provide an acceptable alternative to traditional therapy. Advantages of self-help include freeing up mental health professionals to allow them to deal with individuals who do require more intensive intervention and providing a more easily accessible and less stigmatising alternative for individuals who are unwilling or unable to access traditional services."

While results of the study indicated that pure self help showed limited efficacy for the treatment of social phobia, they did suggest that self-help augmented by therapist assistance may be a legitimate alternative to traditional therapy models.

"At a 24-week follow-up assessment augmented self-help with five therapist-led group sessions resulted in marked improvements in symptoms of social phobia and life interference that were as great as those produced by standard group treatment," says Rapee.

"These results could have major implications for public health. At one extreme, expert therapists treating individual patients under detailed supervision can produce extremely efficacious results at a higher cost and limited accessibility. At the other extreme, simple provision of printed materials can produce small changes at extremely low cost and broad accessibility. Augmentation of printed materials with a few therapist-led sessions provides an extremely viable mid-point alternative."