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Predictors of treatment outcomes and adherence in internet-based cognitive behavioral therapy for social anxiety in China

Published online by Cambridge University Press:  13 January 2020

Huijing Chen ,
Marcus A. Rodriguez ,
Mingyi Qian ,
Tomoko Kishimoto Open the ORCID record for Tomoko Kishimoto [Opens in a new window] ,
Muyu Lin  and
Thomas Berger
Huijing Chen
Affiliation:
School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing100871, People’s Republic of China
Marcus A. Rodriguez
Affiliation:
Boston Child Study Center, Los Angeles and Pitzer College, Claremont, CA91711, USA
Mingyi Qian*
Affiliation:
School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing100871, People’s Republic of China
Tomoko Kishimoto
Affiliation:
School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing100871, People’s Republic of China
Muyu Lin
Affiliation:
School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing100871, People’s Republic of China
Thomas Berger
Affiliation:
Department of Clinical Psychology and Psychotherapy, University of Bern, Bern3012, Switzerland
*
*Corresponding author. Email: [email protected]
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Abstract

Background:

Although internet-based cognitive behaviour therapy (ICBT) is an effective treatment for social anxiety disorder (SAD), a substantial proportion of patients do not achieve clinically significant improvement. More research is needed to identify which factors predict treatment adherence and outcomes.

Aims:

The aims of this study were to (1) identify demographic and clinical factors associated with treatment adherence and outcomes in ICBT for social anxiety in China, and (2) explore whether low-intensity therapist support results in improved treatment adherence or outcomes.

Method:

Participants were assigned to either therapist-guided (N = 183) or self-guided ICBT (N = 72). Level of social anxiety was measured at both pre- and post-treatment. Treatment adherence and outcomes were analysed using a two-step linear and logistic regression approach. Clinical and demographic characteristics were examined.

Results:

No significant group differences were found for treatment adherence or outcomes between the therapist-guided and self-guided conditions. Participants diagnosed with SAD were significantly less likely to drop out (OR 0.531, p = .03) compared with subclinical participants with social anxiety symptoms. Older participants (B = 0.17, SE = 0.04, p = .008) and participants with a diagnosis of SAD (B = 0.16, SE = 0.44, p = .01) tended to complete more modules. Participants who completed more modules (B = 0.24, SE = 0.03, p = .01) and participants who identified as female (B = –0.20, SE = 0.18, p = .04) reported greater reductions in SAD symptoms.

Conclusions:

Understanding of factors related to adherence and outcome is necessary to prevent drop-out and optimize outcome.

Keywords

adherencecognitive behavioural therapydrop-outinternetsocial anxietytherapist support
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 48 , Issue 3 , May 2020 , pp. 291 - 303
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020

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Footnotes

‡

Present address: Zhou Enlai School of Government, Nankai University, Tianjin 300350, People’s Republic of China.

§

Present address: Berlin School of Mind and Brain, Humboldt Universität zu Berlin, 10117 Berlin, Germany.

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