Objective – Cognitive Behavioural Therapy for the treatment of Social Phobia has proved effective through several controlled trials and meta-analyses. In spite of this the CBT has not spread in clinical field yet. Therefore our aim was to verify the effectiveness of the CBT in a public mental health service and to compare our results with those described by experimental research. Design and setting – Partecipants were 11 public mental health center clients, with a primary diagnosis of Social Phobia (according to DSM-IV criteria). The transportability of CBT to a common clinical setting was examined comparing treatment outcome data, at the end of the treatment and at a six months follow up, with results described in controlled efficacy studies. We employed self completion rating scales relating to both general health conditions and life satisfaction (SF36) and trend of symptoms (LSPS). Moreover we recorded the Clinical Global Impression (CGI) and Patient's Global Impression (PGI). Results – Despite differences in setting, clients and treatment providers, both the magnitude of change from pre treatment and maintenance of change at a six months follow up were comparable with the parallele findings in the efficacy studies. Conclusions –. The results attest the effectiveness of CBT even in a public mental health center setting so, in consideration of the fact that social phobia is a very common disease and involve high degree of severity, chronicity and disability, we hope that this effectual and relatively cheap therapy will be routinely applied in public mental health services.

Aims: The present study aims to determine whether cognitive-behavioural minimal contact bibliotherapy is acceptable to participants suffering from DSM-IV-TR hypochondriasis, and whether this intervention is able to reduce hypochondriacal complaints, as well as comorbid depressive complaints and trait anxiety. Method: Participants were assigned to either an immediate treatment condition, or subsequently to a waiting list condition. Participants were sent a book, Doctor, I Hope it's Nothing Serious?, containing cognitive behavioural theory and exercises. Measures were taken pre, post and at follow-up (after 3 months). Those in the waiting list group received a second pre-assessment, and were then enrolled in the bibliotherapy. Results: Results showed that participants were accepting of the cognitive-behavioural theory. Furthermore, results showed beneficial effects of the intervention: all effect measures decreased significantly over time, with the largest effect at post-assessment. However, a large amount of questionnaires were not returned. Conclusion: It is concluded that bibliotherapy may be an efficient aid in reducing hypochondriacal and comorbid complaints, but due to data attrition and methodological flaws should first be studied further.

The current emphasis on Evidence Based Medicine (EBM) is both welcome as a bid to improve the empirical foundations of clinical practice and a cause for concern because it has the potential to distort the scientific approach that has underpinned the development of cognitive-behavioural approaches. It is suggested here that EBM needs to be seen in context; that is, as an approach that almost exclusively focuses on just one of the dimensions that have been and are crucial to the further development of Cognitive-Behavioural Treatments (CBT). EBM is particularly well suited to the development of Biological approaches to treatment, where treatments (and treatment development) are largely atheoretical. However, different considerations apply to CBT, where validated theory and linked research studies are key factors. It is suggested that relationship to evidence in CBT is best conceptualized in terms of Empirically Grounded Clinical Interventions. The parameters of such an approach are considered in relation to the Scientist Practitioner model that is prevalent in the field.