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Targeting fear of positive evaluation in patients with social anxiety disorder via a brief cognitive behavioural therapy protocol: a proof-of-principle study

Published online by Cambridge University Press:  03 August 2020

Justin W. Weeks ,
M. Taylor Wilmer ,
Carrie M. Potter ,
Elizabeth M. Waldron ,
Mark Versella ,
Simona C. Kaplan ,
Dane Jensen  and
Richard G. Heimberg
Justin W. Weeks*
Affiliation:
Nebraska Medicine, Department of Psychology, University of Nebraska Medical Center, Department of Psychiatry, Omaha, NE68198-4185, USA
M. Taylor Wilmer
Affiliation:
Adult Anxiety Clinic of Temple, Temple University, Philadelphia, PA, USA
Carrie M. Potter
Affiliation:
Adult Anxiety Clinic of Temple, Temple University, Philadelphia, PA, USA
Elizabeth M. Waldron
Affiliation:
Adult Anxiety Clinic of Temple, Temple University, Philadelphia, PA, USA
Mark Versella
Affiliation:
Adult Anxiety Clinic of Temple, Temple University, Philadelphia, PA, USA
Simona C. Kaplan
Affiliation:
Adult Anxiety Clinic of Temple, Temple University, Philadelphia, PA, USA
Dane Jensen
Affiliation:
Adult Anxiety Clinic of Temple, Temple University, Philadelphia, PA, USA
Richard G. Heimberg
Affiliation:
Adult Anxiety Clinic of Temple, Temple University, Philadelphia, PA, USA
*
*Corresponding author. Email: juweeks@nebraskamed.com
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Abstract

Background:

Our aim was to develop a brief cognitive behavioural therapy (CBT) protocol to augment treatment for social anxiety disorder (SAD). This protocol focused specifically upon fear of positive evaluation (FPE). To our knowledge, this is the first protocol that has been designed to systematically target FPE.

Aims:

To test the feasibility of a brief (two-session) CBT protocol for FPE and report proof-of-principle data in the form of effect sizes.

Method:

Seven patients with a principal diagnosis of SAD were recruited to participate. Following a pre-treatment assessment, patients were randomized to either (a) an immediate CBT condition (n = 3), or (b) a comparable wait-list (WL) period (2 weeks; n = 4). Two WL patients also completed the CBT protocol following the WL period (delayed CBT condition). Patients completed follow-up assessments 1 week after completing the protocol.

Results:

A total of five patients completed the brief, FPE-specific CBT protocol (two of the seven patients were wait-listed only and did not complete delayed CBT). All five patients completed the protocol and provided 1-week follow-up data. CBT patients demonstrated large reductions in FPE-related concerns as well as overall social anxiety symptoms, whereas WL patients demonstrated an increase in FPE-related concerns.

Conclusions:

Our brief FPE-specific CBT protocol is feasible to use and was associated with large FPE-specific and social anxiety symptom reductions. To our knowledge, this is the first treatment report that has focused on systematic treatment of FPE in patients with SAD. Our protocol warrants further controlled evaluation.

Keywords

cognitive behavioural therapyfear of evaluationfear of positive evaluationsocial anxiety disordersocial phobia
Type
Brief Clinical Report
Information
Behavioural and Cognitive Psychotherapy , Volume 48 , Issue 6 , November 2020 , pp. 745 - 750
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020

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Footnotes

a

M. Taylor Wilmer is now at Center for Anxiety and Behavioral Change, McLean, VA 22101, USA.

b

Carrie M. Potter is now at Cambridge Health Alliance/Harvard Medical School, Cambridge, MA 02139, USA.

c

Elizabeth M. Waldron is now at Northwestern University Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, Chicago, IL 60611, USA.

d

Mark Versella is now at Rutgers University, Piscataway, NJ 08901, USA.

e

Dane Jensen is now at Haverford College Counseling and Psychological Services, Haverford, PA 19041, USA.

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