Feasibility and effectiveness of a developmentally oriented school-based intervention for adolescents with social anxiety disorder

Abstract

Social anxiety disorder (SAD) in adolescence associates with impairment across several developmentally salient life domains. Treating adolescents’ SAD with school-based interventions has multiple benefits. We examined the preliminary feasibility and effectiveness of the brief Developmentally Oriented Cognitive Therapy for SAD (DOCT-SAD), among adolescents with SAD and their parents delivered in the school setting by school psychologists. Participants (n=11, mean age 15.8 years, females 81.8%) were recruited from secondary schools in Tampere, Finland. K-SADS-PL was used to determine primary and co-morbid disorders, augmented with ADIS-5. All participants had primary SAD. Structured feasibility interviews were administered at post-treatment to young people, parents, and school psychologists. Primary outcome measures (SPIN, ADIS-5 based CSR) and secondary outcome measures (SAFE, PHQ-9, YP-CORE, CALIS-C, and CALIS-P) were collected at pre- and post-treatment. On a scale of 0–10, young people perceived the treatment as suitable for them (mean 8.7, SD=1.0). Parents’ general experience of the DOCT-SAD treatment was overall positive (mean 8.9, SD=0.7). Treatment providers rated their general experience of the treatment as good (mean 8.5, SD=0.6). All participants completed the treatment. Significant pre–post decrease in SAD symptoms measured with SPIN was found (mean reduction −8.4, p=.021, r=0.7). Of participants, six (54.5%) were in diagnostic remission at post-treatment according to ADIS-5. The brief, 10-session DOCT-SAD intervention was accepted by young people, their parents and school psychologists. DOCT-SAD seems feasible and beneficial in treating adolescents with SAD in the school environment.