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Overcome Social Anxiety

Online program to reduce social anxiety in university students.

Program Outcomes

  • Anxiety

Program Type

  • Cognitive-Behavioral Training

Program Setting

  • Online

Continuum of Intervention

  • Indicated Prevention

Age

  • Adult
  • Early Adulthood (19-22)

Gender

  • Both

Race/Ethnicity

  • All

Endorsements

Blueprints: Promising

Program Information Contact

Fjola Helgadottir, Ph.D.
AI-Therapy
Email: fjola@ai-therapy.com
Website: ai-therapy.com

Program Developer/Owner

Frances S. Chen, Ph.D.
Department of Psychology, University of British Columbia


Brief Description of the Program

The Overcome Social Anxiety program is administered online and aims to help college students improve their social anxiety through cognitive behavioral therapy. The program targets college students showing high levels of anxiety. Participants complete the program over a period of four to six months and receive email reminders to complete the modules.

Outcomes

McCall et al. (2018) found that at posttest, compared to control participants, intervention participants showed significantly greater reductions in:

  • Social anxiety (two of two measures)

Risk and Protective Factors

McCall et al. (2018) did not find significant effects on risk and protective factors.

Brief Evaluation Methodology

McCall et al. (2018) evaluated the program in 101 participants randomly assigned to intervention or waitlist control conditions. Participants self-reported their anxiety and quality of life at baseline and following the four-month online program.

Study 1

McCall, H. C., Richardson, C. G., Helgadottir, F. D., & Chen, F. S. (2018). Evaluating a web-based social anxiety intervention among university students: Randomized controlled trial. Journal of Medical Internet Research, 20(3): e91. doi:10.2196/jmir.8630


Race/Ethnicity/Gender Details
McCall et al. (2018) did not test for program differences by race or gender.

The program is self-contained online and typically purchased directly by end users; thus, no training is necessary.

Source: Washington State Institute for Public Policy
All benefit-cost ratios are the most recent estimates published by The Washington State Institute for Public Policy for Blueprint programs implemented in Washington State. These ratios are based on a) meta-analysis estimates of effect size and b) monetized benefits and calculated costs for programs as delivered in the State of Washington. Caution is recommended in applying these estimates of the benefit-cost ratio to any other state or local area. They are provided as an illustration of the benefit-cost ratio found in one specific state. When feasible, local costs and monetized benefits should be used to calculate expected local benefit-cost ratios. The formula for this calculation can be found on the WSIPP website.

Start-Up Costs

Initial Training and Technical Assistance

No training is necessary as the program is fully self-contained online and may be purchased directly by end users at ai-therapy.com.

Curriculum and Materials

Online program expense covered with purchase of license.

Licensing

$50-$150 per user, depending on the number of seats in the site license. Individuals may purchase the program directly, or institutions can purchase site licenses to reduce the per user expense. Each user gets access to the program for 6 months.

Other Start-Up Costs

None.

Intervention Implementation Costs

Ongoing Curriculum and Materials

No information is available

Staffing

No information is available

Other Implementation Costs

No information is available

Implementation Support and Fidelity Monitoring Costs

Ongoing Training and Technical Assistance

Included with license. AI-Therapy has been online since 2012 and has performed well technically since then. However, when problems arise, users send an email to support@ai-therapy.com and their issues are solved within 1-2 working days.

Fidelity Monitoring and Evaluation

Included with license. The program self-administers assessments at the beginning and at the end of the program.

Ongoing License Fees

No information is available

Other Implementation Support and Fidelity Monitoring Costs

No information is available

Other Cost Considerations

No information is available

Year One Cost Example

Individuals who are age 18 or older may purchase the program and are given access for a period of six months.

Self-contained program for single user $149.99
Total One Year Cost $149.99

The Year One expense for a single user is $149.99.

An institution may purchase a license, where the per user expense is reduced with increasing number of seats within the license. The minimum per user expense is $50.


No information is available

Program Developer/Owner

Frances S. Chen, Ph.D.Department of Psychology, University of British Columbia3521-2136 West MallVancouver, BC V6T 1Z4Canada+1 (604) 822-2549frances.chen@psych.ubc.ca

Program Outcomes

  • Anxiety

Program Specifics

Program Type

  • Cognitive-Behavioral Training

Program Setting

  • Online

Continuum of Intervention

  • Indicated Prevention

Program Goals

Online program to reduce social anxiety in university students.

Population Demographics

The program targets college students with high levels of social anxiety.

Target Population

Age

  • Adult
  • Early Adulthood (19-22)

Gender

  • Both

Race/Ethnicity

  • All

Race/Ethnicity/Gender Details

McCall et al. (2018) did not test for program differences by race or gender.

Other Risk and Protective Factors

Quality of life

Risk/Protective Factor Domain

  • Individual

Risk/Protective Factors

Risk Factors

Protective Factors


*Risk/Protective Factor was significantly impacted by the program

Brief Description of the Program

The Overcome Social Anxiety program is administered online and aims to help college students improve their social anxiety through cognitive behavioral therapy. The program targets college students showing high levels of anxiety. Participants complete the program over a period of four to six months and receive email reminders to complete the modules.

Description of the Program

The Overcome Social Anxiety program is administered online and aims to help college students improve their social anxiety through cognitive behavioral therapy. The program targets college students showing high levels of anxiety. Participants complete the program over a period of four to six months and receive email reminders to complete the modules.

The program includes seven modules, focusing on: (1) thinking exercises, (2) challenging thinking patterns, (3) creating models to deal with social anxiety, (4) experimenting behaviorally with situations that invoke social anxiety, (5) further challenging thinking, (6) self-processing, and (7) relapse prevention. Modules are individualized for the user based upon responses to a pre-questionnaire on common social anxiety thoughts and avoidance behaviors. A post-questionnaire collects the same information allowing the user to retain his/her data from before and after the treatment. A PDF generated for the user at the end of the program contains all of the exercises and the user's individualized content.

Theoretical Rationale

The program is based in cognitive behavioral therapy (CBT).

Brief Evaluation Methodology

McCall et al. (2018) evaluated the program in 101 participants randomly assigned to intervention or waitlist control conditions. Participants self-reported their anxiety and quality of life at baseline and following the four-month online program.

Outcomes (Brief, over all studies)

McCall et al. (2018) found that intervention participants showed significantly greater reductions in social anxiety at posttest relative to participants in the control condition.

Outcomes

McCall et al. (2018) found that at posttest, compared to control participants, intervention participants showed significantly greater reductions in:

  • Social anxiety (two of two measures)

Risk and Protective Factors

McCall et al. (2018) did not find significant effects on risk and protective factors.

Mediating Effects

McCall et al. (2018) did not test mediation.

Effect Size

McCall et al. (2018) report two significant effect sizes of d = 0.72 and d = 0.82 for the two measures of social anxiety.

Generalizability

McCall et al. (2018) can be generalized to university students with high levels of social anxiety.

A second study by McCall et al. (2019) examined the program's use in a more general population (mean age 35); however, this population falls outside of the scope of Blueprints and thus the study has not been reviewed by Blueprints.

McCall, H. C., Helgadottir, F. D., Menzies, R. G., Hadjistavropoulos, H. D., & Chen, F. S. (2019). An Evaluation of Community Outcomes for a Web-Based Social Anxiety Intervention. Journal of Medical Internet Research, 21(1), e11566. doi:10.2196/11566

Potential Limitations

McCall et al. (2018):

  • Tests for baseline equivalence are incomplete (no tests for demographics)
  • Tests for differential attrition are incomplete (no tests for differences in rates between conditions)
  • High attrition from baseline to posttest

Notes

Tests for differential attrition were incomplete in the published article for Study 1 (McCall et al., 2018) but later provided by the study authors upon request by Blueprints.

Endorsements

Blueprints: Promising

Program Information Contact

Fjola Helgadottir, Ph.D.
AI-Therapy
Email: fjola@ai-therapy.com
Website: ai-therapy.com

References

Study 1

Certified

McCall, H. C., Richardson, C. G., Helgadottir, F. D., & Chen, F. S. (2018). Evaluating a web-based social anxiety intervention among university students: Randomized controlled trial. Journal of Medical Internet Research, 20(3): e91. doi:10.2196/jmir.8630

Study 1

Evaluation Methodology

Design:

Recruitment: Participants were recruited from a large, public Canadian university through an undergraduate psychology course. Students were offered course credit in exchange for participation. Inclusion criteria were showing subclinical levels of social anxiety as determined by endorsing at least one of seven items on a pre-screening questionnaire, not receiving treatment for a chronic mental health condition in the six months leading up to the study, and not having been formerly diagnosed with social anxiety by a clinician. Of the N = 264 participants who completed the eligibility questionnaire, 173 were deemed eligible to participate and 101 enrolled in the study.

Assignment: The 101 enrolled participants were randomly assigned to treatment (N = 51) or waitlist control conditions (N = 50).

Assessments/Attrition: Assessments were collected at pretest and posttest (approximately four months later). One participant assigned to the treatment condition withdrew before the study began, resulting in program participation numbers of N = 50 for both the treatment and control groups. At posttest, 65 participants provided data, resulting in an overall attrition rate of 35% from baseline to posttest. In the intervention group, 30 participants (60%) provided data at posttest and in the control group, 35 participants (70%) provided data at posttest.

Sample:

The sample consisted of Canadian public university students who had subclinical levels of social anxiety, and was 72% female, 48% East Asian, and 19% White with a mean age of 21.86 years (SD = 5.51).

Measures:

Social anxiety was measured with the Social Interaction Anxiety Scale (SIAS) and the Fear of Negative Evaluation Scale (FNE). Life satisfaction was measured with the Quality of Life Enjoyment and Satisfaction Questionnaire - Short form (Q-LES-Q-SF). The researchers state that all three measures are valid and reliable based on prior work.

Analysis:

Effects of the intervention on social anxiety and life satisfaction were analyzed using between-subjects t-tests comparing difference scores between intervention participants and control participants. Primary analyses were conducted on complete cases but were also replicated in five imputed datasets to address potential bias due to missing data.

Intent-to-Treat: All complete-case data were used and results were replicated in imputed datasets.

Outcomes

Implementation Fidelity:

No information on implementation fidelity was provided.

Baseline Equivalence:

Baseline equivalence was tested on three outcome variables and no significant differences were found, but no tests for equivalence on demographic characteristics were conducted. The descriptives listed in Table 1 indicate some potentially large differences (for example, proportion female was 63% in the treatment and 80% in the control).

Differential Attrition:

No significant differences were found in baseline social anxiety scores, quality of life, age, or gender between participants who completed the study and those who did not. The p-value for the Little test was not significant, indicating data were missing completely at random. In the intervention group, 30 participants (60%) provided data at posttest and in the control group, 35 participants (70%) provided data, though there were no tests for differences in rates between groups.

Posttest:

At posttest (four months after baseline), intervention participants showed significantly greater reductions on two of two measures of social anxiety relative to participants in the control condition. Specifically, one measure of social anxiety (the SIAS) showed a medium-large effect size of d = 0.72, and the other measure (the FNE) showed a large effect size of d = 0.82.

No significant differences were found for the third measure, the protective factor of life satisfaction.

Long-Term:

Not examined.

Contact

Blueprints for Healthy Youth Development
University of Colorado Boulder
Institute of Behavioral Science
UCB 483, Boulder, CO 80309

Email: blueprints@colorado.edu

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Blueprints for Healthy Youth Development is
currently funded by Arnold Ventures (formerly the Laura and John Arnold Foundation) and historically has received funding from the Annie E. Casey Foundation and the Office of Juvenile Justice and Delinquency Prevention.