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Group therapy may help ease social anxiety disorder

By Allison Bond

NEW YORK (Reuters Health) - Talk therapy conducted in groups could help people with social anxiety disorder, according to a new review of past studies.

So-called cognitive behavioral therapy (CBT) hinges on helping people change their thoughts and perceptions related to certain situations. It is already used to treat panic disorder, social anxiety disorder and depression, among other conditions.

The new report, published in PLOS One, suggests undergoing CBT in groups is also effective for people with social anxiety disorder, who have a debilitating fear of social situations.

For them, group therapy may be particularly effective because it helps people practice interacting with others, Pim Cuijpers said. He heads the department of clinical psychology at VU University Amsterdam and worked on the new report.

The analysis "confirmed what we had expected, and what we hear from clinicians in practice: group therapy works for many patients with social anxiety disorder," Cuijpers said. Thus it should be one of the first choices for treatment, he said.

Medications like antidepressants are another possible option for social anxiety disorder. But they can have side effects and don't always work.

Individual CBT doesn't provide an outlet for social interaction and is less efficient to administer than group therapy.

For their review, Cuijpers and his colleagues examined 11 studies that randomly split people with social anxiety disorder into multiple treatment groups. Some patients underwent cognitive behavioral group therapy. Others either received no treatment, were given medication or continued with their current treatment.

In the end, group therapy had a "moderate" effect on participants' symptoms, the researchers found. They calculated that three patients would have to go through therapy for one to see benefits.

Group therapy, some researchers say, holds promise in an era in which high-value, cost-effective healthcare is the gold standard.

"Group treatments for psychiatric disorders are of tremendous interest," Dr. John Krystal said. He is the chair of psychiatry at Yale University School of Medicine in New Haven, Connecticut, and was not involved in the new review.

"They reduce the cost of treatment and may increase the access to effective therapy in settings where there are limited resources for mental health treatment," Krystal said.

The extreme fear of interacting with others can lead people with social anxiety disorder to avoid such situations altogether, even if it means losing a job and drifting away from family and friends. An estimated 12 percent of Americans have the condition at some point during their lives.

"Social anxiety disorder is one of the most prevalent anxiety disorders, with a large impact on the personal life of patients and their relatives, and with huge costs for society," Cuijpers told Reuters Health.

Many mental disorders, including social anxiety disorder, are notoriously tough to treat. So calling the effects of cognitive behavioral group therapy "moderate" is actually a misnomer, Krystal told Reuters Health.

"This is a rather large treatment effect by the standards of most medication treatments for social anxiety disorder," he said.

Krystal said the review provides compelling evidence that group therapy offers benefits for social anxiety disorder that have previously only been seen with individual therapy.

"This is very good news, as it may help guide the efficient deployment of mental health treatment resources," he said.

SOURCE: http://bit.ly/1dBZopJ PLOS One, online November 15, 2013.

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