Online Cognitive Therapy for Social Anxiety Disorder in Adolescence: A Clinical Case Study Using the CT@TeenSAD

Abstract

SAD is an intense fear or anxiety associated with past, current, or future social situations. The Clark and Wells (1995) cognitive model for SAD has been proved to be clinically effective in adults, and its developmentally sensitive adaptations for adolescents have recently shown promising results. Given this evidence and considering that adolescence is typically the age of onset for the first SAD symptoms and a critical developmental period for the delivery of evidence-based interventions, we adapted CT for adolescents for online intervention (CT@TeenSAD) encompassing 10 weekly, 90 min sessions, extended by two booster sessions. This work presents the first case study of that intervention as applied to Merida (M.; pseudonym; 17-year-old, girl). The estimated Reliable Change Index shows M.’s progress for most of her symptoms, from pre-to post-treatment (RCI-1 range: −.53 to −8.03), and the maintenance of benefits at 3 months follow-up (RCI-2 range: .00 to −2.25). A relapse in the adoption of safety behaviors was seen between post-treatment and follow-up, which might be explained by the life-changing challenges experienced by M. between session 10 and follow-up, concerning her transition from high school to college. M.’s case study offers a first glance on the promising results of CT@TeenSAD related to its efficacy and feasibility. Likewise, it offers the opportunity to critically appraise the limitations of the intervention as well as practical challenges and suggestions thought to be useful for therapists willing to implement CT@TeenSAD in the future.