Can school counselors deliver cognitive-behavioral treatment for social anxiety effectively? A randomized controlled trial

• Published in: Journal of child psychology and psychiatry 2016-11, Vol.57 (11), p.1229-1238
• Main Authors: Masia Warner, Carrie, Colognori, Daniela, Brice, Chad, Herzig, Kathleen, Mufson, Laura, Lynch, Chelsea, Reiss, Philip T., Petkova, Eva, Fox, Jeremy, Moceri, Dominic C., Ryan, Julie, Klein, Rachel G.
• Format: Article
• Language: English
• Subjects: Academic achievement; Adolescent; Adolescents; Anxiety; Anxiety Disorders; Behavior modification; Child psychology; Clinical outcomes; Clinical standards; Clinical trials; Cognitive behavioral therapy; Cognitive therapy; Cognitive Therapy - methods; Comparative Analysis; Control Groups; Counseling; Counseling Techniques; Counselors; Dissemination; Efficacy; Experimental Groups; Female; Grade 11; Humans; Intervention; Life control; Male; Outcome Assessment (Health Care); Phobia, Social - therapy; Program Effectiveness; Psychologists; Psychology; Psychotherapy, Group - methods; Randomized Controlled Trials; SASS; School based; School counseling; School Counselors; Schools; Skill Development; Social anxiety; Social Development; Social skills; Training; Untreated
• ISSN: 0021-9630; 1469-7610
• DOI: 10.1111/jcpp.12550

Background Social anxiety disorder (SAD) typically onsets in adolescence and is associated with multiple impairments. Despite promising clinical interventions, most socially anxious adolescents remain untreated. To address this clinical neglect, we developed a school‐based, 12‐week group intervention for youth with SAD, Skills for Academic and Social Success (SASS). When implemented by psychologists, SASS has been found effective. To promote dissemination and optimize treatment access, we tested whether school counselors could be effective treatment providers. Method We randomized 138, ninth through 11th graders with SAD to one of three conditions: (a) SASS delivered by school counselors (C‐SASS), (b) SASS delivered by psychologists (P‐SASS), or (c) a control condition, Skills for Life (SFL), a nonspecific counseling program. Blind, independent, evaluations were conducted with parents and adolescents at baseline, post‐intervention, and 5 months beyond treatment completion. We hypothesized that C‐SASS and P‐SASS would be superior to the control, immediately after treatment and at follow‐up. No prediction was made about the relative efficacy of C‐SASS and P‐SASS. Results Compared to controls, adolescents treated with C‐SASS or P‐SASS experienced significantly greater improvement and reductions of anxiety at the end of treatment and follow‐up. There were no significant differences between SASS delivered by school counselors and psychologists. Conclusion With training, school counselors are effective treatment providers to adolescents with social anxiety, yielding benefits comparable to those obtained by specialized psychologists. Questions remain regarding means to maintain counselors’ practice standards without external support.