The efficacy of psychotherapy for social anxiety disorder, a systematic review and meta-analysis

• Published in: Journal of anxiety disorders 2024-06, Vol.104, p.102881, Article 102881
• Main Authors: de Ponti, Nino, Matbouriahi, Minoo, Franco, Pamela, Harrer, Mathias, Miguel, Clara, Papola, Davide, Sicimoğlu, Ayşesu, Cuijpers, Pim, Karyotaki, Eirini
• Format: Article
• Language: English
• Subjects: Humans; Meta Analysis; Phobia, Social - therapy; Psychotherapy; Psychotherapy - methods; Randomized Controlled Trials as Topic; Social Anxiety; Social Phobia; Treatment Outcome
• ISSN: 0887-6185; 1873-7897; 1873-7897
• DOI: 10.1016/j.janxdis.2024.102881

Given the growth in research examining the effects of psychotherapy on social anxiety disorder (SAD), an up-to-date comprehensive meta-analysis in this field is needed. We selected studies from a database of randomized trials (RCTs) on psychotherapies for anxiety disorders (last updated search of PubMed, PsycINFO, Embase, and Cochrane (CENTRAL): 1 January 2024) We included RCTs comparing psychotherapy to a control condition for adults with SAD and conducted random effects meta-analyses to examine the efficacy of psychotherapy compared to control conditions at post-treatment. Sixty-six RCTs were included with 5560 participants and 98 comparisons between psychotherapy and control groups. Psychotherapy was effective in reducing SAD symptoms, with a large effect size (g = 0.88; 95 % CI: 0.76 to 1.0; I2 = 74 %; 95 % CI: 69 to 79, NNT = 3.8). Effects remained robust across sensitivity analyses. However, there was evidence for significant risk of bias in the included trials. The multivariable meta-regression indicated significant differences in treatment delivery formats, type of recruitment strategy, target group, and number of sessions. Psychotherapy is an effective treatment for SAD, with moderate to large effect sizes across all treatment types and formats. Future research is needed to determine the long-term effects. •Largest meta-analysis about psychotherapy for SAD (66 studies with 98 comparisons).•Psychotherapy is an effective treatment for SAD (g = 0.88, NNT = 3.8).•Moderate to large effect sizes across all treatment types and formats.•Self-help treatments can increase psychotherapy scalability in low-resource settings.