The Efficacy Of Internet-Based Cognitive Behavioural Therapy For Social Anxiety Disorder: A Systematic Review And Meta-Analysis

Social anxiety disorder (SAD) is one of the most common lifelong anxiety disorders. Although cognitive behavioural therapy (CBT) has proven to be effective in treating people with SAD, it may not be available for a considerable proportion of patients. Internet-based CBT (ICBT) is more accessible than face-to-face treatment. This meta-analysis evaluated the efficacy of ICBT in patients with SAD. We searched five databases, PubMed, Cochrane Central Register of Controlled Trials, Health Management Information Consortium, Ovid MEDLINE and EMBASE, and identified 20 eligible randomized controlled trials published from inception to 25 July 2020, with the outcome data from 1,743 participants. The results indicated that ICBT had a significant positive effect on patients with SAD compared with the control groups (g = -0.55). A subgroup analysis revealed that ICBT and CBT had an equal effect on treating patients with SAD (g = -0.18). There was also no difference between ICBT and ICBT plus other therapies in the treatment of patients with SAD (g = -0.07). The effect size of ICBT on patients with SAD was maintained at the 6-month follow-up (g = -0.08) and at the 12-month follow-up (g = -0.17). The findings of this review demonstrated that ICBT can significantly reduce SAD symptoms and that ICBT and face-to-face CBT produce equivalent effects. The results of this meta-analysis contributed to the literature on ICBT for the treatment of patients with SAD, although numerous aspects of ICBT were identified for future investigations.