Two investigations compared manualized CBT (MAN-CBT) vs. treatment-as-usual CBT (TAU-CBT) for social anxiety disorder in outpatient settings, using propensity score matching to create balanced subsamples (n=148 and n=64) and multilevel modeling to assess social anxiety symptoms and general psychopathology.
After the total number of sessions, both MAN-CBT (d=0.93–1.99) and TAU-CBT (d=0.89–1.44) produced significant symptom reductions with few between-group differences. However, TAU-CBT required a higher overall therapy dose; at equivalent dose, MAN-CBT yielded significantly better outcomes across nearly all measures.
TAU-CBT data came from routine care (not a prior RCT), introducing potential selection bias despite propensity score matching. The study is a secondary analysis, limiting causal inference. Full text was unavailable for review, so details on therapist training, adherence, and specific session counts could not be verified.
Manualized CBT for social anxiety disorder appears to achieve comparable or better outcomes with fewer sessions than treatment-as-usual CBT. Clinicians and health systems should consider adopting structured CBT manuals to improve efficiency and increase treatment capacity.
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