Behavioural and Cognitive Psychotherapy

  • Behavioural and Cognitive Psychotherapy / Volume 41 / Issue 04 / July 2013, pp 383-397
  • Copyright © British Association for Behavioural and Cognitive Psychotherapies 2013 The online version of this article is published within an Open Access environment subject to the conditions of the Creative Commons Attribution-NonCommercial-ShareAlike licence <>. The written permission of Cambridge University Press must be obtained for commercial re-use.
  • DOI: (About DOI), Published online: 16 May 2013

Accelerated Publication

Internet-Delivered Cognitive Therapy for Social Anxiety Disorder: A Development Pilot Series

Richard Stotta1, Jennifer Wilda2, Nick Greya3, Sheena Linessa4, Emma Warnock-Parkesa5, Siobhan Comminsa6, Jennifer Readingsa6, Georgina Bremnera7, Elizabeth Woodwarda8, Anke Ehlersa8 and David M. Clarka8 c1

a1 Institute of Psychiatry, Kings College London, UK

a2 University of Oxford, UK

a3 South London and Maudsley NHS Foundation Trust, UK

a4 Institute of Psychiatry, Kings College London, UK

a5 Institute of Psychiatry, Kings College London, and University of Oxford, UK

a6 Institute of Psychiatry, Kings College London, UK

a7 Institute of Psychiatry, Kings College London, and University of Oxford, UK

a8 University of Oxford, UK


Background: Randomized controlled trials have established that individual cognitive therapy based on the Clark and Wells (1995) model is an effective treatment for social anxiety disorder that is superior to a range of alternative psychological and pharmacological interventions. Normally the treatment involves up to 14 weekly face-to-face therapy sessions. Aim: To develop an internet based version of the treatment that requires less therapist time. Method: An internet-delivered version of cognitive therapy (iCT) for social anxiety disorder is described. The internet-version implements all key features of the face-to-face treatment; including video feedback, attention training, behavioural experiments, and memory focused techniques. Therapist support is via a built-in secure messaging system and by brief telephone calls. A cohort of 11 patients meeting DSM-IV criteria for social anxiety disorder worked through the programme and were assessed at pretreatment and posttreatment. Results: No patients dropped out. Improvements in social anxiety and related process variables were within the range of those observed in randomized controlled trials of face-to-face CT. Nine patients (82%) were classified as treatment responders and seven (64%) achieved remission status. Therapist time per patient was only 20% of that in face-to-face CT. Conclusions: iCT shows promise as a way of reducing therapist time without compromising efficacy. Further evaluation of iCT is ongoing.


  • Social phobia;
  • social anxiety disorder;
  • safety behaviours;
  • fear of blushing;
  • cognitive behaviour therapy;
  • CCBT


c1 Reprint requests to David M. Clark, Department of Experimental Psychology, University of Oxford, South Parks Road, Oxford OX1 3UD, UK. E-mail: