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Cognitive therapy versus exposure and applied relaxation in social phobia: A randomized controlled trial

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David M Clark, Anke Ehlers, Ann Hackmann, Freda McManus, Melanie Fennell, Nick Grey, Louise Waddington, Jennifer Wild

Original languageEnglish
Article numberN/A
Pages (from-to)568-578
Number of pages11
JournalJournal of Consulting and Clinical Psychology
Issue number3
PublishedJun 2006

King's Authors


A new cognitive therapy (CT) program was compared with an established behavioral treatment. Sixty-two patients meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed., American Psychiatric Association, 1994) criteria for social phobia were randomly assigned to CT, exposure plus applied relaxation (EXP + AR), or wait-list (WAIT). CT and EXP + AR were superior to WAIT on all measures. On measures of social phobia, CT led to greater improvement than did EXP + AR. Percentages of patients who no longer met diagnostic criteria for social phobia at posttreatment-wait were as follows: 84% in CT, 42% in EXP + AR, and 0% in WAIT. At the 1-year follow-up, differences in outcome persisted. In addition, patients in EXP + AR were more likely to have sought additional treatment. Therapist effects were small and nonsignificant. CT appear,; to be superior to EXP + AR in the treatment of social phobia.

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