{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T10:39:44Z","timestamp":1790678384831,"version":"4.1.0"},"reference-count":48,"publisher":"Cambridge University Press (CUP)","issue":"7","license":[{"start":{"date-parts":[[2020,9,11]],"date-time":"2020-09-11T00:00:00Z","timestamp":1599782400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0033291720003001_sec_a1\"><jats:title>Background<\/jats:title><jats:p>Cognitive behavior therapy (CBT) is effective for most patients with a social anxiety disorder (SAD) but a substantial proportion fails to remit. Experimental and clinical research suggests that enhancing CBT using imagery-based techniques could improve outcomes. It was hypothesized that imagery-enhanced CBT (IE-CBT) would be superior to verbally-based CBT (VB-CBT) on pre-registered outcomes.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291720003001_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>A randomized controlled trial of IE-CBT <jats:italic>v.<\/jats:italic> VB-CBT for social anxiety was completed in a community mental health clinic setting. Participants were randomized to IE (<jats:italic>n<\/jats:italic> = 53) or VB (<jats:italic>n<\/jats:italic> = 54) CBT, with 1-month (primary end point) and 6-month follow-up assessments. Participants completed 12, 2-hour, weekly sessions of IE-CBT or VB-CBT plus 1-month follow-up.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291720003001_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Intention to treat analyses showed very large within-treatment effect sizes on the social interaction anxiety at all time points (<jats:italic>d<\/jats:italic>s = 2.09\u20132.62), with no between-treatment differences on this outcome or clinician-rated severity [1-month OR = 1.45 (0.45, 4.62), <jats:italic>p<\/jats:italic> = 0.53; 6-month OR = 1.31 (0.42, 4.08), <jats:italic>p<\/jats:italic> = 0.65], SAD remission (1-month: IE = 61.04%, VB = 55.09%, <jats:italic>p<\/jats:italic> = 0.59); 6-month: IE = 58.73%, VB = 61.89%, <jats:italic>p<\/jats:italic> = 0.77), or secondary outcomes. Three adverse events were noted (substance abuse, <jats:italic>n<\/jats:italic> = 1 in IE-CBT; temporary increase in suicide risk, <jats:italic>n<\/jats:italic> = 1 in each condition, with one being withdrawn at 1-month follow-up).<\/jats:p><\/jats:sec><jats:sec id=\"S0033291720003001_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>Group IE-CBT and VB-CBT were safe and there were no significant differences in outcomes. Both treatments were associated with very large within-group effect sizes and the majority of patients remitted following treatment.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0033291720003001","type":"journal-article","created":{"date-parts":[[2020,9,11]],"date-time":"2020-09-11T04:51:43Z","timestamp":1599799903000},"page":"1277-1286","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":28,"title":["Imagery-enhanced <i>v.<\/i> verbally-based group cognitive behavior therapy for social anxiety disorder: a randomized clinical trial"],"prefix":"10.1017","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2924-6760","authenticated-orcid":false,"given":"Peter M.","family":"McEvoy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew P.","family":"Hyett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha R.","family":"Bank","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Erceg-Hurn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew R.","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Kyron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa M.","family":"Saulsman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle L.","family":"Moulds","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica R.","family":"Grisham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily A.","family":"Holmes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Moscovitch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ottmar V.","family":"Lipp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce N. 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