Internet-based therapy for social anxiety in adults in Portugal (PORTiSOFIE) and its impact on sexual and...

Social anxiety disorder (SAD) is a common condition that affects intrapersonal (e.g., distress and impairment) and interpersonal functioning (e.g., difficulties in amorous relationships). People with SAD tend to have difficulties in communicating feelings to partners and report lower levels of sexual and relationship satisfaction. Cognitive behavioral therapy (CBT) for SAD has been found to reduce symptoms of social anxiety, but less is known about its impact on relationship functioning. Internet-based CBT (iCBT) has gained attention for its primary advantage: bridging distances and saving time for the patient. In the planned study, we aim to translate and culturally adapt an iCBT program for social anxiety for use in Portugal (PORTiSOFIE) and measure the effects of the program on social anxiety symptoms. We will also study the impact on sexual and relationship satisfaction, as well as other relationship- relevant outcomes.

We will conduct a randomized controlled trial and divide participants in a two-arm study with parallel groups (i.e., intervention group and attention group). After allocation, the intervention group will receive treatment, while the control group (i.e., attention group) will receive treatment 9 weeks later. The treatment is based on the Clark and Wells model of social phobia and consists of nine modules, with one module completed each week. Participants will answer questionnaires to assess social anxiety symptoms and relationship outcomes at pre-treatment, post-treatment, and 6-month follow-up. Participants' partners will also be asked to complete questionnaires on the same periods of time, but only regarding relationship outcomes.

iCBT for SAD in adults has not yet been tested in Portugal, and overall, there is a gap in the literature regarding the role of partners in iCBT for SAD. We hope our study contributes to increasing accessibility to therapy (and better mental health) by promoting online evidence-based therapies. In addition, we hope it helps to better understand how relationship components are affected and affect clinical symptoms and their progression within receiving treatment.

ClinicalTrials.gov NCT06767878. Registered on January 10, 2025.