Imagery rescripting for social anxiety disorder via internet videoconferencing: An open trial

Imagery rescripting (ImR) has demonstrated efficacy in reducing symptoms of social anxiety disorder (SAD). However, there are many logistical and psychological barriers that prevent individuals with SAD from accessing treatment. The efficacy of remote treatment methodologies, such as internet videoconferencing, has recently been demonstrated across a range of mental disorders. However, the efficacy of videoconferencing-delivered ImR (vImR) has not yet been examined. The present study aims to examine the efficacy and acceptability of vImR for SAD in a multiple baseline trial utilising the waitlist control group from a larger randomised controlled trial (RCT). 35 participants (M_age = 37.86; SD = 12.90) received no intervention for 8-weeks, then received an 8-session manualised vImR treatment protocol. Within-group analyses indicated negligible effect sizes from baseline to pre-treatment (SIAS-6: d = 0.22; 95 % CI: 0.25 - 0.69; SPS-6: d = -0.03; 95 % CI: 0.49 - 0.44). Large effect sizes were found from pre-treatment to post-treatment (SIAS-6: d = 0.81; 95 % CI: 0.32-1.29; SPS-6: d = 0.80; 95 % CI: 0.30-1.27) and pre-treatment to 3-month follow-up (SIAS-6: d = 0.85; 95 % CI: 0.36-1.33; SPS-6: d = 0.90; 95 % CI: 0.40-1.38). At post-treatment, 66 % of participants no longer met criteria for SAD (74 % at 3-month follow-up). Benchmarking analyses indicated similar treatment effect sizes to in-person ImR for SAD. Participants rated the program as highly acceptable. The results indicate that the mechanisms of ImR appear to be transferable to vImR and therefore this may be a viable remote treatment option for individuals with SAD who do not respond to first-line treatments.