Cognitive behaviour therapy for social anxiety disorder: a systematic review and meta-analysis investigating different treatment formats

Cognitive behaviour therapy (CBT) for social anxiety disorder (SAD) can be delivered through several modalities, including individually-administered CBT (ICBT), group-based CBT (GCBT), and CBT delivered remotely (RCBT). We synthesised the current literature on ICBT, GCBT, and RCBT approaches in adults with SAD, and compared their relative effectiveness using a meta-analytic approach. This review included randomised controlled trials comparing a disorder specific CBT monotherapy (ICBT, GCBT, or RCBT) to a non-active control group in adults with diagnosed SAD. Eligible studies were searched through PsycINFO, Scopus, and EMBASE databases to April 2023. A total of 37 studies met the inclusion criteria (with 55 between-group comparisons; <i>N</i> = 3234). Between-group effect sizes were conducted using random effects models. Analyses indicated that RCBT (<i>k</i> = 23; <i>g</i> = 0.90; 95% CI = 0.74–1.06) and ICBT (<i>k</i> = 17; <i>g</i> = 0.95; 95% CI = 0.66–1.23) demonstrated large effects, while GCBT demonstrated medium effects (<i>k</i> = 15; <i>g</i> = 0.71; 95% CI = 0.49–0.94). The groups, however, did not differ significantly (Q₂ = 2.17, <i>p</i> &gt; .05). This study builds on the existing literature demonstrating the efficacy of these treatment approaches. <b>What is already known about this topic:</b>Cognitive behaviour therapy (CBT) is an effective treatment for adults with social anxiety disorder (SAD).CBT for SAD can be delivered using a variety of treatment approaches.Individually-administered CBT, group-based CBT and remotely-delivered CBT are the primary treatment modalities. Cognitive behaviour therapy (CBT) is an effective treatment for adults with social anxiety disorder (SAD). CBT for SAD can be delivered using a variety of treatment approaches. Individually-administered CBT, group-based CBT and remotely-delivered CBT are the primary treatment modalities. <b>What this topic adds:</b>This study compared the effectiveness of different CBT delivery methods.Individually-administered CBT and remotely delivered CBT result in large effect sizes, while group-based CBT results in medium effect sizes.Individually-administered CBT, group-based CBT and remotely-delivered CBT can be delivered with equal confidence based on client preference. This study compared the effectiveness of different CBT delivery methods. Individually-administered CBT and remotely delivered CBT result in large effect sizes, while group-based CBT results in medium effect sizes. Individually-administered CBT, group-based CBT and remotely-delivered CBT can be delivered with equal confidence based on client preference.