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BACKGROUND: Cognitive Therapy for Social Anxiety Disorder (CT-SAD) based on the Clark & Wells model is a complex intervention comprised of a series of therapeutic elements. Two of the key ingredients are the self-focused attention and safety behaviour experiment and video feedback. The present study examined the effects of these two therapeutic procedures in adolescents with SAD, as well as common themes of the young people's social fears and negative self-images. METHOD: 35 participants with a diagnosis of SAD completed internet-delivered CT-SAD as part of a randomised controlled trial. We conducted a series of paired samples t-tests to evaluate the effects of the self-focused attention and safety behaviour experiment and video feedback. We applied Latent Dirichlet Allocation to identify latent topics based on participants' description of their social fears and negative self-images that were elicited during the course of these therapy procedures. RESULTS: Participants reported lower anxiety and more positive self-appraisals when focusing externally and dropping safety behaviours, compared to when focusing internally and using safety behaviours (ps 

Original publication

DOI

10.1016/j.jbtep.2025.102020

Type

Journal article

Journal

J Behav Ther Exp Psychiatry

Publication Date

15/02/2025

Volume

88

Keywords

Adolescent, CBT, Cognitive therapy, Imagery, Safety behaviours, Self-focused attention, Social anxiety