An intervention to build social identities improves mental health and wellbeing in people with elevated social anxiety: Evidence from a single-arm clinical trial

Objectives: Current best-practice treatments for social anxiety disorder do not directly address loneliness, despite its role in the maintenance of the condition. The current study targets this issue directly, using mixed methods to provide an initial test of the efficacy of an established loneliness intervention, Groups 4 Health (G4H), among 33 people with clinically elevated social anxiety symptoms. 

Design: A single-arm design was used and outcomes were assessed at baseline, programme completion and 5-month follow-up (3 months after programme completion). 

Methods: Loneliness, social anxiety symptoms, depression symptoms and well-being were assessed at each time point. Semi-structured follow-up interviews were also conducted to explore the feasibility and acceptability of G4H in this population. 

Results: Results from intention-to-treat analyses provide initial evidence of the programme's efficacy: participants' loneliness (d = −1.08), social anxiety symptoms (d = −.45), and depression symptoms (d = −.60) reduced significantly from baseline to 5-month follow-up while their well-being (d = 1.00) increased. Four themes emerged from reflexive thematic analysis: (1) the importance of challenging initial anxiety about attending group therapy, (2) the value of being vulnerable with fellow group members, (3) the role of G4H in increasing participants' social confidence, and (4) processes which both helped and hindered participants' ability to engage with their group. 

Conclusions: Together, results suggest that G4H is a promising and innovative treatment option for people with social anxiety, and further controlled evaluation is warranted.