Work-Related Cognitive-Behavioral Therapy for Unemployed Persons with Social Anxiety

Prior research on social anxiety disorder (SocAD) has identified several work-related impairments (Stein et al., 2000; Wittchen et al., 2000; Stein & Kean, 2000; Heimberg et al.,1990; Scheier et al., 1992). Our prior longitudinal study of welfare-dependent mothers has shown that SocAD is the strongest psychiatric predictor of sustained reliance on welfare for support over time (Author, 2009). There is a need to develop a sustainable intervention to address employment problems among persons with SocAD.

This project involved a randomized trial comparing our newly-developed work-related cognitive behavioral therapy for social anxiety (WCBT; n=20) experimental group versus a vocational services-as-usual control condition (n=20). Participants were primarily homeless African Americans with social anxiety disorder who were seeking vocational assistance at a comprehensive vocational service center. WCBT is an eight session, work-focused, group CBT intervention for SocAD delivered by vocational service professionals to enhance intervention sustainability.

Preliminary results indicate that WCBT participants experienced significantly lower levels of social anxiety-related avoidance (Liebowitz - M=32.25 vs 40.84; p=.03) post-treatment compared to controls. WCBT participants also experienced non-significant, yet lower post-treatment scores on ratings of overall social anxiety, general anxiety and depression at the end of treatment. 35.0% of the WCBT versus 15.8% of control participants were working 20 or more hours per week at post-treatment.

WCBT is a promising method to improve social anxiety and employment among persons with SocAD. This ongoing project involves a unique sample of underserved participants with SocAD and an innovative community-based, participatory research effort.