While computers are not capable of replacing human therapists, a new pilot study finds that a software program can help to relieve social anxiety.
The new therapy application is called cognitive bias modification (CBM), a technique that helps individuals relieve anxiety and view new situations in a calm manner.
Participants in the study improved their scores on a standardized measure of anxiety and on a public speaking task after completing two simple exercises twice a week for four weeks.
The research findings are published in the journal Depression and Anxiety.
Investigators hope CBM can provide a new option for anxiety sufferers who cannot find or pay for a qualified therapist, who are afraid to try cognitive behavior therapies where they directly confront their fears, or who can’t or don’t want to try medications.
Nevertheless, the idea of computer-based therapy is controversial.
“A lot of people are skeptical, particularly people like me who are clinicians and know how hard it is to help people with anxiety and how much effort and time it takes in therapy,” said study author and psychologist Dr. Courtney Beard.
“It just doesn’t seem possible that a computer program could produce similar effects. But I’m more of a scientist than a clinician so I want to see data.”
The study is the first to combine two techniques of CBM to treat social anxiety disorder: one that seeks to enhance subjects’ control over what they pay attention to and another that trains them to interpret situations less anxiously.
In the “attention” part of the study, participants were trained by the computer program to ignore a worrying social cue and instead to complete a task.
Subjects were quickly shown both a disgusted face and a neutral face on a split screen. One face would quickly be replaced with a letter, either an E or an F. The subjects’ task was to report which letter they saw.
For those receiving the therapy, the neutral face was always the one replaced, meaning the subjects had to divert their attention from the worrisome disgusted face.
For the placebo group, either face had an equal chance of being replaced.
The objective of the intervention is to train anxiety sufferers to assign nonthreatening interpretations to social situations.
After the therapy intervention, subjects self-reported their anxiety level dropped by 25 percent using a standard anxiety scale.
Participants were also evaluated by trained personnel who did not know if the individuals were part of the test group or the placebo (blinded). The evaluators judged individuals on a public speaking task, a five-minute impromptu speech, at the beginning and the end of the study.
The scores showed a significant improvement in those who received the therapy, while the speaking scores of the placebo group got worse.
The authors said the study is the first clinical trial to measure anxiety and behavioral performance measures, such as public speaking.
Researchers also asked participants if the therapy was credible (e.g., did the therapy make sense?) and acceptable (was this something you could do?). On both issues, participants were generally positive.
Despite the positives associated with the study, a major limitation of the randomized clinical trial was the small sample size (20 people who received the therapy and 12 placebo controls).
Although the study’s results agree with many of the other small studies published to date, Beard said CBM still must be subjected to larger trials with longer followup times before the therapy can be considered convincing.
“This certainly isn’t going to replace therapy,” she said. “I see it more as a very inexpensive, very easy to deliver, first-line intervention that could help a lot of people. For those it doesn’t help, then maybe we could devote the more expensive and time-intensive resources to them.”
Source: Brown University