Evidence-based interventions to address social anxiety disorder during COVID-19.
Social anxiety disorder (SAD), the fear of social situations, is one of the most common and disabling anxiety disorders in Canada, which is associated with reduced functioning, isolation, depression and suicidal ideation. COVID‑19 may have led to the persistence and eventual worsening of SAD as the opportunities for exposure to social interactions and access to health services were decreased. Further, deconfinement announcements may lead to worsening of symptoms. With anxiety on the rise in Canada, and more so in underserved and at-risk groups due to the differential impacts of COVID‑19 and pre-existing social and health inequities, mental health service needs are increasing. Cognitive behavioural therapy (CBT) is the most evidence-based treatment for SAD. With the move towards telehealth, it is reassuring that studies also show the effectiveness of CBT offered virtually for anxiety disorders. The Shyness Programme internet-delivered CBT (iCBT) for SAD was developed in Australia in 2008 and is available in English. We aim to 1) adapt the iCBT Shyness Program to the Canadian context, by conducting a French and English adaptation in Quebec and in Ontario to account for the preferences of racialized persons, socio-cultural, and linguistic minority groups; 2) examine the adapted program’s effectiveness; and 3) explore barriers and facilitating factors, including acceptability (e.g., among socio-cultural groups), to its implementation. The study will be carried out in community-based primary health care in Quebec and Ontario. Participants with SAD will self-refer or be prescribed iCBT. The program will be implemented via a virtual clinic at U de Sherbrooke. The trial outcomes will provide important evidence-based data to support the implementation and adoption of a Canadian adapted iCBT program, information useful for the scale-up of the intervention in Canada to improve the mental health of underserved populations with SAD and timely access to low-intensity iCBT.