Digital single-session intervention for social anxiety across the lifespan – SEAL

• Applicant: Dr. Matthias Domhardt
• Subject Area: Personality Psychology, Clinical and Medical Psychology, Methodology
• Term: since 2025
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 560025923

Social anxiety disorder (SAD) is among the most common mental disorders across the lifespan and is associated with substantial functional impairments. Cognitive Behavioral Therapy (CBT) shows the best empirical support across age groups and is considered as first-line treatment of SAD. Despite the availability of evidence-based treatments like CBT, most individuals with SAD are unrecognized and untreated. Internet-based CBT (ICBT) has emerged as a scalable and cost-effective intervention that can contribute to address this treatment gap. Meta-analyses demonstrate the efficacy of ICBT for SAD, with medium to large effect sizes compared to controls in adolescent and adult samples. However, there is still much room for improving ICBT for SAD, since many individuals drop out from treatment or fail to achieve full recovery with standard ICBT. Single-session Interventions (SSIs) may contribute to improve the accessibility to mental health care by overcoming some treatment barriers such as time, costs, and personnel resources needed for standard-length treatments with multiple sessions while still achieving meaningful and rapid clinical improvement. Initial research has generally reported positive effects of SSIs in reducing a broad range of mental health problems so far. However, it remains unclear if the promising effects of SSIs apply also to SAD and can be generalized to clinical samples and different age groups across the lifespan. Furthermore, it needs to be investigated for whom SSIs or multi-session interventions for SAD might be more appropriate and which evidence-based components may lead to changes in treatment outcomes. The project SEAL, conducted in Switzerland and Germany, aims to be the first to evaluate a digital SSI for SAD in a larger multicenter randomized controlled trial (RCT), recruiting 420 adolescents and adults with a diagnosis of SAD. The primary outcome will be social anxiety symptoms measured using the Social Phobia Inventory at baseline, during the intervention, and at follow-up. Secondary outcomes include depressive symptoms, quality of life, social functioning, and potential negative effects. At the same time, moderators such as age, expectations, and preferences, as well as mediators derived from the maintenance mechanisms postulated by the cognitive model of SAD, will be examined to determine for whom and how the interventions work. In addition, by including adolescents and adults, the study provides a unique lifespan perspective on SAD treatment, addressing the artificial age boundaries that often separate adolescent and adult treatment. The project is the first of its kind to evaluate a digital SSI for SAD rigorously and will contribute to the scientific understanding of the moderators and mediators of change in single-session and multi-session interventions. This will be particularly valuable for designing future treatments, not only for SAD, but also for other mental health conditions.

• DFG Programme: Research Grants
• International Connection: Switzerland
• Co-Investigator: Professor Dr. Harald Baumeister
• Cooperation Partners: Professor Dr. Thomas Berger; Professorin Dr. Stefanie Julia Schmidt