Peer coach support in internet-based cognitive behavioral therapy for college students with social anxiety disorder: efficacy and acceptability

Social anxiety disorder is common among emerging adults and is associated with serious functional impairment. Cognitive-behavioral therapy (CBT) is an effective intervention for social anxiety. An online version may increase access but low completion rates limit utility. This study investigated a self-guided, internet-based CBT (ICBT) with peer coach support. Participants were 35 undergraduate students randomized for immediate treatment (IT) or wait-list control (WL) in a randomized controlled trial design. IT participants completed a six-week ICBT program on their own and met briefly with a minimally trained undergraduate student as a “coach” between each lesson. IT participants had a greater decline in social anxiety relative to WL participants. High treatment retention and satisfaction ratings demonstrate the acceptability of this online intervention with peer coach support. The higher than expected enrollment from international students suggests ICBT may serve hard-to-reach college populations. This model of care could augment traditional mental health services to expand the availability of care.