Self-help for Social Anxiety:
Preliminary Results on a Mindfulness and Acceptance-Based Approach
Nancy
1
Kocovski,
Jan
2
Fleming,
1Wilfrid
Laurier
Meagan
2
University, The
Hypotheses
It was expected that compared to those in the control condition, those
assigned to the self-help condition would experience significantly less social
anxiety, depression, fusion with thoughts, and greater mindfulness and selfcompassion at post-treatment, and the one-month follow-up.
Method
Participants
• Community participants (N = 117) wanting help with social anxiety or
shyness were recruited via flyers and online posts.
• Participants’ ages ranged from 17-51 (M = 23.63, SD = 6.88), with the
majority being female (71.79%), and single/not married (83.76%).
• Ethnicity/Race: Caucasian (56.4%), Asian (23.9%), Indian/South Asian
(8.5%), Middle Eastern (3.4%) Hispanic (1.7%), Native Canadian (1.7%),
Mixed/Other (4.3%).
Measures:
•
•
•
•
•
Social Phobia Inventory (SPIN; Connor K. M. et al., 2000)
Beck Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996)
Freiburg Mindfulness Inventory (FMI; Walach et al., 2006)
Cognitive Fusion Questionnaire (CFQ; Gillanders et al., 2014)
Self-Compassion Scale (SCS; Neff, 2003)
Mindfulness
3
Clinic, Ryerson
• Participants in the self-help condition were given a book (Fleming & Kocovski,
2013) containing an 8-week plan of exercises to alleviate social anxiety and
shyness, which included strategies on mindfulness practice, values and goals,
defusion, and exposure.
• Participants in the wait-list control received the book at the end of 12 weeks.
Book
Condition
n = 60
Time 2
(8-weeks)
n = 48
Time 3
(12-weeks)
n = 49
Control
Condition
n = 57
Time 2
(8-weeks)
n = 46
Time 3
(12-weeks)
n = 45
Results
Book Completion
• 60.42% of participants fully read each of the chapters
• 4.17% read at least 50% of the book
• 20.83% read less than 50% of the book
• 10.42% did not read any of the book
• 4.16% did not answer
Feedback on Book
• At time 2, participants either agreed or strongly agreed that the book was
helpful (80.0%), helped them become more mindful (75.6%), and helped
with their social anxiety (66.6%).
• At time 3, participants either agreed or strongly agreed that they were
satisfied with the book (72.3%), found the book helped with their social
anxiety (53.1%), and continued to use the strategies they learned (55.3%).
Hierarchical Linear Modeling (HLM)
Measure
Rebecca
1
Blackie
Results (continued)
Procedure
Time 1
Baseline
Assessment
1
Flett,
University
Method (continued)
Introduction
Restricted Access to Treatment for Social Anxiety
• Social anxiety is often times a debilitating condition given its established
association with social isolation, reduced quality of life, and impaired social and
occupational functioning (see Steinert et al., 2013, for review)
• Many individuals are not able to access empirically supported treatment for
social anxiety for various reasons (e.g., financial, lack of availability, stigma, etc.)
• Self-help interventions may be one way in which this underserved population
is more readily able to access treatment
Benefits of Mindfulness and Acceptance-based Interventions
• These interventions encourage people to take a mindful, accepting stance to
experienced thoughts and feelings
• Research has shown that mindfulness and acceptance-based interventions
(MABIs) are nearly equivalent compared to traditional cognitive-behavioral
therapy (CBT) with respect to improvements in social anxiety and positive
mental health outcomes (Faucher et al., 2016; Kocovski et al., 2013)
• Given that these promising treatments may not be accessible to all who want
them, the present study sought to explore whether treatment delivered in an
alternative (self-help book) format would be effective
• Participants were assigned to self-help (book) condition or wait-list control
3
MacKenzie, Alison
% variance in
slopes of time
explained by
condition
90.76%
Coeff.
SE
t
p
d
SPIN
-3.47
0.74
-4.68
<.001
0.74
BDI-II
Variable
FMI
-2.63
TraitRNT
0.94
0.86
-3.07
<.001
0.39
RSQRSQSIAS
BDI-II
Rum 1.82 Dist .07
0.51
0.36
CFQ
SARQ-T
-2.20
.72*
0.60
.56* -3.64 .02 <.001 .54* 0.61 .41*
20.86%
.38*
.07
SCS
SARQ-S
3.31
.69*
0.79
.54* 4.17 -.02 <.001 .42* 0.82 .49*
23.39%
.34*
-.07
38.26%
ERQ-ES ERQ-CR
4.51%
Table 1. Between-Groups Comparisons on Slopes of Time.
Note. Random effects were not significant in any model. Coeff. = coefficient.
HLM Results (cont’d)
• All final HLM models
were estimated with
restricted maximum
likelihood estimation.
• As shown in Table 1,
condition significantly
predicted the slopes
of time for each
dependent variable,
with one exception.
The FMI (mindfulness)
was only approaching
significance.
• Means and standard
deviations per
condition, across
each time point are
presented in
Table 2.
Book Condition Control Condition
Variable
M
SD
M
SD
SPIN
Time 1
59.38
14.10
58.77
14.37
Time 2
51.50
12.06
57.84
14.32
Time 3
47.57
12.83
57.34
14.34
BDI-II
Time 1
20.55
13.24
24.73
11.79
Time 2
17.52
11.64
24.32
12.23
Time 3
14.68
11.91
24.12
14.87
FMI
Time 1
30.54
7.41
26.78
6.94
Time 2
33.99
7.00
28.36
5.58
Time 3
35.71
7.66
29.14
7.90
CFQ
Time 1
34.94
10.69
34.70
9.32
Time 2
29.99
8.84
34.42
8.38
Time 3
27.52
8.57
33.87
8.96
SCS
Time 1
70.40
12.00
64.83
11.66
Time 2
78.02
15.32
65.83
12.14
Time 3
81.83
14.33
66.33
12.80
Table 2. Differences between conditions across time
Discussion
• As expected, those in the book condition experienced significant
reductions in social anxiety, depression, and fusion with thoughts, as well
as significant increases in self-compassion, and marginal increases in
mindfulness, compared to those in the wait-list control condition.
• A very large proportion in the slopes of time for social anxiety were
accounted for by condition, suggesting the book played a very large role
in reducing social anxiety over time.
• However, only a small proportion in the slopes of time for mindfulness
were explained by condition. Future research is needed to investigate the
mechanisms of change. Change in the dependent variables over the 8
weeks will also be investigated.
• Limitations: all measures were self-report.
• Given the difficulties accessing treatment for some socially anxious
individuals, a mindfulness and acceptance self-help approach may be useful
Acknowledgements
The authors gratefully acknowledge financial support awarded to the first author from the
Ministry of Research and Innovation and from a grant partly funded by Laurier Operating funds.