A study found that progressive muscle relaxation (PMR) group sessions improved treatment adherence of a scalable social anxiety intervention but had little effect on outcomes. These findings were published in Internet Interventions.

University students (N=39) with high social anxiety from Reykjavík University in Iceland were recruited for this study. Participants had full access to an automated, web-based cognitive behavioral therapy (CBT) intervention with 7 modules and were randomized to receive 3 additional group online psychoeducation sessions (n=8), 3 additional online PMR session (n=12), or no additional group sessions (control; n=19). Participants were evaluated for intervention adherence and the effect on social phobias and anxiety.

Participants were aged mean 29.0 (range, 19-56) years and 82.7% were women.

Continue Reading

Half of participants attended the group psychoeducation session (52.38%) or the group PMR session (54.54%). Completion of all 7 modules in the CBT intervention was highest for the PMR recipients (27.27%), followed by the controls (17.39%), and was lowest for the psychoeducation group (9.52%).

Module completion differed significantly among treatment arms (F[2,43], 5.06; P =.011).

Posttreatment Social Interaction Anxiety Scale (SIAS; F[2,35], 1.18; P =.319), Brief Fear of Negative Evaluation (BFNE; F[2,35], 1.19; P =.318), or Quality of Life Scale (QOLS; F[2,35], 0.843; P =.439) scores did not differ between treatment arms. However, within treatment groups, BFNE differed significantly from baseline (all P <.013) and overall, QOLS scores had improved (P =.014).

This study may have been limited as it was conducted during the COVID-19 pandemic, which may have affected participants’ social phobias and anxiety during the intervention period.

“In conclusion, the current results indicate PMR can improve treatment adherence for scalable social anxiety interventions. This finding has important implications for bolstering completion of online treatments for anxiety disorders. Future research with a larger sample should aim to explore the mechanisms by which additional relaxation group sessions may improve adherence to online CBT treatments,” said the study authors.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Sigurðardóttir S, Helgadóttir FD, Menzies RE, Sighvatsson MB, Menzies RG. Improving adherence to a web-based cognitive-behavioural therapy program for social anxiety with group sessions: A randomised control trial. Internet Interv. 2022;28:100535. doi:10.1016/j.invent.2022.100535