What should be treated first? Social anxiety or insomnia? A pilot study investigating the effects from cognitive behavioural therapy for people with comorbid social anxiety and insomnia.

Brief name (Arm 1): Six individual sessions of cognitive behavioural therapy for social anxiety + four individual sessions of cognitive behavioural therapy for insomnia over ten weeks. Brief name (Arm 2): Four individual sessions of cognitive behavioural therapy for insomnia + six individual sessions of cognitive behavioural therapy for social anxiety over ten weeks. There was no washout period between the two treatments. Cognitive behavioural therapy (CBT) is an evidence-based psychotherapy method for social anxiety and sleep problems respectively. The emphasis is on problems "here and now" rather than problems in the past. CBT includes a combination of cognitive techniques and behavioural techniques. The cognitive techniques strive to, in short, an increased awerness of negative thoughts and beliefs related to a specific disorder and to consciously strive to question or alter them. The aim is to learn to interpret situations in a more realistic manner. Behavioural techniques means trying new behaviors and approaches, as mental disorders often are maintained by dysfunctional behaviours such as avoiding any situation that might provoke anxiety. The treatment manuals used in this study have been scientifically tested. CBT for insomnia included the following techniques: psychoeducation about sleep, stimulus control, sleep hygiene, sleep restriction, and constructive worry. CBT for social anxiety includes the following techniques: psychoeducation about social anxiety, cognitive restructuring, exposure, and behavioural experiments. Two master students in clinical psychology will conduct the therapies. The students have previous experience in clinical manual-based therapies. The sessions will be about one hour long each and be delivered face to face at Örebro University (Sweden). The therapists will receive supervision from two clinical psychologists (one expert on insomnia and one expert on social anxiety) with licenses to practice. The treatments will be manual-based and as such not personalised. Treatment fidelity will be assessed through the use of therapist check lists, to be completed by the therapists after every session.