Social anxiety disorder (SAD) in young people aged 11-18 years Mental and Behavioural Disorders
Conditions
Interventions
This interventional study is a parallel RCT in adolescents with SAD. Participants will be randomised to receive either OSCA or General CBT, with a randomisation ratio of 1:1 and stratification based o
Sponsors
University of Oxford
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Clinicians: 1. Working within a participating NHS-commissioned service 2. Willing to participate 3. Clinical capacity and managerial approval to participate Young people: 1. Aged 11-18 years at assessment 2. A DSM-5 diagnosis of social anxiety disorder (American Psychiatric Association, 2013) that has been identified as the primary presenting disorder based on clinical assessment. SAD will be deemed primary if participants meet diagnostic criteria for SAD and this is the difficulty that they associate with most impairment (of any comorbid conditions) and for which they are seeking treatment. 3. Agreement not to start medication during the trial. If on a psychotropic medication at eligibility assessment then this has been stable for 8 weeks and there is an agreement to remain on a stable dose throughout the trial. 4. Agreement not to start another psychological therapy during the trial 5. Able to speak, read and write in English to a level that allows them to access treatment content and measures 6. Willingness to be randomised to either treatment 7. Willing to assent/consent to participate Parents/Carers: 1. Over 18 years of age 2. Able and willing to provide written informed consent for their child’s participation in the study. 3. Willing and able to participate.
Exclusion criteria
Exclusion criteria: Current participant exclusion criteria as of 24/06/2025: Clinicians No further exclusion criteria Young people 1. Diagnosed with a learning disability (i.e., IQ<70). Neither treatment has been sufficiently evaluated with this population 2. Autism has been diagnosed or is suspected (which we operationalise based on clinical assessment and in line with standard local procedures) and one or both of the treatments offered in this trial is considered to require adaptation to accommodate the young person’s autistic traits 3. Another condition is primary. Anxiety is a common feature of conditions that neither broad-based CBT or OSCA were designed to treat (e.g., eating disorder, trauma-related disorders, dissociative disorders, psychosis, somatic symptom and related disorders, gender dysphoria, and autism/ADHD where there are significant unmet social/environmental needs). Where these other conditions are primary, they will require priority assessment and treatment and the individual will not be eligible for inclusion in this study. 4. At high risk of significant harm to self, to other, or from others to the point where managing risk needs to be the primary focus of any intervention 5. Currently receiving a psychological intervention or have received previous treatment with cognitive therapy or Graded CBT for social anxiety 6. There are clear environmental risks that need to be urgently addressed and if addressed are likely to relieve symptoms (e.g., severe and ongoing bullying, subject to current abuse or neglect, ongoing trauma) Parents/Carers No further exclusion criteria Previous participant exclusion criteria: Clinicians a. No further exclusion criteria. Young people a. Diagnosed with a learning disability (i.e., IQ<70). Neither treatment has been sufficiently evaluated with this population. b. Autism has been diagnosed or is suspected (the potential participant has been referred for ASD assessment). c. Another condition is primary. Anxiety is a common feature of conditions that neither broad-based CBT or OSCA were designed to treat (e.g., eating disorder, trauma-related disorders, dissociative disorders, psychosis, somatic symptom and related disorders, gender dysphoria, and autism/ADHD where there are significant unmet social/environmental needs). Where these other conditions are primary, they will require priority assessment and treatment and the individual will not be eligible for inclusion in this study. d. At high risk of significant harm to self, to other, or from others to the point where managing risk needs to be the primary focus of any intervention. e. Currently receiving a psychological intervention or have received previous treatment with cognitive therapy or Graded CBT for social anxiety. f. There are clear environmental risks that need to be urgently addressed and if addressed are likely to relieve symptoms (e.g., severe and ongoing bullying, subject to current abuse or neglect, ongoing trauma). Parents/Carers a. No further exclusion criteria.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Self-reported social anxiety symptoms as measured by the Liebowitz Social Anxiety Scale for children and adolescents (self-report version; LSAS-CA), at baseline, 16-, 26-, and 40-weeks post-randomisation. | — |
Secondary
| Measure | Time frame |
|---|---|
| The following secondary outcome measures will be assessed at baseline, 16-, 26-, and 40-weeks post-randomisation: 1. Parent and self-reported general anxiety and depression symptoms as measured by the Revised Child Anxiety and Depression Scale (RCADS) 2. Anxiety-related impairment as measured by the Child Anxiety Impact Scale 3. To assess cost-effectiveness, the self-reported CHU-9D, parent-reported EQ-5D-5L, and parent/carer-report Client Service Receipt Inventory (CSRI) will be completed | — |
Countries
England, United Kingdom
Contacts
Public ContactCharlotte Mason
Outcome results
None listed