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Purpose <p>University students show elevated rates of social anxiety, yet most never access treatment, and brief scalable formats remain underdeveloped. This study developed and evaluated a 14-day fully self-help internet-based cognitive behavioral therapy (iCBT) intervention for university students with subclinical social anxiety. A second aim was to examine the timing of symptom change across the program. A third was an exploratory cross-study comparison with a previous virtual reality exposure therapy (VRET) self-help intervention.</p> Methods <p>In a randomized controlled trial, 61 students were allocated to the iCBT intervention or a waitlist control condition. Fifty-seven were included in the final analysis. Social anxiety, psychological distress, and positive and negative affect were assessed at pretest and posttest. The iCBT group was additionally assessed on Days 6 and 10 and at 1-month follow-up.</p> Results <p>Compared with waitlist control, iCBT produced significantly greater reductions in social anxiety and psychological distress. Effect sizes were large, though the waitlist comparator likely inflates this magnitude. Negative affect decreased significantly. Positive affect did not change. Uncontrolled within-group analyses in the iCBT arm tracked the timing of change: global social anxiety and psychological distress improved by Day 6, and reductions in social fear/anxiety and avoidance were clearer by post-intervention. Most within-group gains held at 1-month follow-up. These timing patterns lack a control group at the intermediate and follow-up points and are therefore descriptive. An exploratory between-study comparison with a prior VRET self-help intervention suggested broadly similar overall improvement, but the non-randomized, cross-sample design does not support claims about which intervention performed better on any domain.</p> Conclusions <p>A brief, fully self-help iCBT format reduced social anxiety and psychological distress relative to waitlist control in university students with subclinical symptoms. Retention was high (57 of 61). Whether the format is low-burden, scalable, or superior to existing self-help options remains untested here and requires direct comparison and dedicated feasibility outcomes.</p>

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A 14-Day Self-help Internet-Based Cognitive Behavioral therapy for Social Anxiety College Students: Randomized Controlled Evidence and Exploratory Cross-Study Comparison

  • 期刊论文

  • 发表日期：

    2026年7月25日

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  • Heming Wang,
  • Boyi Song,
  • Chinghsiang Kan,
  • Ya Zhang

摘要

Purpose

University students show elevated rates of social anxiety, yet most never access treatment, and brief scalable formats remain underdeveloped. This study developed and evaluated a 14-day fully self-help internet-based cognitive behavioral therapy (iCBT) intervention for university students with subclinical social anxiety. A second aim was to examine the timing of symptom change across the program. A third was an exploratory cross-study comparison with a previous virtual reality exposure therapy (VRET) self-help intervention.

Methods

In a randomized controlled trial, 61 students were allocated to the iCBT intervention or a waitlist control condition. Fifty-seven were included in the final analysis. Social anxiety, psychological distress, and positive and negative affect were assessed at pretest and posttest. The iCBT group was additionally assessed on Days 6 and 10 and at 1-month follow-up.

Results

Compared with waitlist control, iCBT produced significantly greater reductions in social anxiety and psychological distress. Effect sizes were large, though the waitlist comparator likely inflates this magnitude. Negative affect decreased significantly. Positive affect did not change. Uncontrolled within-group analyses in the iCBT arm tracked the timing of change: global social anxiety and psychological distress improved by Day 6, and reductions in social fear/anxiety and avoidance were clearer by post-intervention. Most within-group gains held at 1-month follow-up. These timing patterns lack a control group at the intermediate and follow-up points and are therefore descriptive. An exploratory between-study comparison with a prior VRET self-help intervention suggested broadly similar overall improvement, but the non-randomized, cross-sample design does not support claims about which intervention performed better on any domain.

Conclusions

A brief, fully self-help iCBT format reduced social anxiety and psychological distress relative to waitlist control in university students with subclinical symptoms. Retention was high (57 of 61). Whether the format is low-burden, scalable, or superior to existing self-help options remains untested here and requires direct comparison and dedicated feasibility outcomes.