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Daydreamer and Night Owl: Comparing Positive and Negative Outcome Cases in an Online, Clinician-Guided, Self-Help Intervention for Social Anxiety Disorder

Ava Schulz, Alessia Vincent, Thomas Berger

Abstract


Internet-Based Cognitive-Behavior Treatment (ICBT) has garnered strong empirical support in the last decade. However, despite the growing body of evidence that web-based treatments work, there are still a considerable number of clients who do not benefit sufficiently from such interventions. Recently, research has started to focus on identifying factors that affect treatment outcome and adherence to Internet interventions. To explore the difference between clients who are successful versus unsuccessful in response to ICBT, this article presents two systematic case studies that describe the course of treatment of a positive-outcome client (named "Daydreamer") and a more negative outcome client (named "Night Owl") in clinician-guided ICBT for Social Anxiety Disorder (SAD). We present focal points of therapist communication, as well as the clients’ individual gains and obstacles. Lastly, we explore several factors that seem to be crucial in this specific setting, such as therapist support, motivation, and establishing a working alliance via the Internet.

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