Cognitive-Behavioral and Pharmacological Treatment for Social Phobia: A Meta-Analysis


Address correspondence to Robert A. Gould, Ph.D., Anxiety Disorders Program, WACC 815, Massachusetts General Hospital, 15 Parkman Street, Boston, MA 02114.


We conducted a meta-analysis using all available controlled treatment outcome studies of cognitive-behavioral and pharmacological treatments for social phobia (N= 24 studies, N= 1079 subjects). The mean social anxiety effect size for cognitive-behavioral treatments was .74 and for pharmacological treatments was .62. Both were significantly different from zero and the difference between them was not significant. Among cognitive-behavioral treatments, exposure-interventions yielded the largest effect size (ES) whether alone (ES = .89) or combined with cognitive restructuring (ES = .80). Selective serotonin reup-take inhibitors (ES = 1.89) and benzodiazepines (ES = .72) yielded the largest effect sizes for pharmacotherapy. According to cost projections, group cognitive-behavioral treatment offered the most cost-effective intervention.