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Emotion regulation therapy for social anxiety disorder: a single case series study

Published online by Cambridge University Press:  06 May 2021

Imaneh Abasi
Former Affiliation: Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Current Affiliation: Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abbas Pourshahbaz*
Former Affiliation: Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
Parvaneh Mohammadkhani
Former Affiliation: Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
Behrouz Dolatshahi
Former Affiliation: Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
Latif Moradveisi*
Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical Sciences, Hamadan, Iran
Douglas S. Mennin
Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, United States of America
*Corresponding authors. Emails: and
*Corresponding authors. Emails: and



Despite the vast majority of evidence indicating the efficacy of traditional and recent cognitive behaviour therapy (CBT) therapies in treating social anxiety disorder (SAD), some individuals with SAD do not improve by these interventions, particularly when co-morbidity is present.


It is not clear how emotion regulation therapy (ERT) can improve SAD co-morbid with symptoms of generalized anxiety disorder (GAD) and depression. This study investigated this gap.


Treatment efficacy was assessed using a single case series methodology. Four clients with SAD co-occurring with GAD and depression symptoms received a 16-session version of ERT in weekly individual sessions. During the treatment, self-report measures and clinician ratings were used to assess the symptom intensity, model-related variables, and quality of life, work and social adjustment of participants every other week throughout the treatment. Follow-up was also conducted at 1, 2 and 3 months after treatment. Data were analysed using visual analysis, effect size (Cohen’s d) and percentage of improvement.


SAD clients with depression and GAD symptoms demonstrated statistically and clinically significant improvements in symptom severity, quality of life, work, social adjustment and model-related measures (i.e. negative emotionality/safety motivation, emotion regulation strategies). The improvements were largely maintained during the follow-up period and increased for some variables.


These findings showed preliminary evidence for the role of emotion dysregulation and motivational factors in the aetiology and maintenance of SAD and the efficacy of ERT in the treatment of co-morbid SAD.

© The Author(s), 2021. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies

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