What is the effectiveness of Group Cognitive Behaviour therapy compared to a wait list control in a group of university students with social phobia?

Participants would be seen at a community setting (non-hospital based) at the Faculty of Medicine, University of Kelaniya, and the University of Moratuwa

Participants meeting the inclusion/exclusion criteria will be randomized into two arms using computer generated random numbers.

Arm 1 will receive Cognitive Behavior Group Therapy (GCBT). This will run for 12-weeks and will combine in vivo exposure and cognitive restructuring with sessions by a trained therapist (total of four sessions). Sessions will take place in groups of ten participants. Each session will be specifically structured to include education, role plays and repeated scenarios, and discussion on treatment gains and recommendations for future practice. Between sessions, subjects will complete homework assignments designed to help them confront fearful social situations using the techniques learned in therapy.

The sessions will be videotaped, evaluated and feedback and supervision will be provided to the therapists weekly by a psychiatrist who has had extensive training in psychotherapy.

Arm 2 will be the wait list control arm. Participants will be managed in the standard manner and reviewed for symptoms pattern worsening, etc at one week, 6 weeks and 12 weeks. Sessions will be randomly audio recorded to make sure no CBT is being administered.

All participants will be reviewed by a blinded consultant psychiatrist at one week, six weeks and 12 weeks, especially to see any worsening of symptoms, emergence of depressive symptoms and or suicidal ideas. In such an instance participants will be withdrawn from the trial and offered an alternative treatment.

1. Consenting males and females above 18 years of age
2. Current registration as an undergraduate student of University of Kelaniya or the University of Moratuwa
3. Score of 6 or more in the Mini-Social Phobia Inventory(Mini-SPIN), then confirmed by the Liebowitz Social Anxiety Scale- Self Rated version (LSAS -SR, a score of 55 or more) and the social phobia criteria of the Mini-International Neuropsychiatric Interview (M.I.N.I.)
4. Score of less than 70 on the Zung Depression rating scale and score less than 3 suicidal ideas (on item 19) of the Zung depression rating scale

1. Currently undegoing CBT with psychologist or another healthcare professional
2. Currently on a medication for social phobia (selective Serotonine Reuptake Inhibitor/Tricyclic antidepressant/ Benzodiazepines)
3. At risk of self-harm or suicide
4. Current or past diagnosis of psychosis, schizophrenia or bipolar disorder
5. Primary diagnosis of major depressive disorder, panic disorder, obsessive compulsive disorder, post-traumatic stress disorder or substance dependence
6. Planning to become pregnant or if pregnant or breastfeeding