Bridging thought and experience Integrating CBT with psychodrama for social anxiety

This dissertation introduces and evaluates Cognitive Behavioral Psychodrama Therapy (CBPT), an integrative group treatment for Social Anxiety Disorder (SAD). SAD is a prevalent and impairing condition marked by fear of negative evaluation and commonly co-occurs with depression, which reduces treatment responsiveness. While Cognitive Behavioral Group Therapy (CBGT) is an evidence-based intervention, many individuals do not fully benefit. CBPT was developed by integrating the cognitive-behavioral framework of CBGT with experiential, action-based techniques of psychodrama (PD), aiming to enhance treatment outcomes.
A pilot study demonstrated the feasibility and acceptability of CBPT. A subsequent randomized controlled trial compared CBPT, CBGT, and PD, showing that all three effectively reduced social anxiety,. An experimental single-session study confirmed the unique value of role reversal, a central psychodrama technique, in modifying negative social cognitions. Mechanism analyses identified avoidance as a consistent mediator across treatments, while CBPT uniquely addressed both perceived costs and probabilities of negative evaluation. Finally, moderation analyses indicated that patients with comorbid depression benefited more from CBPT than from CBGT or PD. Overall, the findings highlight CBPT as a promising, person-oriented, and evidence-informed intervention for SAD, particularly for individuals with comorbid depression.