Group Exposure Workshops for Socially Anxious Undergraduates (OASIS)

Pilot Trial on the Contribution of Peer Leaders and Self-Compassion to Group Exposure Workshops for Socially Anxious Undergraduates

The purpose of the study is to investigate the effects of four versions of a workshop for social anxiety and public speaking stress. All participants are current University of Colorado Boulder undergraduate students. Participation in this research study lasts for approximately 8 weeks, and includes a pre-workshop questionnaire, 3 weekly workshop sessions (ranging from 2 to 3 hours each, including a 5-minute post-session questionnaire), a post-workshop questionnaire, and a 1-month follow-up questionnaire.

Study Overview

• Status: Recruiting
• Conditions: Social Anxiety Disorder; Public Speaking Fear; Public Speaking Anxiety; Social Fear
• Intervention / Treatment: Behavioral: Group Exposure for Social Anxiety; Behavioral: Peer-Enhanced Group Exposure Therapy for Social Anxiety; Behavioral: Self-Compassion Enhanced Group Exposure Therapy for Social Anxiety; Behavioral: Peer and Self-Compassion Enhanced Group Exposure Therapy for Social Anxiety

Detailed Description

The present study seeks to evaluate the feasibility, acceptability, and efficacy potential of a full factorial trial of a peer-led common humanity- and exposure-based workshop for social anxiety within a Multiphase Optimization Strategy (MOST) trial framework. The present study seeks to enroll and randomize participants (up to N = 200) by cohort to one of four conditions, reflecting a full factorial trial design. The inclusion of common humanity enhancements and the presence of a peer leader will each serve as independent variables, comprising of the following four study conditions: 1) common humanity with peer leader, 2) common humanity without peer leader, 3) peer leader without common humanity, and 4) exposure only (no common humanity and no peer leader). The investigators will assess outcomes after the workshop sessions (mid1, mid2, mid3, Post[T1]) and one-month following the conclusion of the last workshop session (T2).

The study has the following aims and hypotheses:

Aim 1: To evaluate the feasibility and acceptability of conducting a full factorial trial of a group exposure workshop for social anxiety within a MOST trial framework.

Hypothesis 1a (feasibility): At least 50% of screened, eligible participants will enroll in the study.

Hypothesis 1b (feasibility): Enrolled research participants will attend on average at least 2 out of 3 workshop sessions.

Hypothesis 1c (feasibility): Workshops will be delivered with high fidelity (80% of content checklist items covered, on average) and low contamination (20% or less inclusion of content specific to other conditions, on average) in each randomized condition.

Hypothesis 1d (acceptability): Participants will report a median satisfaction with the workshops of 4 or higher on the 1-5 Acceptability of Intervention Measure (AIM).

Hypothesis 1e (acceptability): Participation in the group workshops will be acceptable, indicated by high overall satisfaction with the workshop across conditions (mean rating of >20 on the Client Satisfaction Questionnaire-8).

Hypothesis 1f (acceptability): ≤20% of participants will report a study burden of 4 or higher on a 1-5 burden measure.

Aim 2: To evaluate the feasibility and efficacy potential of primary and secondary outcomes. Please note that the investigators do not expect to find statistically significant differences between conditions in this pilot study - only patterns of differences in the predicted directions outlined below. This pilot study will establish the foundation for a larger, definitively powered, future trial.

Hypothesis 2a (Feasibility of assessment): At least 70% of participants will complete pre, post, and follow-up surveys.

Hypothesis 2b (Efficacy potential): Compared to the exposure only condition, reliable change magnitudes (Jacobson & Truax, 1991) will be higher within the peer and compassion-enhanced conditions, with additive effects for the fully enhanced condition, on measures of 1) participant retention, 2) social anxiety, 3) depression, and 4) self-compassion.

Hypothesis 2c (Cultivating community): Compared to the exposure-only condition, reliable change magnitudes will be higher within the peer and compassion-enhanced conditions, with additive effects for the fully enhanced condition, on measures of 1) stigma and 2) sense of belonging.

Hypothesis 2d (Barriers to access and engagement): Compared to the exposure only condition, reliable change magnitudes will be higher in the peer and compassion-enhanced conditions, with additive effects for the fully enhanced condition, on measures of 1) enjoyableness, 2) likelihood to recommend, and 3) readiness and willingness to engage in therapy. Across conditions, participants will indicate a preference for peer co-facilitators over mental health providers only.

• Study Type: Interventional
• Enrollment (Estimated): 200
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Joanna Arch, PhD; Phone Number: 303.492.4634; Email: joanna.arch@colorado.edu

Study Locations

• United States
  • Colorado
    • Boulder, Colorado, United States, 80302
      • Recruiting
      • Renee Crown Wellness Institute and Department of Psychology & Neuroscience, University of Colorado Boulder
      • Principal Investigator: Joanna Arch, PhD
      • Contact: Joanna Arch, PhD; Phone Number: 303.492.4634; Email: joanna.arch@colorado.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age = 18-30
• Able to read and write fluently in English
• Current undergraduate students at CU
• Experiencing elevated social anxiety symptoms indicated by a SPIN score ≥ 19
• Experiencing moderate to high communication anxiety indicated by a PRCA- 24 score ≥ 59
• Open to receiving help for social anxiety or public speaking fears indicated by a help seeking score of ≥ 3 out of 5 (at both screening timepoints as explained below)
• Able to voluntarily consent to participation
• Able to participate fully in the study (including in the in-person group workshops and in survey completion) as assessed by screening questions and the study P

Exclusion Criteria:

• Are currently experiencing moderately severe or severe depression represented by the validated cutoff score for major depression on the PHQ-8 of greater than 14 (Kroenke et al., 2001)
• Score in the moderate-high range for suicide risk as indicated by the CSSRS (Salvi, 2019), report a suicide attempt in the past 12 months, or report current, ongoing suicidal ideation along with a past (lifetime) suicide attempt
• Are current students of the PI or clients or current students of the doctoral student co-facilitators

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: Single

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Exposure Only; Group exposure therapy for social anxiety and public speaking fears.	Behavioral: Group Exposure for Social Anxiety; Group exposure therapy for social anxiety and public speaking fears.
Experimental: Compassion Enhanced; Group exposure therapy for social anxiety and public speaking fears plus self-compassion exercises aimed at inducing a sense of common humanity.	Behavioral: Self-Compassion Enhanced Group Exposure Therapy for Social Anxiety; Group exposure therapy for social anxiety and public speaking fears plus piloted exercises from the investigators' previous studies among socially anxious undergraduates (Slivjak et al., 2022; Slivjak & Arch, in preparation), refined during the investigators' quality improvement project, that are designed to enhance compassion.
Experimental: Peer enhanced; Group exposure therapy for social anxiety and public speaking fears facilitated by a pair of doctoral student and undergraduate student co-facilitators who will explicitly use appropriate self-disclosure to establish the co-facilitators as individuals with lived experiences of social anxiety and public speaking fears.	Behavioral: Peer-Enhanced Group Exposure Therapy for Social Anxiety; Group exposure therapy for social anxiety and public speaking fears facilitated by a pair of doctoral student and undergraduate student co-facilitators who explicitly use appropriate self-disclosure to establish the co-facilitators as individuals with lived experiences of social anxiety and public speaking fears.
Experimental: Fully enhanced; Group exposure therapy for social anxiety and public speaking fears plus self-compassion exercises aimed at inducing a sense of common humanity, facilitated by a pair of doctoral student and undergraduate student co-facilitators who will explicitly use appropriate self-disclosure to establish the co-facilitators as individuals with lived experiences of social anxiety and public speaking fears.	Behavioral: Peer and Self-Compassion Enhanced Group Exposure Therapy for Social Anxiety; Group exposure therapy for social anxiety and public speaking fears plus piloted exercises from the investigators' previous studies among socially anxious undergraduates (Slivjak et al., 2022; Slivjak & Arch, in preparation), refined during the investigators' quality improvement project, that are designed to enhance compassion. These groups are facilitated by a pair of doctoral student and undergraduate student co-facilitators who explicitly use appropriate self-disclosure to establish the co-facilitators as individuals with lived experiences of social anxiety and public speaking fears.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Attendance rate	Average number of workshop sessions attended by enrolled research participants.	3 weeks during the intervention (workshops 1, 2, and 3, 1 week apart)
Enrollment rate	Ratio of screened, eligible participants who enrolled in the study.	Pre-intervention (from screening to enrollment)
Acceptability of Intervention Measure (AIM)	Workshop satisfaction rating, Range = 1 - 5, Higher scores indicate better outcome (greater acceptability)	48 hours after the final intervention session and 1-month follow-up
Client Satisfaction Questionnaire-8 (CSQ-8)	Satisfaction with workshops, Range = 8 - 32, Higher scores indicate better outcome (greater satisfaction)	48 hours after the final intervention session and 1-month follow-up
Social Phobia Inventory (SPIN)	Social anxiety symptom measure, Range = 0 - 68, Higher scores indicate worse outcome (worse social phobia)	48 hours after the final intervention session and 1-month follow-up
Liebowitz Social Anxiety Scale (LSAS)	Measure assessing fear/anxiety across a broad range of social and performance situations, Range = 0 - 144, Higher scores indicate worse outcome (worse social anxiety)	48 hours after the final intervention session and 1-month follow-up

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Fidelity	Percentage of content checklist items covered during in-person workshops.	3 weeks during the intervention (workshops 1, 2, and 3, 1 week apart)
Contamination	Percentage of content specific to other conditions covered in each randomized condition.	3 weeks during the intervention (workshops 1, 2, and 3, 1 week apart)
Study Burden	Rating of study burden.	48 hours after the final intervention session and 1-month follow-up
Survey Completion	Percentage of participants who complete pre, post, and follow-up surveys.	between 10 and 0 days before the first intervention session, 48 hours after the final intervention session, and 1-month follow-up
Participant Retention	Percentage of participants who completed workshops.	3 weeks during the intervention (workshops 1, 2, and 3, 1 week apart)
Likelihood to Recommend	Rating of how likely participants would be to recommend the workshop to others.	48 hours after the final intervention session and 1-month follow-up
Enjoyableness	Rating of degree to which participants found the workshop to be enjoyable.	48 hours after the final intervention session and 1-month follow-up
Provider preference	Rating of whether participants have a preference for peer co-facilitators over mental health providers only.	between 0 and 10 days before the first intervention session, 48 hours after the final intervention session, and 1-month follow-up
Personal Report of Communication Apprehension (PRCA-24)	Measure of trait communication and public speaking anxiety, Range = 24 - 120, Higher scores indicate worse outcome (greater communication apprehension)	48 hours after the final intervention session and 1-month follow-up
Patient Health Questionnaire-8 (PHQ-8)	Measure of depressive symptoms, Range = 0 - 24, Higher scores indicate worse outcome (worse depression)	48 hours after the final intervention session and 1-month follow-up
Self-Compassion Scale - Short (SCS)	Measure of trait self-compassion and common humanity, Range = 1 - 5, Higher scores indicate better outcome (greater self-compassion)	48 hours after the final intervention session and 1-month follow-up
Stigma and Self-Stigma Scale, help seeking behaviors and self-stigma subscales (SASS)	Measure of stigma toward mental health problems. Help-seeking behaviors subscale: Range = 0 - 24, Higher scores indicate worse outcome (worse help-seeking behaviors) Self-stigma subscale: Range = 0 - 24, Higher scores indicate worse outcome (greater self-stigma)	48 hours after the final intervention session and 1-month follow-up
Sense of Belonging Scale	Measure of how connected participants feel to their group members, Range = 1-7, Higher = Higher scores indicate better outcome (greater sense of belonging)	48 hours after the final intervention session and 1-month follow-up

Collaborators and Investigators

• Sponsor: University of Colorado, Boulder

Study record dates

Study Major Dates

• Study Start (Actual): June 12, 2024
• Primary Completion (Estimated): October 1, 2025
• Study Completion (Estimated): October 1, 2025

Study Registration Dates

• First Submitted: October 8, 2024
• First Submitted That Met QC Criteria: November 1, 2024
• First Posted (Actual): November 4, 2024

Study Record Updates

• Last Update Posted (Estimated): May 20, 2025
• Last Update Submitted That Met QC Criteria: May 15, 2025
• Last Verified: May 1, 2025

More Information

Terms related to this study

• Keywords: Social Anxiety; Self-compassion; Exposure Therapy; Peer-led; Public Speaking Anxiety; Common Humanity
• Additional Relevant MeSH Terms: Mental Disorders; Phobic Disorders; Phobia, Social; Anxiety Disorders
• Other Study ID Numbers: 24-0178

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No