Randomized clinical trial of adapted mindfulness-based stress reduction versus group cognitive behavioral therapy for heterogeneous anxiety disorders

ObjectiveTo compare a mindfulness-based intervention with cognitive behavioral therapy (CBT) for the group treatment of anxiety disorders.MethodOne hundred five veterans (83% male, mean age = 46 years, 30% minority) with one or more DSM-IV anxiety disorders began group treatment following randomization to adapted mindfulness-based stress reduction (MBSR) or CBT.ResultsBoth groups showed large and equivalent improvements on principal disorder severity thru 3-month follow up (ps < .001, d = ?4.08 for adapted MBSR; d = ?3.52 for CBT). CBT outperformed adapted MBSR on anxious arousal outcomes at follow up (p < .01, d = .49) whereas adapted MBSR reduced worry at a greater rate than CBT (p < .05, d = .64) and resulted in greater reduction of comorbid emotional disorders (p < .05, d = .49). The adapted MBSR group evidenced greater mood disorders and worry at Pre, however. Groups showed equivalent treatment credibility, therapist adherence and competency, and reliable improvement.ConclusionsCBT and adapted MBSR were both effective at reducing principal diagnosis severity and somewhat effective at reducing self-reported anxiety symptoms within a complex sample. CBT was more effective at reducing anxious arousal, whereas adapted MBSR may be more effective at reducing worry and comorbid disorders.     

Religious versus Conventional Internet-based Cognitive Behavioral Therapy for Depression

The accessibility and efficacy of two Internet-supported interventions for depression: conventional cognitive behavioral therapy (C-CBT) and religious CBT (R-CBT) were investigated. Depressed participants (N = 79) were randomly assigned to either active treatment or wait-listed control group. Self-report measures of depression, anxiety, and life quality were collected before, immediately after, and 6 months after the intervention. Significant differences among the three conditions emerged at post-intervention with medium to large effect sizes (Cohen’s d between 0.45 and 1.89), but no differences between the R-CBT and C-CBT were found. However, the addition of religious components to CBT contributed to the initial treatment appeal for religious participants, thus increasing the treatment accessibility.     

Comparing Cognitive Behavioral Therapy and Systemic Therapy for Social Anxiety Disorder: Randomized Controlled Pilot Trial (SOPHO-CBT/ST)

This randomized controlled trial (RCT) aimed to pilot the newly developed manualized and monitored systemic therapy (ST) for social anxiety disorder (SAD), as compared to manualized and monitored cognitive behavioral therapy (CBT). We conducted a prospective multicenter, assessor-blind pilot RCT on 38 outpatients (ICD F40.1; Structured Clinical Interview for DSM (SCID); Liebowitz Social Anxiety Scale, LSAS-SR >30). The primary outcome was level of social anxiety (LSAS-SR) at the end of treatment. A total of 252 persons were screened, and 38 patients were randomized and started therapy (CBT: 20 patients; ST: 18 patients; age: M = 36 years, SD = 14). Within-group, simple-effect intent-to-treat analyses (ITT) showed significant reduction in LSAS-SR (CBT:d = 1.04; ST:d = 1.67), while ITT mixed-design ANOVA demonstrated the advantage of ST (d = 0.81). Per-protocol analyses supported these results. Remission based on reliable change indices also demonstrated significant difference (LSAS-SR: 15% in CBT; 39% in ST;h: 0.550), supported by blind diagnosticians’ ratings of those who completed therapy (SCID; 45% in CBT, 78% in ST,p = .083). No adverse events were reported. CBT and ST both reduced social anxiety, supporting patient improvement with the newly developed ST for SAD; this has yet to be verified in a subsequent confirmatory RCT.     

Brief Cognitive-Behavioral Therapy for Suicidal Inpatients

Suicide risk is elevated in psychiatric patients following discharge from inpatient care. Despite this vulnerability, there has been limited research investigating suicide prevention protocols that take into account the unique system characteristics of this setting (e.g., short lengths of stay, crisis stabilization treatment model, multidisciplinary team coordination). Cognitive-behavioral therapy (CBT) has demonstrated efficacy for improving suicide risk in outpatients, but has not been validated with inpatients. The current study was a treatment development and pilot feasibility open trial that modified brief cognitive-behavioral therapy (BCBT) for an inpatient setting (BCBT-I). Key treatment modifications included administering up to 10 sessions (depending on patient length of stay), daily, and in a standardized order, with core crisis management skills introduced during the first three sessions. In addition, coordination with the inpatient treatment team was included in BCBT-I implementation. Six adult inpatients with a recent suicide attempt enrolled and completed an average of 4.67 BCBT-I sessions (SD = 1.36). The treatment was highly acceptable (Client Satisfaction Questionnaire total score M = 3.49, SD = 0.73). Pre- to posttreatment effect sizes demonstrated improvements in suicidal ideation (d = 0.97), depression (d = 1.33), and suicidal implicit associations (d = 1.28). All but one of the participants (83%) completed follow-up assessments 1-, 2-, and 3-months postdischarge. Over follow-up, two participants reported suicidal ideation (both without intent), and none reported suicide attempts, preparatory acts or behaviors, or nonsuicidal self-injury. This study provided preliminary evidence supporting the feasibility of CBT to treat suicidal inpatients. Future research is needed to validate BCBT-I in a larger, randomized controlled trial to determine whether BCBT-I reduces suicide risk beyond that afforded by inpatient treatment alone.     

Emotional intelligence and risky driving behaviour in adults

BackgroundRisky driving is considered a key predictive factor in road traffic accidents resulting in morbidity and mortality. Intra-individual emotional and personality factors have been shown to influence risk-taking behaviours among drivers. Despite this, there is limited research investigating the individual dimensions of these constructs and their relationship to risky driving behaviour (RDB). The current study therefore aimed to assess whether the individual dimensions of Emotional Intelligence (EI) were implicated in RDB.MethodsThe sample comprised 179 adults (55% male) aged between 18 and 64 years (M = 29.85, SD = 11.46) and who currently held a valid driver’s licence completed an online survey. Emotional Intelligence was assessed via self-report using the Swinburne University Emotional Intelligence Test (SUEIT), and RDB was measured using both the Brief Distracted Driving Scale (BDDS) and the Dula Dangerous Driving Index (DDDI).ResultsRegression analyses revealed that ‘Risky Driving’ was related to greater levels of Emotional Recognition and Expression and lesser Age [F_{(6, 172)} = 2.27, p < 0.05: R² = 7.3%], and the Negative Emotions sub-scale of DDDI, was significantly predicted by Emotional Control and Age [F_{(6, 172)} = 6.41, p < 0.05: R² = 18.3%]. A mediation model incorporating Age, Emotional Control scores and the Negative Emotions driving behaviour score indicated that a significant indirect effect of Age through Emotional Control (K² = 0.08, 95% CI [−0.02, −0.03]). (H [3] = 10.98, p = 0.012).ConclusionsLower scores on specific indices of EI are associated with increased rates of RDB, suggesting that poor emotional control may impede an individuals’ ability to make safe behavioural decisions when driving. The effect sizes for these models were small, however, and further research is needed to explore the contributory components in this association. Greater awareness of the role of emotional regulation and driving behaviours may be useful in preventing RDB in adults.     

Dynamic vision training transfers positively to batting practice performance among collegiate baseball batters

A growing body of evidence demonstrates visual, perceptual, and oculomotor abilities contribute to batting performance in baseball and there is interest in whether training such abilities can transfer positively to batting performance. The current study tested this question through a pre-registered, randomized, and placebo-controlled intervention, conducted with 24 collegiate baseball players at two NCAA Division 1 universities. Athletes were randomized to receive either dynamic vision training consisting of stroboscopic, anticipatory timing, and eye quickness drills, or placebo drills stylized after control procedures in previous vision therapy studies. Generalized near-transfer was tested via a digital visual-motor task battery (n = 20), while sports-specific intermediate and far transfer of training were evaluated through instrumented batting practice metrics (n = 14) and box score performance in NCAA-sanctioned games (n = 12), respectively. The effects of training group were tested on these outcome measures while controlling for covariates such as pre-training expectations and site. Participants averaged 8.50 hours of training with no significant group differences in training adherence, expectations, or baseline assessments. ANCOVA revealed no group differences in measures of visual-motor skills or NCAA game statistics. However, batting practice demonstrated significant improvements in launch angle (p = 0.002, Cohen’s d = 0.74) and hit distance (p < 0.001, Cohen’s d = 0.70) for the active training cohort relative to the placebo control. This controlled and pre-registered pilot study therefore provides preliminary evidence that vision training may improve batting practice performance, creating new opportunities for the transfer of skill training and warranting further study.     

Psychometric adaptation of the driving cost and benefit scale in Chinese drivers

The present study aimed to adapt the Driving Cost and Benefit Scale (DCBS, Taubman-Ben- Ari, 2008) to Chinese drivers and examine its relationships with driving style and traffic violations. Nine hundred drivers aged 18 to 60 years were asked to complete the DCBS and the Multidimensional Driving Style Inventory. The results of exploratory factor analysis (n = 429) and confirmatory factor analysis (n = 429) yielded a 36-item scale with satisfactory reliability. The Chinese version of the DCBS contains seven factors, including three driving cost factors (damage to self-esteem, life endangerment and distress) and four driving benefit factors (impression management, sense of control, thrill and pleasure). Significant associations between the DCBS-C factors and driving styles and traffic violations show that the discriminant validity of the scale is acceptable. Moreover, the driving cost factor of damage to self-esteem and the driving benefit factor of thrill both contributed to drivers’ traffic violations and crashes. The findings show that the reliability and validity of the Chinese version of the DCBS are acceptable, and it can be used as a tool to measure driving motivation in China.     

The differences in hazard response time and driving styles of violation-involved and violation-free taxi drivers

The present study aimed to investigate the relationships between taxi drivers’ traffic violations in past driving and two domains: driving skill (hazard perception skill) and driving style. Five hundred and fifty taxi drivers aged 25 – 59 were recruited to finish a video-based hazard perception test and the Chinese version of the Multidimensional Driving Style Inventory (MDSI). The relationships between hazard response time, driving style and traffic violations were examined, and the differences in hazard response times and driving styles of violation-involved drivers (n = 220) and violation-free drivers (n = 330) were compared. The results showed that taxi drivers’ traffic violations are closely related to their driving styles and hazard response time. Violation-involved drivers scored significantly higher in hazard response time and maladaptive driving styles (i.e., anxious, risky and angry styles) and lower in careful driving style than violation-free drivers. More importantly, drivers’ hazard response time and driving styles can effectively predict their violation involvement in the last 12 months with an overall classification accuracy of 66.4%. The findings provide evidence for the usefulness of video-based hazard perception tests and the MDSI in taxi driver testing and training.     

Stepped Care Versus Direct Face-to-Face Cognitive Behavior Therapy for Social Anxiety Disorder and Panic Disorder: A Randomized Effectiveness Trial

The aim of this study was to assess the effectiveness of a cognitive behavioral therapy (CBT) stepped care model (psychoeducation, guided Internet treatment, and face-to-face CBT) compared with direct face-to-face (FtF) CBT. Patients with panic disorder or social anxiety disorder were randomized to either stepped care (n = 85) or direct FtF CBT (n = 88). Recovery was defined as meeting two of the following three criteria: loss of diagnosis, below cut-off for self-reported symptoms, and functional improvement. No significant differences in intention-to-treat recovery rates were identified between stepped care (40.0%) and direct FtF CBT (43.2%). The majority of the patients who recovered in the stepped care did so at the less therapist-demanding steps (26/34, 76.5%). Moderate to large within-groups effect sizes were identified at posttreatment and 1-year follow-up. The attrition rates were high: 41.2% in the stepped care condition and 27.3% in the direct FtF CBT condition. These findings indicate that the outcome of a stepped care model for anxiety disorders is comparable to that of direct FtF CBT. The rates of improvement at the two less therapist-demanding steps indicate that stepped care models might be useful for increasing patients’ access to evidence-based psychological treatments for anxiety disorders. However, attrition in the stepped care condition was high, and research regarding the factors that can improve adherence should be prioritized.     

Exercise training and health-related quality of life in generalized anxiety disorder

ObjectiveTo quantify the effects of six-weeks of resistance (RET) and aerobic exercise training (AET) on quality of life (QoL) among sedentary women with Generalized Anxiety Disorder (GAD).DesignData from our published randomized controlled trial of the effects of six-weeks of either RET or AET among GAD patients were analyzed.MethodThirty women with GAD were randomized to either six weeks of twice-weekly lower-body weightlifting or cycling, or wait-list control (WL). SF-36 subscales assessed dimensions of QoL. Hedges’ d effect sizes (95%CIs) quantified the magnitude of change in response to exercise training compared to WL.ResultsRET significantly improved role-physical (d = 1.04; 95%CI: [0.11–1.97]), role-emotional (d = 0.96; [0.04–1.89]), and mental health (d = 1.05; [0.11–1.98]). AET resulted in significant improvements in physical function (d = 1.31; [0.34–2.27]) and vitality (d = 0.93; [0.01–1.85]).ConclusionsExercise training improves dimensions of QoL among GAD patients. The largest effects were observed for role impairments, physical function, vitality, and mental health.     

When grandparents drive their grandchildren

Driving their grandchildren has become one of the common tasks grandparents perform as part of the support they provide for working parents. The current research made use of qualitative and quantitative methodologies in two complementary studies conducted on grandparents who drive their grandchildren, the first using personal interviews and the second self-report questionnaires. The goal of the qualitative study was to capture grandparents’ subjective experience (n = 27), whereas the quantitative study sought to provide more specific data on the factors affecting grandparents’ experience behind the wheel and attitudes to child restraints by examining the contribution of driving styles and parental influence (n = 330). The findings of the qualitative study indicate that having grandchildren in the car is a unique situation which affects grandparents’ emotions and driving behavior. Less careful drivers were found to adapt a more careful driving style when driving their grandchildren than when driving without them. In the quantitative study, risky and anxious drivers felt more tension when driving their grandchildren. Furthermore, parental intervention was found to heighten tension among grandparents. Finally, heightened tension and less angry and more careful grandparents’ driving styles were associated with more positive attitudes to child restraints. Possible explanations of the findings are discussed.     

Effectiveness of an Individualized Case Formulation-Based CBT for Non-responding Youths with Anxiety Disorders

The study examined the effectiveness of an individualized case formulation-based cognitive behavior therapy (CBT) for youths (9–17 years) with anxiety disorders and their parents after unsuccessful treatment with a manualized group CBT program (the Cool Kids). Out of 106 participant youths assessed at a 3-month follow-up after manualized CBT, 24 were classified as non-responders on the Clinical Global Impression-Improvement scale (CGI-I), and 14 of 16 non-responders with anxiety as their primary complaint accepted an offer for additional individual family CBT. The treatment was short-term (M sessions = 11.14) and based on a revised case formulation that was presented to and agreed upon by the families. At post-treatment, nine youths (64.3 %) were classified as responders on the CGI-I and six (42.9 %) were free of all anxiety diagnoses, while at the 3-month follow-up 11 (78.6 %) had responded to treatment and nine (64.3 %) had remitted from all anxiety diagnoses. Large effect sizes from pre- to post-individualized treatment were found on youths’ anxiety symptoms, self-reported (d = 1.05) as well as mother-reported (d = .81). There was further progress at the 3-month follow-up, while treatment gains remained stable from post-treatment to the 1-year follow-up. Results indicate that non-responders to manualized group CBT for youth anxiety disorders can be helped by additional CBT targeting each family’s specific needs.     

Children’s Perspectives of an Enhanced Cognitive-Behavioral Treatment for Child–Parent Dyads With Anxiety Disorders

Prior research has extensively evaluated the efficacy of cognitive-behavioral therapy (CBT) for child anxiety disorders—however, few studies have investigated anxious children’s perspectives and experiences of participating in CBT. This qualitative study explored children’s acceptability of a newly developed enhanced CBT intervention, designed specifically for the treatment of anxiety disorders in children with a clinically anxious parent. The study also explored children’s perceptions and experiences of individual (child only) and joint observational (child–parent) exposure activities that were key to the intervention. Ten children (age range 6–11, M = 8.5 years) and their mothers (age range 34–45, M = 39.5 years) completed in-depth semistructured interviews to investigate child participants’ anticipated and experiential acceptability of the enhanced CBT intervention. Thematic analysis revealed seven major themes broadly reflecting the acceptability, appropriateness, and perceived benefit of the intervention elements, with particular value credited to exposure tasks and the dyadic nature of the intervention. Findings suggest that future experimental evaluation of the enhanced intervention is warranted. Further, the study highlights that CBT for child anxiety disorders, where exposure work is a feature, is acceptable and perceived to be effective by its intended treatment recipients. Trial prospectively registered, preresults, ANZCTR1261900033410.     

Alliance

The alliance highlights the qualities of coordination, sincerity, and trust that run through the various (CBT) interventions. This commemoration of Dr. Aaron T. Beck’s contribution to the field focuses on the alliance that emerges as one of the best-studied process characteristics in psychotherapy, with hundreds of studies on different orientations, treatment conditions, and mental health services. Overall, there is a robust meta-analytic predictive relation between alliance during therapy and therapy outcome (Cohen's d = .58). However, socio-cultural aspects such as the existence of substance use disorder or ethnic minorities partly moderates this relation. In addition, therapist effects are likely. Clinical implications are discussed based on the excellent meta-analytic empirical evidence.     

Developmentally Adapted Cognitive Processing Therapy for Adolescents Suffering from Posttraumatic Stress Disorder after Childhood Sexual or Physical Abuse: A Pilot Study

Although childhood sexual abuse and childhood physical abuse (CSA and CPA) have severe psychopathological consequences, there is little evidence supporting psychotherapeutic interventions for adolescents who have experienced CSA or CPA. To provide a treatment tailored to the specific needs of adolescents suffering from abuse-related posttraumatic stress disorder (PTSD), we modified Cognitive Processing Therapy (CPT) by adding new treatment modules and changing the therapy setting. To evaluate the feasibility and efficacy of Developmentally Adapted CPT (D-CPT), we treated 12 adolescents suffering from PTSD secondary to CSA or CPA. Patients were assessed prior to treatment (t0), post-treatment (t1), and 6 weeks after treatment (t2). Assessments included the Clinician-Administered PTSD Scale (CAPS), the UCLA PTSD Index (UCLA), the Children’s Depression Inventory (CDI), the Adolescent Dissociative Experiences Scale (A-DES), and the Borderline Symptom List (BSL-23). MANOVAs revealed that posttraumatic stress measurements and associated symptom measurements significantly differed across time points. When comparing t0 with t2, Cohen’s d was large with respect to the CAPS scores (d = 1.45, p < .001) and the UCLA scores (d = 1.91, p < .001). Cohen’s d had a medium magnitude with respect to the CDI scores (d = .78, p < .001), the A-DES scores (d = 0.64, p < .05), and the BSL-23 scores (d = 0.74, p < .01). D-CPT has the potential to reduce PTSD symptoms and comorbid psychopathology in adolescents with histories of CSA or CPA.     

Effects of distraction and experience on situation awareness and simulated driving

This study examined the impact of cell phone conversation on situation awareness and performance of novice and experienced drivers. Driving performance and situation awareness among novice drivers ages 14–16 (n = 25) and experienced drivers ages 21–52 (n = 26) were assessed using a driving simulator. Performance was measured by the number of driving infractions committed: speeding, collisions, pedestrians struck, stop signs missed, and centerline and road edge crossings. Situation awareness was assessed through a query method and through participants’ performance on a direction-following task. Cognitive distractions were induced through simulated hands-free cell phone conversations. The results indicated that novice drivers committed more driving infractions and were less situationally aware than their experienced counterparts. However, the two groups suffered similar decrements in performance during the cell phone condition. This study provides evidence of the detrimental effects of cell phone use for both novice and experienced drivers. These findings have implications for supporting driving legislation that limits the use of cell phones (including hands-free) in motor vehicles, regardless of the driver’s experience level.     

Family-focused cognitive behaviour therapy versus psycho-education for adolescents with chronic fatigue syndrome: Long-term follow-up of an RCT

The aim of this study was to investigate the long term efficacy of family-focused cognitive behaviour therapy (CBT) compared with psycho-education in improving school attendance and other secondary outcomes in adolescents with chronic fatigue syndrome (CFS). A 24 month follow-up of a randomised controlled trial was carried out. Participants received either 13 one-hour sessions of family-focused CBT or four one-hour sessions of psycho-education. Forty-four participants took part in the follow-up study. The proportion of participants reporting at least 70% school attendance (the primary outcome) at 24 months was 90% in CBT group and 84% in psycho-education group; the difference between the groups was not statistically significant (OR = 1.29, p = 0.80). The proportion of adolescents who had recovered in the family-focused CBT group was 79% compared with 64% in the psycho-education, according to a definition including fatigue and school attendance. This difference was not statistically significant (Fisher's exact test, p = 0.34). Family-focused CBT was associated with significantly better emotional and behavioural adjustment at 24 month follow-up compared to psycho-education, as reported by both adolescents (F = 6.49, p = 0.02) and parents (F = 4.52, P = 0.04). Impairment significantly decreased in both groups between six and 24 month follow-ups, with no significant group difference in improvement over this period. Gains previously observed for other secondary outcomes at six month follow-up were maintained at 24 month follow-up with no further significant improvement or group differences in improvement. In conclusion, gains achieved by adolescents with CFS who had undertaken family-focused CBT and psycho-education generally continued or were maintained at two-year follow-up. The exception was that family-focused CBT was associated with maintained improvements in emotional and behavioural difficulties whereas psycho-education was associated with deterioration in these outcomes between six and 24-month follow-up.     

A Nonrandomized Effectiveness Comparison of Broad-Spectrum Group CBT to Individual CBT for Depressed Outpatients in a Community Mental Health Setting

Controlled trials have established the efficacy of cognitive-behavior therapy (CBT) for depression. However, the relative effectiveness of individual versus group treatment formats in real-world settings is less well established. The current study evaluated the effectiveness of group CBT (n = 157) compared to individual CBT (n = 77) for depressed outpatients in a naturalistic setting. Symptom improvements for depression, anxiety, and quality of life were compared between treatment formats in intent-to-treat and completer analyses. Effect sizes and rates of recovery were examined. Results showed that both individual and group CBT were effective, even in the presence of high levels of comorbidity. Whereas individual CBT was associated with larger effect sizes and significantly higher rates of recovery, group CBT compared favorably to outcomes established by past research. A broad-spectrum group CBT program may be a viable treatment option when depression symptoms are less severe and when this format of treatment delivery is desirable.     

Nomophobia and self-reported smartphone use while driving: An investigation into whether nomophobia can increase the likelihood of illegal smartphone use while driving

In Australia, illegal smartphone use while driving is on the rise, increasing the likelihood drivers could be distracted and crash. Smartphones avail users a sense of belonging, connectedness, and access to information. As such, the sensation of being without one’s smartphone has developed into the prevalence of nomophobia, defined as the fear and anxiety associated with being without smartphone. The aim of the current study was to specifically examine the relationship between smartphone use while driving and nomophobia by 1) determining the types and frequency of illegal phone use while driving and, 2) exploring the relationship between nomophobia and illegal phone use while driving. The sample consisted of 2,774 Victorian smartphone users (47.0% male) with a valid driver’s licence. Driver’s nomophobia levels were measured using the Nomophobia Questionnaire (NMP-Q), while driver’s smartphone use was measured using an original scale developed by the authors. A binary logistic regression was conducted which showed that the longer average time spent per day on a smartphone and a lack of knowledge of the mobile phone road law were the strongest positive predictors of illegal use (OR = 1.32, 95% CI = 1.09–1.60; OR = 1.84, 95% CI = 1.48–2.28, respectively). However, only one nomophobia factor (i.e., access to information) significantly predicted illegal smartphone use (OR = 1.06, 95% CI = 1.04–1.09). Smartphone use is a complex and contextual behaviour, therefore, focusing on the fear of being without in dependency overlooks the nuances of the need to be with. This study offered several practical interventions that may mitigate illegal smartphone use and reduce the likelihood of crashes among Victorian road users.     

A randomized pilot study of motivation enhancement therapy to increase utilization of cognitive–behavioral therapy for social anxiety

Despite the efficacy of cognitive–behavioral therapy (CBT), most socially anxious individuals do not seek treatment or seek treatment only after many years of suffering. This study evaluated the efficacy of a three-session motivation enhancement therapy (MET) designed to increase CBT utilization among socially anxious individuals. Twenty-seven non-treatment-seeking socially anxious individuals (92.6% met current DSM-IV criteria for social anxiety disorder) were randomly assigned to either MET for CBT (n = 12) or a control condition (n = 15). The primary outcome was attendance at first CBT appointment. Secondary outcomes included openness to therapist contact and willingness to schedule a CBT appointment. After the intervention, seven of the 12 (58.3%) participants in the MET condition attended a CBT appointment compared to two of 15 (13.3%) control participants. Eight of 11 (72.7%) participants in the MET condition indicated they would like a CBT therapist to contact them compared to four of 12 (33.3%) controls. Further, willingness to schedule a CBT appointment increased at a significantly greater rate in the MET condition. Results suggest MET for CBT may be a time-efficient means to increase CBT utilization among socially anxious individuals.