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A preliminary study of individual cognitive behavior therapy for social anxiety disorder in Japanese clinical settings: a single-arm, uncontrolled trial

Naoki Yoshinaga12*, Fumiyo Ohshima12, Satoshi Matsuki12, Mari Tanaka1, Tomomi Kobayashi1, Hanae Ibuki1, Kenichi Asano2, Osamu Kobori23, Tetsuya Shiraishi24, Emi Ito2, Michiko Nakazato2, Akiko Nakagawa2, Masaomi Iyo34 and Eiji Shimizu12

Author Affiliations

1 Department of Cognitive Behavioral Physiology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260–8670, Japan

2 Research Center for Child Mental Development, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan

3 Center for Forensic Mental Health, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan

4 Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, 1-8-1 Inohana, Chuo-ku, 260-8670, Japan

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BMC Research Notes 2013, 6:74  doi:10.1186/1756-0500-6-74

Published: 28 February 2013



Cognitive behavior therapy (CBT) is regarded as an effective treatment for social anxiety disorder (SAD) in Europe and North America. Individual CBT might be acceptable and effective for patients with SAD even in non-Western cultures; therefore, we conducted a feasibility study of individual CBT for SAD in Japanese clinical settings. We also examined the baseline predictors of outcomes associated with receiving CBT.


This single-arm trial employed a 14-week individual CBT intervention. The primary outcome was the self-rated Liebowitz Social Anxiety Scale, with secondary measurements of other social anxiety and depressive severity. Assessments were conducted at baseline, after a waiting period before CBT, during CBT, and after CBT.


Of the 19 subjects screened, 15 were eligible for the study and completed the outcome measures at all assessment points. Receiving CBT led to significant improvements in primary and secondary SAD severity (ps < .001). The mean total score on the Liebowitz Social Anxiety Scale improved from 91.8 to 51.7 (before CBT to after CBT), and the within-group effect size at the end-point assessment was large (Cohen’s d = 1.71). After CBT, 73% of participants were judged to be treatment responders, and 40% met the criteria for remission. We found no significant baseline predictors of those outcomes.


Despite several limitations, our treatment—which comprises a 14-week, individual CBT program—seems feasible and may achieve favorable treatment outcomes for SAD in Japanese clinical settings. Further controlled trials are required in order to address the limitations of this study.

Trial registration

UMIN-CTR UMIN000005897

Cognitive behavioral therapy; CBT; Social anxiety disorder; Social phobia; SAD; Japanese