REal world internet COgnitiVE theRapy for SAD (RECOVER-SAD)
Research type
Research Study
Full title
Clinical trial of digitally enabled cognitive therapy for social anxiety disorder in NHS Talking Therapies for anxiety and depression services
IRAS ID
352935
Contact name
Anke Ehlers
Contact email
Sponsor organisation
University of Oxford / Research Governance, Ethics and Assurance
Duration of Study in the UK
2 years, 10 months, 30 days
Research summary
Social Anxiety Disorder (SAD) is a common and disabling mental health problem. Cognitive Therapy for Social Anxiety Disorder (CT-SAD) is recommended by the National Institute for Health and Care Excellence (NICE) as the first-line treatment for SAD in the NHS and is highly effective. Full CT-SAD consists of 12-14 weekly 90-min sessions. NHS Talking Therapies (NHS TT) services cannot always offer the full treatment to patients due to resource constraints and therapist workloads. Many patients can also find it difficult to attend weekly sessions within clinic hours due to their own work and life commitments. Therefore, it is desirable to improve the accessibility of CT-SAD, by reducing the therapist time required without compromising on treatment outcomes.
Internet-delivered treatment could provide a solution to these challenges. An internet-based cognitive therapy for SAD (iCT-SAD) has been developed, which allows therapists to guide patients through an online programme that patients can access in their own time at a place convenient to them. Preliminary research suggests that recovery rates for iCT-SAD are comparable to CT-SAD, whilst iCT-SAD requires substantially less therapist time (Clark et al., 2023). Based on preliminary findings, NICE has recommended the use of iCT-SAD for use in the NHS, but there is a need for further research to unambiguously assess its value. This randomised controlled trial directly compares iCT-SAD to usual NHS treatment for SAD in a real-world setting. 220 people seeking treatment for SAD in 6 NHS TT services within 4 NHS Trusts across England will be randomised to receive iCT-SAD or treatment-as-usual (TAU), delivered by trained therapists. The trial will investigate whether iCT-SAD leads to greater improvement in SAD symptoms and recovery rates than TAU and will examine its cost-effectiveness compared to TAU. It will also examine how satisfied patients and therapists are with the internet-delivered treatment.
REC name
London - Bloomsbury Research Ethics Committee
REC reference
25/LO/0574
Date of REC Opinion
12 Aug 2025
REC opinion
Favourable Opinion