Treating social phobia without personal contact between patient and therapist—or without any therapist involvement at all—could be viewed as ironic, but two recent studies suggest that it works. Self-guided online therapy may offer relief for a wide range of disorders.

The first study, published in the October 2010 issue of the Australian and New Zealand Journal of Psychiatry, found that self-guided, Internet-based cognitive-behavior therapy (CBT) reduced social phobia symptoms in most of the participants. The Internet CBT program consisted of eight online lessons with components similar to those used in face-to-face CBT: education about symptoms and treatment, instruc­tion on how to challenge the negative thoughts and core beliefs that maintain social phobia, preparation for dealing with physical symptoms of panic, graded exposure to social situations, and techniques for relapse prevention.

A more recent study examined whether adding therapist support via e-mail or telephone would affect the outcome of online treatment for social phobia. The paper, published in the March 2011 issue of Behaviour Research and Therapy, found that programs are equally effective regardless of therapist involvement.

The October experiment was the latest of eight studies on Internet-based self-help for social phobia led by Nickolai Titov, director of the eCenter Clinic ( at Macquarie University in Sydney, Australia. The team has also conducted 20 trials on conditions such as depression and generalized anxiety disorder. “A similar formula seems to work for all conditions,” Titov says.

With such programs sprouting across the Internet, Titov advises consumers to verify the credentials of the people running them and to confirm that the regimens are evidence-based. He recommends AnxietyOnline ( as a great resource offering free and low-cost Web-based treatments for various anxiety disorders.