Starting to develop self-help for social anxiety associated with vitiligo: using clinical significance to measure the potential effectiveness of enhanced psychological self-help

BACKGROUND: Vitiligo can be associated with high levels of distress, yet there are currently no self-help interventions available. OBJECTIVES: To describe the initial development of a psychosocial self-help intervention designed to reduce social anxiety associated with vitiligo. Also to examine whether including a planning exercise, aimed at increasing use of the intervention (termed implementation intentions), has the potential to achieve a clinically significant reduction in distress. METHODS: Participants (n = 75) were randomized to one of three groups: cognitive behavioural self-help (CBSH), CBSH augmented with implementation intentions (CBSH+), or no intervention. Participants were assessed at baseline and after 8 weeks on measures of social anxiety, anxiety and depression, and appearance-related concern. The two intervention groups also completed a questionnaire evaluating their use of, and satisfaction with, the intervention. RESULTS: High levels of social anxiety and concern over appearance were reported. Twenty-four per cent of participants in the CBSH+ group experienced clinically significant change on the measure of social anxiety compared with 8% in the CBSH group and 0% in the control group. In addition, 58% of the control group deteriorated during the study period. There were no significant differences between the conditions on the other outcome measures. Participants reported that the self-help leaflets were helpful. CONCLUSIONS: The findings demonstrate that augmented CBSH provides a relatively simple and accessible intervention that can result in a clinically significant reduction in social anxiety. The augmented intervention has potential and might be further developed and evaluated in subsequent trials.