Developing and Evaluating a Fully Integrated Treatment Program for Comorbid Social Anxiety and Alcohol Use Disorders

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Abstract Social anxiety disorder and alcohol use disorder commonly co-occur, and are associated with significant impairment. The primary aims of the study for which an administrative supplement is being requested were to develop and evaluate a fully integrated behavioral intervention for comorbid social anxiety disorder and alcohol use disorder. In the first year of the project, we successfully developed an Intensive Outpatient Program (IOP) level of care group intervention to be delivered by community-based substance use disorder (SUD) specialty clinicians. The fully integrated treatment (FIT) combines principles and strategies of exposure-based cognitive behavioral therapy (CBT) for social anxiety disorder with the Matrix Model approach to the treatment of addiction (i.e., combining CBT and 12-step facilitation). Thus, Aim 1 has been completed. We have begun to evaluate its effectiveness in this real-world setting, in which adult treatment seekers with comorbid social anxiety and alcohol use disorders are randomized to (a) FIT IOP or (b) Matrix Model IOP for twelve weeks, and are assessed at baseline, mid-treatment, post-treatment, and a 6-month follow-up on engagement (Aim 2), and on alcohol use and social anxiety outcomes (Aim 3). The COVID-19 pandemic has led to a shut-down of the IOP program, group services, and any in-patient visits at the clinic site, for an indefinite period of time in Los Angeles. In-person visits for this type of research are also currently prohibited by the UCLA Vice Chancellor of Research. As a consequence, recruitment has halted, and we have managed only to provide remote sessions with the remaining patients who were already enrolled in the study, which is not in the spirit of our intervention that focuses on using the group as a platform for social anxiety exposure therapy. Moreover, even if we could do some assessments remotely (though others may not be possible), few patients are seeking remote services at the clinic currently and thus the pace of recruitment would not allow us to meet our project goals. Therefore, we are anticipating significant delays in completing our recruitment and enrollment goals, which are necessary for achieving sufficient statistical power to detect effects between two active treatments. In sum, we are unable to complete Aims 2 and 3 without supplemental funds. The supplemental funds would support the project coordinator, a graduate student researcher, and the Principal Investigator for the additional time needed to carry out the study; and importantly, would fund the clinicians and administrators at the community clinic who carry out their clinical services and referral/recruitment services that enable us to proceed with the clinical trial. Given the uncertainty of the shut-down of research and clinical operations, this supplement would enable us to provide salary coverage for staff to continue their work once we can resume activity.