The Bergen 4-day treatment for social anxiety disorder: a pilot study

BMC Psychiatry. 2024 Feb 21;24(1):145. doi: 10.1186/s12888-024-05607-4.


Background: Few studies have examined the use of concentrated and intensified cognitive behaviour therapy for treating social anxiety disorder (SAD). The aim of this study was to examine the feasibility of the Bergen 4-Day Treatment (B4DT) for treating SAD.

Methods: This study adopted an open trial design without a control group. Thirty consecutively referred patients who were diagnosed with SAD were treated and assessed at pre-treatment, at post-treatment, and at the 3-month follow-up. The Liebowitz Social Anxiety Scale was used to assess symptoms of SAD; the Generalized Anxiety Disorder-7 scale was used to assess anxiety symptoms; and the Patient Health Questionnaire-9 was used to assess symptoms of anxiety and depression. The Client Satisfaction Questionnaire-8 was administered posttreatment.

Results: Overall, patients reported a high level of satisfaction with the B4DT. Large effect sizes were observed for symptoms of SAD (d = 1.94-2.66) and for the secondary outcomes, i.e., generalized anxiety (d = 0.86-0.99) and depression (d = 0.62-0.83). The remission rate was 55.2% at follow-up, while the treatment response rate was 89.7%.

Conclusions: The B4DT is a promising treatment approach for patients with SAD. In the future, controlled trials should be performed to compare the efficacy of this treatment approach with standard outpatient treatment. Practical consequences, policy implications, and suggestions for future research are discussed herein.

Keywords: B4DT; CBT; Exposure; Intensive treatment; Social anxiety disorder.

Publication types

  • Clinical Trial

MeSH terms

  • Anxiety / therapy
  • Anxiety Disorders / psychology
  • Anxiety Disorders / therapy
  • Humans
  • Outpatients
  • Phobia, Social* / psychology
  • Phobia, Social* / therapy
  • Pilot Projects
  • Treatment Outcome