Digitala Vetenskapliga Arkivet

Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Efficacy of transdiagnostic cognitive-behavioral therapy for assertiveness: A randomized controlled trial
Stockholm University, Faculty of Social Sciences, Department of Psychology.ORCID iD: 0000-0001-6059-6668
Stockholm University, Faculty of Social Sciences, Department of Psychology.ORCID iD: 0000-0002-2883-9751
Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.ORCID iD: 0000-0002-8209-5351
Show others and affiliations
2023 (English)In: Internet Interventions, ISSN 2214-7829, Vol. 32, article id 100629Article in journal (Refereed) Published
Abstract [en]

Assertiveness training has been an essential component in cognitive-behavioral therapy (CBT), for example, in the treatment of social anxiety and in dialectical behavioral therapy. However, the assertiveness construct has garnered little attention in recent clinical research. The objective of this study was to investigate the efficacy of an eight-week transdiagnostic stand-alone internet-based CBT intervention specifically aimed at increasing levels of assertive behavior. Following inclusion, we randomized N = 210 participants into three groups: therapist-guided self-help, unguided self-help, and a wait-list control condition. After a one-year follow-up, we employed a linear mixed model to estimate the effects at both post-test and follow-up for the primary outcome measures of assertiveness, Adaptive and Aggressive Assertiveness Scales, the Rathus Assertiveness Schedule, and secondary outcome measures of anxiety, depression, and general well-being. We also assessed reliable clinical change. Compared to the wait list at the post-treatment, estimated between-group effect sizes on self-rated adaptive assertiveness were statistically equivalent for the two treatment groups both at the post and at the one-year follow-up time points, ranging from ES = 0.95 to 1.73, with reliable clinical recovery proportions from 19 % to 36 %. The increase in aggressive assertiveness ranged from ES = 0.62 to 0.90 compared to the wait-list condition at post. For social anxiety symptoms, the effects compared to the wait list at post-treatment ranged from ES = 0.67 to 0.93, with a reliable clinical recovery rate from 16 % to 26 %. For self-assessed well-being, the effects compared to the wait list at post ranged from ES = 0.70 to 1.05. No effects were observed for generalized anxiety, although within-group evidence was found for a medium effect on depression one year after treatment. Overall, the two treatment conditions produced similar effects. In general, participation increased healthy assertive expressions regardless of treatment condition, all the while reducing self-assessed social anxiety and, over time, possibly also depression. Participation also improved general well-being. The findings demonstrate that the assertiveness construct can be a suitable target for intervention, with reductions of both psychiatric symptoms and non-syndromal problems in daily life. The study was preregistered at ClinicalTrials.gov (NCT04240249).

Place, publisher, year, edition, pages
Elsevier, 2023. Vol. 32, article id 100629
Keywords [en]
assertiveness, assertive behavior, anxiety, depression, stress, avoidance
National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:su:diva-217166DOI: 10.1016/j.invent.2023.100629OAI: oai:DiVA.org:su-217166DiVA, id: diva2:1757699
Available from: 2023-05-17 Created: 2023-05-17 Last updated: 2024-01-11Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full text

Search in DiVA

By author/editor
Hagberg, TobiasManhem, PatrikOscarsson, MartinAndersson, GerhardCarlbring, Per
By organisation
Department of PsychologyClinical psychology
In the same journal
Internet Interventions
Psychology

Search outside of DiVA

GoogleGoogle Scholar

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 84 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf