Daydreamer and Night Owl: Comparing Good and Bad Outcome Cases in an Internet-Based Cognitive Behavioural Treatment for Social Anxiety Disorder

Internet-based cognitive behavioural therapy (ICBT) has garnered strong empirical support in the last decades. Despite the growing body of evidence that web-based treatments work, there is still a considerable number of clients who do not benefit sufficiently from such interventions. Recently, research has started to focus on identifying factors that affect treatment outcome and adherence to Internet interventions. This article describes the course of treatment of two clients in guided ICBT for Social Anxiety Disorder (SAD) who were selected based on their contrasting treatment outcomes. Focal points of therapist communication are shown as well as the clients’ individual gains and obstacles. Lastly, we explore several aspects that seem to be crucial in this specific setting, such as therapist support, motivation and establishing a working alliance via the Internet.