About the Go-OSCA Trial

Social anxiety disorder is the most common anxiety problem and usually begin during adolescence. While social worries are common, it becomes a problem when the worries get in the way of a young person's ability to take part in day-to-day life, including in school, with friends and with family.

The standard treatment in NHS Child and Adolescent Mental Health Services (CAMHS) for young people with social anxiety is a type of Cognitive Behavioural Therapy (CBT) used to treat all common anxiety problems. This involves teaching young people ways to manage their anxiety and gradual exposure to feared situations. Although outcomes from this type of CBT are good overall, young people with social anxiety don't seem to benefit as much from this treatment as those with other anxiety disorders.

Effective treatments have been developed for social anxiety in adults. For example, Cognitive Therapy for Social Anxiety Disorder (CT-SAD) is a type of CBT that was developed to target the specific thoughts and behaviours that keep social anxiety going. An online version (called iCT-SAD) has been shown to be just as effective as the face-to-face version of the therapy.  

There is promising evidence that Cognitive Therapy for Social Anxiety Disorder may also be helpful for young people but it can be hard to access. Delivering therapy online makes the treatment more accessible, because it can be delivered in less specialist services. ICT-SAD was adapted for young people. The digital version of CT-SAD for young people is called OSCA. This stands for Online Social anxiety Cognitive therapy for Adolescents.  

In the Go-OSCA study, we are comparing the effectiveness of OSCA with the usual NHS treatment (called Graded CBT), as well learning about how best to deliver OSCA in routine mental health services. We want to compare the effects on young people and family's mental health and functioning as well as finding out how cost-effective the treatments are.  

OSCA is a 14-week programme that combines online therapy with regular support from a therapist. Young people start with a set of core modules that introduce key ideas and skills, and additional modules can be added to focus on their individual worries or situations. 

The programme includes videos, activities, and practical exercises to help young people test out fears and build confidence. Young people can log in as often as they like and work through the material at their own pace. 

As part of the OSCA treatment, young people have short weekly phone or video calls with their therapist and regular messaging in between to review progress, plan next steps, and get support. Most calls last around 15–20 minutes, with one longer call early in the programme. Optional follow-up calls are also offered after treatment ends. 

OSCA is delivered through a secure online platform developed by the University of Oxford . It has been approved for use in this study by the participating NHS Trusts  

Only limited personal information is used to set up an account, and this is shared securely by the care team. When young people first log in, they are guided through the programme with a welcome video and clear instructions. Help pages and technical support are available for families and clinicians if needed.