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SOCIAL ANXIETYhave developed resources and therapies for SADthat can be offered on the Internet (Erwin, Turk,Heimberg, Fresco, & Hantula, 2004).In addition to being more accessible thanin-person therapies, IBTs also appear to behighly effective. Over the past decade,numerous studies have demonstrated the clinicalsignificance of IBTs by assessing their effectsizes. Researchers have commonly usedCohen’s d as a measure of effect size whencomparing symptom reduction in groupsreceiving an IBT to groups receiving notreatment or an alternative treatment. It isimportant to note that the meaning of themagnitude of Cohen’s d is dependent upon thecontext of the study, and thus it is necessary toconsult the relevant literature for typicaltreatment effect sizes. The authors of a metaanalysisof psychological and pharmacologicaltreatments of SAD (Acarturk, Cuijpers, vanStraten, & de Graaf, 2009) suggest that effectsizes of d = 0 to d = 0.32 are to be consideredsmall, effect sizes ranging from d = 0.33 to d =0.55 are to be considered moderate, and effectsof d = 0.56 and above are to be consideredlarge. Hedges’g is another measure of effect sizeused in the literature that provides a moreconservative value, and uses the same ratingsystem of small, moderate and large as Cohen’sd.Numerous studies have found InternetCognitive-Behavioral Therapy (ICBT) to beeffective in reducing symptoms of SAD (e.g.Andersson, Carlbring, & Furmark, 2012;Andersson et al., 2012; Berger, Hohl, &Caspar, 2009; Botella et al., 2009; Furmark etal., 2009; Hedman et al., 2011a; Hedman et al.,2011b; Hedman et al., 2011c; Tillfors et al,2013; Titov, Andrews, Choi, Schwencke, &Mahoney, 2008; Titov, Andrews, & Schwencke,2008; Titov, Andrews, Schwencke, Drobny, &Einstein, 2008). The effect sizes found in thesestudies were large, ranging from d = 0.63(Furmark et al., 2009) to d = 1.28 (Tillfors et al.,2013). For studies which reported Hedge’s g,effect sizes for ICBT were found to be moderateand large, ranging from g = 0.5 (Hedman,2011b) to g = 0.75 (Andersson, Carlbring, &Furmark, 2012). These effect sizes are similarto those achieved with in-person therapies; forexample, Fedoroff and Taylor (2001) reportedthe effect sizes for CBT to be d = 0.94, exposuretherapy to be d = 1.31, and cognitive therapy tobe d = 0.78. ICBT has also been found to beeffective for treating adults (Titov, Andrews,Kemp, & Robinson, 2010) and high schoolstudents (Tillfors et al., 2013). Moreover,studies have shown that improvements inquality of life (QOL), and reductions insymptoms of SAD, depression and generalanxiety were maintained for 12 months (Botellaet al., 2009), 30 months (Carlbring, Nordgren,Furmark & Andersson, 2009) and five years(Hedman et al., 2011c), after treatment.Researchers have worried that thetherapeutic alliance may be compromised inIBTs as clients spend significantly less timeconferring with therapists, and may never meettheir therapists in person (Andersson et al.,2012). However, a study assessing therapeuticalliance in ICBT treatments for depression,Generalized Anxiety Disorder, and SAD foundthat the mean ratings of therapeutic alliancereported by participants receiving ICBT weresimilar to those reported by individualsreceiving in-person treatments (Andersson et al.,2012). Furthermore, even though theresearchers found large treatment effects forICBT, there was a non-significant correlationbetween clients’ ratings of therapeutic allianceand treatment outcomes. This suggests thestrength of the therapeutic alliance may notnecessarily affect the outcomes of ICBT, andtherefore its success depends on other factors.This is supported by a study by Furmark et al.(2009), which found that the effect size ofguided ICBT was comparable to unguidedbibliotherapy. However, two others studies(Nordgreen et al., 2012; Titov et al., 2008) havefound that guided ICBT increased participants’adherence to the self-help modules better thanunguided ICBT, and resulted in the completionof more modules. Although therapist guidanceincreases the cost of treatment, it alsoencourages individuals to complete moremodules, thereby increasing the likelihood they