First, it is not restricted in time or to a specific geographic location. Second, since ICBT demands less therapist time, ICBT therapists can treat significantly more patients than possible with CBGT. Consequently, ICBT has the potential to dramatically increase availability of CBT. Although ICBT for SAD has demonstrated effects in line with CBGT, the current evidence holds a number of limitations. There has been no comparison to conventional CBT, such as CBGT, and most studies have relied solely on self-report instruments as measures of treatment outcome. In addition, most studies have been conducted in university settings, which might have a different impact on treatment experience and outcome compared to receiving care at a psychiatric clinic. Although one study has AMN107 Src-bcr-Abl inhibitor indicated that the characteristics of Internet clinic patients could be similar to those of outpatient clinics, the research field would benefit from a trial conducted in a psychiatric context. Finally, diagnostic procedures may be more clinically valid when conducted in a clinical setting. This has not been the case in the previous studies where only telephone interviews or self-report have been used. In summary, more empirical evidence is needed before ICBT can be validly employed in a psychiatric context. As CBGT is an effective gold standard treatment appropriate for use as a benchmark, the necessary evidence to validate ICBT is to demonstrate non-inferiority to CBGT. The aim of the present study was to determine whether ICBT is as effective as CBGT for patients with SAD when administered in a psychiatric setting. We hypothesized that ICBT would be at least as effective as CBGT in reducing social anxiety. We also predicted that the two treatments would be equal on secondary outcome measures of depressive symptoms, general anxiety, quality of life, and global functioning. Recruitment for the study took place between 2007 and 2009. Participants were recruited by referral from primary care physicians and psychiatrists, and by self-referral to the psychiatric clinic at the Karolinska University Hospital in Stockholm, Sweden. Information about the treatment and the study was published on the official web page of the clinic. There were no advertisements in newspapers or other media. The study protocol was approved by the Regional Ethical Review Board in Stockholm and written informed consent was obtained from all participants after a detailed description of the study had been given. To be eligible for inclusion potential participants had to meet the following criteria: fulfill the DSM-IV criteria of social anxiety disorder as assessed using the Structured Clinical Interview for DSM-IV axis I disorders, agree to undergo no other psychological treatment for the duration of the study, have no history of CBT for the last four years, have constant dosage two months prior to treatment of any prescribed medication for anxiety or depression and agree to keep dosage constant PI-103 throughout the study, have a primary diagnosis of SAD as assessed by the interviewing psychiatrist were not excluded, not currently meet the diagnostic criteria for substance abuse have no history of psychosis or bipolar disorder, not score.20 on the Montgomery sberg Depression Rating Scale-self report, if criteria for major depression were met, have a score of less than 4 of 6 on the suicide ideation item of MADRS-S, and not meet criteria for any personality disorders within cluster A or B, which could interfere with the therapeutic process in group therapy.