Background: Self-help resources such as books may help meet critical mental health needs in college students, but there is insufficient evidence on whether and how such books work. This randomized trial compared acceptance and commitment therapy (ACT) and traditional cognitive behavior therapy (tCBT) self-help books for social anxiety, a common concern with notable barriers to treatment seeking.

Methods: A sample of college students (n = 102) with social anxiety was randomly assigned to use one of the two self-help books over eight weeks.

Results: Improvements were observed in both conditions across all outcomes (social anxiety, general well-being, and social functioning) as well as potential processes of change (cognitive fusion, appraisals of social concerns, and progress toward personal values). Few differences were observed between conditions. Changes in general cognitive fusion consistently predicted outcomes at posttreatment, and anxiety-specific cognitive fusion and concern about negative social interactions also predicted some later outcomes.

Conclusions: Use of self-help books to address social anxiety in college students is promising, and addressing cognitive fusion appears to be important.