Breathe Hard to Breathe Easy: Online breathwork-assisted therapy for social anxiety

This project will try combining online psychotherapy with guided breathwork sessions to see if it reduces social anxiety in adults.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 96 (estimated)
• Ages: 18 Years to 65 Years
• Sex: All
• Sponsor: Maastricht University (Academic / other)
• Locations: 1 site (Maastricht, Limburg)
• Trial ID: NCT07259005 on ClinicalTrials.gov

What this trial studies

This randomized, between-groups trial will enroll 96 adults with clinically significant social anxiety and randomly assign them to either a breathwork-assisted psychotherapy program that induces altered states of consciousness or an active control that does not. Each intervention consists of six remote sessions (two preparation, two breathwork, two integration) delivered online. Eligible participants are aged 18–65, fluent in English or Dutch, and have an LSAS score ≥50. Key safety exclusions include cardiovascular or respiratory disease, seizure disorders, psychotic or bipolar disorders, pregnancy, and prior adverse reactions to breathwork.

Who should consider this trial

Good fit: Adults 18–65 with clinically significant social anxiety (LSAS ≥50), fluent in English or Dutch, who can safely perform guided breathwork and give informed consent.

Not a fit: People with serious heart or lung problems, epilepsy, psychotic or bipolar disorders, pregnancy, prior adverse reactions to breathwork, or who cannot tolerate paced breathing are unlikely to be eligible or to benefit.

Why it matters

Potential benefit: If successful, this approach could provide an accessible online option that reduces social anxiety symptoms and improves daily functioning.

How similar studies have performed: Some prior studies using altered-state methods (including breathwork and psychedelic-assisted therapies) paired with psychotherapy have shown promising results for other mental health conditions, but online breathwork-assisted treatment specifically for social anxiety is novel and less tested.

Eligibility criteria

Inclusion Criteria:

* Fluent in the English or Dutch language
* Aged between 18 and 65
* LSAS score ≥50
* Written informed consent

Exclusion Criteria:

* Hypotension (diastolic \< 60 mmHg; systolic \> 90 mmHg) or hypertension (diastolic \> 90 mmHg; systolic \> 140 mmHg)
* History or presence of psychotic or bipolar disorders or first-degree relatives suffering from this
* History of respiratory or cardiovascular/heart problems or disease, cerebral aneurysm
* History of fainting or syncope, epilepsy or seizures
* History of panic disorder or panic attacks,
* Having had adverse reactions with prior breathwork sessions (i.e., fainting),
* Pregnancy, thinking one might be pregnant, trying to get pregnant, or breastfeeding
* Any problems affecting the ability to pace breathing (i.e., active/chronic respiratory infection including blocked nose/cough/cold/fever, etc.), breathlessness, abnormally slow breathing (bradypnea), or abnormally fast breathing (tachypnoea), any other physical/mental health conditions or current life events impairing the ability to engage in activities involving breath control
* Taking any regular medication other than the contraceptive pill, including medications to reduce blood pressure (i.e., Ramipril or other ACE-inhibitors) and beta-blockers (i.e., Propranolol).

Where this trial is running

Maastricht, Limburg

• Maastricht University — Maastricht, Limburg, Netherlands (Recruiting)

Study contacts

• Principal investigator: Kim PC Kuypers, PhD — Maastricht University
• Study coordinator: Mauro Cavarra, PhD

Conditions Social Anxiety; social anxiety; breathwork; psychotherapy; breathwork-assisted psychotherapy; altered states of consciousness