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Treating Social Phobias
Below is a brief description of professional treatment of social phobias. See The Seven Issues in Recovery and How to Get Comfortable for the self-help skills of this program.
Most people with social phobia can be helped by a therapy program. Although results vary, it appears as many as 80% of those who enter treatment programs report significant improvement, and say that they are able to get their social phobia under control.
Treatment for social phobia generally centers around a combination of a type of behavior therapy called exposure, and cognitive therapy. In exposure therapy people gradually confront the situation that brings on their anxiety. Repeated exposure, combined with practice in coping with the dreaded situation, is designed to show people that they can perform satisfactorily without embarrassing themselves.
Exposure therapy for some disorders may be administered in one-on-one sessions with the therapist. In social phobia, the treatment can have an even greater impact if it takes place in a group setting, because the key feature of this disorder is that anxiety is only triggered by an activity performed in front of others. Additionally, group members may benefit by observing simulations and borrowing others' coping techniques.
Most treatment programs include homework, in which the patient initiates his own exposure sessions according to plans made in the group session. A report is then made at the next group meeting.
Exposure therapy alone may not be sufficient to control some people's social anxiety. Therefore, cognitive therapy is added, designed to alter their thinking about themselves and their social abilities. Cognitive therapy examines people's expectations of social situations and perceptions of their own performance. Typically the individual with social phobia exaggerates others' competence and expectations while belittling his own.
This therapy is intended to help the individual with social phobia learn to separate realistic from unrealistic assumptions. Training in social skills may support cognitive therapy and exposure by boosting confidence levels.
Medication is sometimes useful in easing the core symptoms of social phobias. Individuals whose anxiety is triggered by just a few predictable situations may be helped by taking medication about an hour before a feared event. Those with more pervasive or less predictable anxiety may do better with medication that is administered daily. See our section on medications for general information.
next: The Seven Issues in Recovery From Social Anxiety
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