What does treatment involve?

Cognitive Behaviour Therapy

Cognitive Behaviour Therapy (CBT) is an approach that helps to break the cycle of anxiety and reduce the experience of anxiety by focusing on the way that a person thinks, feels, and behaves. Research has shown the use of CBT in a group format to be highly effective in the treatment of social phobia (Barlow, 2002).

CBT for social phobia incorporates a package of techniques aimed at targeting the person’s:

• unhelpful thinking styles;
• emotional and bodily reactions experienced in social situations (or when thinking of the situations), and
• behaviours in response to these situations (e.g. avoidance).

Specific components include:

Education about social phobia:

• Similar to that presented in this brochure, and as specific to the person.

Breathing and relaxation exercises:

• Help the person experience a relaxed state, allowing the person to be able to better assess the situation in a calm and objective manner. 

Challenging unhelpful thinking:

• Targets the thinking patterns of people with social phobia, which are most often peppered with negative evaluations. 

Graded exposure tasks (and response prevention): 

• Avoidance behaviours are one of the strongest maintaining factors of the social anxiety, and an important part of the cycle that need to be addressed and broken.
• This part of treatment involves setting up tasks that place the person in the feared and avoided situation and allows them to test out within the situation the very thing that they worry will happen.

Social skills training:

• The person is provided with an opportunity to learn and practice specific social skills, such as assertive communication, appropriate levels of eye contact and addressing people within various situations.
• The process of treatment is graded and gentle and ensures that the person feels comfortable with each step that they complete, making it more likely that they will continue with treatment.

Treatment continues for approximately 16-24 weeks

Medications

Medications may be helpful in reducing the levels of anxiety that a person might feel in or leading up to a social situation.

Effective medications include:

• Monoamine oxidase inhibitors (MAOI’s): phenelzine (Nardil)
• Selective Serotonin Reuptake Inhibitors (SSRI’s): paroxetine (Aropax); fluvoxamine (Luvox), and sertraline (Zoloft).
• Benzodiazepines: clonazepam (Klonopin) and alprazolam (Xanax).
• Anxiolytic: buspirone (BuSpar).

It is important that a person consult with their doctor before taking any such medication(s), so as to enure that the most suitable medication is prescribed and that the levels and possible side-effects are monitored and managed as needed.