Social Anxiety Disorder (SAD) and Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT) is one of the treatments for SAD.[1][2] CBT emphasizes how inaccurate thoughts and unrealistic perceptions of events may lead to negative emotions and inappropriate behaviors.[3] The goal of CBT is to teach patients how to replace distorted thinking and unrealistic perceptions with realistic ways of viewing and dealing with situations.[3] CBT may also involve homework assignments, which can help alleviate symptoms.[3]

CBT is available in individual or group formats; both have been used in the treatment of SAD.[4] Group CBT sessions can last 2.5 hours per session over 12 weeks, and individual therapy typically lasts 75 minutes per session for 16 weeks.[5]

According to the Practitioner's Guide to Evidence-Based Psychotherapy, CBT can incorporate different approaches to break the cycle of SAD:

  1. Social Skills Training teaches patients the basic skills of competent interpersonal performance in social situations.
  2. Relaxation Training helps patients reduce physiologic arousal in anxiety-provoking situations.
  3. Cognitive Restructuring instructs patients to challenge their maladaptive beliefs, in order to create a more realistic, and presumably more accurate, view of themselves and the world.
  4. Exposure Therapy helps patients face their feared situations (through imagery or in their natural environments) and stay psychologically engaged such that their anxiety reaction may subside through the processes of habituation and extinction.
  5. Combined Exposure and Cognitive Restructuring Treatments integrate the teaching of cognitive skills with behavioral exposure to feared situations. The emphasis during exposure is then to provide an opportunity for patients to gather information that may serve to disconfirm maladaptive beliefs about themselves in social and performance situations.

    6. Source: [5]

For some people, SAD symptoms may improve after 6 to 12 weeks of CBT, and for others it may take longer.[6]

No medications approved for the treatment of SAD have been approved for combination therapy with CBT.

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References:

  1. ^ Bandelow B, et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the pharmacologic treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders. World Journal of Biological Psychiatry. 2002;3:171-99.
  2. ^ Baldwin DS, et al. Evidence-based guidelines for the pharmacological treatment of anxiety disorders: recommendations from the British Association for Psychopharmacology. Journal of Psychoapharmacology. 2005;19:567-96.
  3. ^ Taylor RR. Overview of cognitive behavioral therapy. In: Cognitive behavioral therapy for chronic illness and disability. Chicago: Springer, 2005.
  4. ^ Swinson RP. Clinical practice guidelines: management of anxiety disorders. Canadian Journal of Psychiatry. 2006;51:1S-93S.
  5. ^ Harb GC and Heimberg RG. Social anxiety disorder. In: Fisher JE and O'Donohue WO, eds. Practitioner's guide to evidence-based psychotherapy. New York: Springer, 2006.
  6. ^ Cottraux J, et al. Cognitive behavior therapy versus supportive therapy in social phobia: a randomized controlled trial. Psychotherapy and Psychosomatics. 2000;69:137-46.

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