How Effective Is Cognitive Behavioral Therapy for Social Phobia?

Cognitive behavioral therapy for social phobia typically is more effective when it integrates behavioral interventions such as exposure therapy, coping mechanisms and social skills development. At the core of this type of therapy is the exploration of negative thought patterns and their effects on behavior. Through counseling, a person who is fearful in social situations can learn anxiety-reducing coping mechanisms. Identifying specific fear-provoking scenarios and gradually exposing the client to such situations is one effective strategy. Teaching social skills often helps reduce social phobia and increases comfort during social interaction.

Examining debilitating thoughts is an important component of cognitive behavioral therapy for social phobia. It generally is believed that phobias are caused by exaggerated, fear- provoking thoughts. An employee who must make a presentation, for example, might worry that giving a speech will lead to humiliation before his or her colleagues. By focusing on all of the things that can possibly go awry, he or she intensifies his or her fears. Counselors generally present more positive, alternate scenarios to encourage clients to consider the potential for brighter outcomes.

Cognitive behavioral therapy for social phobia often includes the development of coping mechanisms. Visualization techniques might be used to help the client imagine more pleasurable social experiences. Breathing deeply before and during a social event often assists in calming the nerves. Smiling while speaking in a small group typically assists in minimizing tension or improving a shaky voice. Meditating before social events is another way of reducing anxiety.

Exposure therapy is often an integral part of social phobia counseling. Specific fear-provoking social situations are first identified, and each incremental exposure is discussed in detail with the client. A person might be scared of meeting new people, for example. The counselor might then encourage him or her to face this fear gradually, perhaps by communicating with new people in writing as a gradual step. Progressing to a phone conversation might be the next step, followed by meeting in person.

Cognitive behavioral therapy for social phobia also is effective when it focuses on building social skills. Some social fears are centered on not knowing what to say or feeling awkward in new situations. Through the development of conversation skills and social intelligence, a socially fearful person often interacts more effectively with others. As others begin to feel at ease, smile and respond positively, social fears sometimes subside. Developing social skills also typically involves focusing less intently on negative outcomes and more specifically on positive social experiences.