2015 EST Status: Treatment pending re-evaluation Very strong: High-quality evidence that treatment improves symptoms and functional outcomes at post-treatment and follow-up; little risk of harm; requires reasonable amount of resources; effective in non-research settings

Strong: Moderate- to high-quality evidence that treatment improves symptoms OR functional outcomes; not a high risk of harm; reasonable use of resources

Weak: Low or very low-quality evidence that treatment produces clinically meaningful effects on symptoms or functional outcomes; Gains from the treatment may not warrant resources involved

Insufficient Evidence: No meta-analytic study could be identified

Insufficient Evidence: Existing meta-analyses are not of sufficient quality

Treatment pending re-evaluation

1998 EST Status: Strong Research Support Strong: Support from two well-designed studies conducted by independent investigators.

Modest: Support from one well-designed study or several adequately designed studies.

Controversial: Conflicting results, or claims regarding mechanisms are unsupported.

Brief Summary

• Basic premise: thoughts, feelings and behaviors are inter-related, so altering one can help to alleviate problems in another
• Essence of therapy: Cognitive therapy techniques focus on modifying the catastrophic thinking patterns and beliefs that social failure and rejection are likely; exposure therapies are designed to gradually encourage the individual to enter feared social situations and try to remain in those situations.
• Length: approx. 12 sessions

Treatment Resources

Editors: Evan Forman, PhD; Joanna Kaye, BA

Note: The resources provided below are intended to supplement not replace foundational training in mental health treatment and evidence-based practice

Treatment Manuals / Outlines

Treatment Manuals

• Comprehensive Cognitive Behavior Therapy for Social Phobia (Ledley, Foa, & Huppert; adapted by Herbert, Forman, & Yuen)

Books Available for Purchase Through External Sites

• Managing Social Anxiety Therapist Guide (Hope, Heimberg, & Turk)
• Cognitive-Behavioral Group Therapy for Social Phobia: Basic Mechanisms and Clinical Strategies (Heimberg & Becker)

Treatment Outlines

• CBT for Social Anxiety Disorder Outline (Hofmann & Otto)

Training Materials and Workshops

• Beck Institute for Cognitive Behavior Therapy

Measures, Handouts and Worksheets

• Liebowitz Social Anxiety Scale
• Social Phobia Inventory
• Social Phobia and Anxiety Inventory
• Brief Fear of Negative Evaluation Scale
• Record of Weekly Self-Report Measures
• Blank Model of Social Phobia
• Annotated Model of Social Phobia
• Social Behaviour Questionnaire
• Video Feedback Recording Form (Safety Behaviors Experiment)
• Subjective Units of Distress Scale
• Fear Hierarchy (of Social Situations)
• Worksheet for Exposures
• Imaginal Exposure Recording Form
• Cognitive Distortions
• Dispute Questions
• Automatic Thought Record
• Attention and Safety Behaviors Monitoring Form

Self-help Books

• Managing Social Anxiety Workbook (Hope, Heimberg & Turk)
• Shyness and Social Anxiety Workbook (Antony & Swinson)

 

Important Note: The books listed above are based on empirically-supported in-person treatments. They have not necessarily been evaluated empirically either by themselves or in conjunction with in-person treatment. We list them as a resource for clinicians who assign them as an adjunct to conducting in-person treatment.

Smartphone Apps

• iCBT (Bonfire Development Advisors)
• AnxietyCoach (Mayo Clinic)

 

Important Note: The apps listed above are based on empirically-supported in-person treatments. They have not necessarily been evaluated empirically either by themselves or in conjunction with in-person treatment. We list them as a resource for clinicians who assign them as an adjunct to conducting in-person treatment.

 

Video Demonstrations

Group CBT for SAD (Hofmann et al)

• Introducing group members (Hofmann et al.)

• Overview of group treatment (Hofmann et al.)

• Establishing ground rules (Hofmann et al.)

• Presenting social anxiety model (Hofmann et al.)

• Assigning homework (Hofmann et al.)

• Exposure rationale (Hofmann et al.)

• Setting up speech exposure (Hofmann et al.)

• Speech exposure (Hofmann et al.)

• Post-processing speech exposure (Hofmann et al.)

• Rationale for social cost exposures (Hofmann et al.)

• Setting up in vivo exposure (Hofmann et al.)

• In vivo exposure (Hofmann et al.)

• Post-processing after in vivo exposure (Hofmann et al.)

Videos Available for Purchase Through External Sites

• Shyness and Social Phobia (APA/Albano)
• Cognitive Behavioral Therapy for Social Anxiety (APA/Wenzel)

Clinical Trials

• Cognitive therapy versus fluoxetine in generalized social phobia (Clark et al., 2003)
• Cognitive—behavioral therapy versus supportive therapy in social phobia (Cottraux et al., 2000)
• Fluoxetine, comprehensive cognitive behavioral therapy, and placebo in generalized social phobia (Davidson et al., 2004)
• Cognitive—behavioral group treatment for social phobia: Effectiveness at five-year followup (Heimberg et al., 1993)
• Treatment of social phobia in cognitive-behavioral groups (Heimberg et al., 1994)
• Cognitive behavioral group therapy versus phenelzine therapy for social phobia (Heimberg et al., 1998)
• Cognitive mediation of treatment change in social phobia (Hofmann, 2004)
• Cognitive therapy for social phobia: individual versus group treatment (Stangier et al., 2003)

Meta-analyses and Systematic Reviews

• Cognitive-behavioral and pharmacological treatment for social phobia: A meta-analysis (Gould et al., 1997)
• Psychological treatment of social anxiety disorder: A meta-analysis (Acarturk et al., 2009)
• Meta-analysis of cognitive-behavioral treatments for social phobia (Taylor, 1996)
• Cognitive and behavioral treatments for anxiety disorders: A review of meta-analytic findings (Deacon & Abramowitz, 2005)
• The treatment of social anxiety disorder (Rodebaugh, Holaway, & Heimberg, 2004)
• Cognitive-behavioral therapy for social anxiety disorder: Current status and future directions (Heimberg, 2002)
• Cognitive-behavioral therapy for social anxiety disorder: The state of the science (Gordon, Wong, & Heimberg)

Other Treatment Resources

• Cognitive-behavioral treatment of social phobia: new advances (Huppert, Roth, & Foa, 2003)
• Cognitive factors that maintain social anxiety disorder (Hofmann, 2007)
• Social mishap exposures for social anxiety disorder (Fang et al., 2013)
• Cognitive behavioral therapy for social anxiety disorder: Evidence-based and disorder-specific treatment techniques (Hofmann & Otto, 2008)
• Cognitive-behavioral therapy for social anxiety disorder: Applying the approach (Rowa, Milosevic, & Antony)