Cognitive behavioral therapy is a form of treatment that can be used with clients who have been diagnosed with social anxiety disorder. Social anxiety disorder most commonly appears during early childhood or adolescents, and most individuals with this disorder do not seek treatments. Social anxiety is actually more common than not, and that is why a lot of the characteristics experienced by people are often minimized, involving little drug or psychological interventions. While behavioral therapy is another accepted approach, CBT is still the best form of treatment for social anxiety disorder. From a cognitive perspective, anxiety consists of three components. First, autonomic hyperarousal symptoms are experienced such as heart racing, sweating, shortness of breath and trembling. The second component is negative cognitions, which can include impending thoughts of impending doom. The third component is behavioral and prototypically involved either escape or avoidance of situations associated with the anxiety. According to the NCS-R, which assessed over 9,000 noninstitutionalized individuals, throughout the U.S, found that over 2% of people have social anxiety disorder, SAD. People with this disorder report having their work, school and social life impaired by their fears. Some studies even show that people with social anxiety disorder have trouble making friends, dating, marrying and even work at jobs below their level of educational attainment. There are many fears associated with this disorder such as fear of social interactions, performance and observation fears. The DSM-V includes a performance-only subtype, focusing on individuals having to speak or perform in public. The process of this disorder begins when the individual is in the presence of their audience. People with this anxiety perceive their audience as essentially critical and as having standards that they are unlikely to meet. The image of the self is further influenced by external and internal cues. Internal cues can include anything from heart beating fast to sweating. External cues may include reactions from other people such as peoples attention or facial expressions. The fear of any evaluation, especially, negative evaluation, is sought to be the core fear in social anxiety disorder. CBT has gained substantial empirical support for their high levels of efficacy and effectiveness for treating SAD.
Different forms of treatment include social skills training, cognitive therapy, relaxation training, exposure and interpersonal psychotherapy. There are a number of measurements taken to identify those for treatment for SAD. For example, there was a study done on 58 individuals, of ages 7 and 65 among a pool of ethnicities, recruited through online postings, targeting those with elevated symptoms of social anxiety. The first tools of measurement were the online versions of the Social Phobia Inventory and the Personal Report of Confidence as a Speaker. Those who scored 9 or above on the SPIN and 6 or above on the PRCS were invited to participate with the full study (Carter, Sbrocco, 208). Other meas
ures of participants included The Intervention Acceptability and Helpfulness Scale, IAHS, which is an 8-item self-report questionnaire that was designed to measure views related to credibility, perceived helpfulness, likability, and predicted continued use of psychotherapeutic strategies, created by Devilly & Borkovec. Most success is made after a long period of time, sometimes up to five years. However, the combination of exposure and cognitive restructuring has been the most frequently studied form of psychosocial interventions for social anxiety disorder. Exposure to what the client fears are and cognitive restructuring are the most effective intervention for social anxiety disorder. Exposure is extremely beneficial because it allows the opportunity to test dysfunctional beliefs and generate more realistic ways of understanding the self and others. It also allows clients to experience the natural anxiety reduction that comes with staying in a feared situation for prolonged periods of time, while allowing the client to practice long-avoided behavioral skills. Exposure based CBT is the treatment of choice for anxiety disorders (Craske, 205). Exposure therapy usually starts with a situation thats only mildly threatening and works up from there. This step-by-step approach is called systemic desensitization. This allows for gradual challenges of fears, building confidence, and mastering skills for controlling panic. The patient is taught relaxation skills in order to control fear and a hierarchy of fears are created. Cognitive restructuring allows the client to learn to treat their anxiety-provoking thoughts as hypothesis. The therapist will help the client restate a question as a statement of what he or she feared. For example, instead of a client asking themselves, what will other people think if me, the client can think, other people will think I am unprepared for this presentation. Cognitive restructuring allows a client to identify errors such as fortune-telling, mind reading and catastrophizing among others. Behavior therapy emphasizes the importance of learning, both in the development of behaviors and the strategies for changing them (Shikatani, B.K., Anthony, 209). Both cognitive and behavior therapy are empirical, present centered, and problem oriented, requiring explicit identification of problems and that situations in which they occur, as well as of the resulting consequences. For example, simple exposure to anxiety filled situations while verbalizing negative automatic thoughts may lead to improvement on cognitive measures. The more clients view the situation as less threatening the more willing they would confront their fears. When their fears are confronted, social tasks and performance may increase. The sooner a client is able to assess the situation as non-danger the situation becomes more realistic, allowing the psychological symptoms to diminish. With these forms of treatment, there should be a reduction in symptoms pertaining to this disorder, improved functionality, as well as an overall positive sense of well-being and life satisfaction.