Treatment for Phobias
The treatment for Social and Specific Phobias are very similar. Both disorders are treated with cognitive-behavioral therapy, but target different types of cognitive distortions. Additionally, Social Phobia frequently benefits from the addition of social skill training.
Cognitive-behavioral therapy for specific phobias is typically a straightforward and systematic approach. Behavioral exposure therapy consists of gradual exposure to the feared object or situation either in vivo (live), in imagination, or a combination of both. Therapy participants may begin by exposure to photographs of the feared object before facing the real object or situation. Cognitive therapy can be utilized to address cognitive distortions related to over-estimation of risk or harm associated with the feared object. For example, a person who has developed a fear of snakes may be misinformed and believe that snakes are aggressive and predatory, when in reality their tendency is to hide and avoid human contact.
Social Phobia responds quite well to standard cognitive-behavioral therapy and studies demonstrate the positive effects of treatment remain after treatment ends (Taylor, 1996). There is evidence that behavioral exposure therapy alone may be as effective as a combination of cognitive and behavioral therapies. (Feske & Chamblass, 1995). Behavioral techniques for social phobia consist of exposing the therapy participant to feared interpersonal situations, such as interacting with strangers or peers, inconveniencing others, and eating in public.
Cognitive therapy frequently focuses on decreasing the excessive concern regarding the opinion of others, as well as correcting the inaccurate belief that inept, social behavior will result in becoming a social outcast. People with social anxiety also display a tendency toward excessive self-monitoring, or self-observation, when faced with anxiety-provoking, social situations. This excessive self-focus heightens their level of distress by creating more uncomfortable physical sensations of anxiety (such as blushing); which in turn, increases the person's worry that others will notice, and judge them in a negative way. Self-focus can also interfere with a person's ability to fully participate in conversations, thereby strengthening their belief that they are socially incompetent.
Often, social skills training can be an important component of treatment. Social skills training is usually delivered in a group therapy format because a therapy group provides an ideal social environment in which to practice these skills. The reason social skills training is so important is because persons with Social Phobia have typically avoided social situations for much of their life. Thus, they may lack the experience and skills needed to be effective in social situations, and often misread social cues. A high percentage of people with Social Phobia use alcohol to self-medicate before attending social events. Treatment may need to specifically address excessive alcohol use/abuse.