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10 - Social phobia: Clinician Guide

Published online by Cambridge University Press:  05 August 2016

Gavin Andrews
Affiliation:
University of New South Wales, Sydney
Mark Creamer
Affiliation:
University of Melbourne
Rocco Crino
Affiliation:
University of New South Wales, Sydney
Caroline Hunt
Affiliation:
University of New South Wales, Sydney
Lisa Lampe
Affiliation:
University of New South Wales, Sydney
Andrew Page
Affiliation:
University of Western Australia, Perth
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Summary

Chapter 11 (Social phobia: Patient Treatment Manual) contains the information given to patients in our cognitive behavioral treatment program for social phobia. This chapter discusses the issues of relevance to treatment for the therapist: assessing patients for treatment, the treatment process, and solving problems and difficulties that may be encountered.

fiorking with individuals with social phobia is challenging but rewarding. The treatment program makes significant demands on the patient. Confronting feared situations will generate high levels of anxiety, and doing so consistently is exhausting. To support the person with social phobia in this task requires genuineness, respect, and empathic firmness. Appropriate empathy is assisted by a thorough familiarity with the physiological, cognitive, and behavioral experience of social phobia. Reading case examples can be helpful, but the best learning experience is talking to individuals with a personal experience of social phobia.

Assessment

Diagnosis

This aspect has been covered in detail in Chapter 9. Correct diagnosis is essential. The core cognitions of social phobia differ from those of the other anxiety disorders: the cognitive component of treatment must be directed at the core cognitive distortions of social phobia to be maximally effective.

The presence or absence of comorbid conditions will influence treatment priorities, choice of treatment format and response to treatment.

Comorbid anxiety disorders

Many patients presenting for treatment will meet criteria for more than one anxiety disorder, since such comorbidity is common in the community (Turner et al., 1991;Schneier et al., 1992;Magee et al., 1996;Offord et al., 1996). Simple phobia appears to be the anxiety disorder consistently reported as having the highest rate of comorbidity, with panic disorder, agoraphobia and GAD also frequently reported. Conversely, social anxiety and concerns about negative evaluation occur in other anxiety disorders (Rapee et al., 1988). fihen more than one anxiety disorder is present, the underlying concerns that maintain the anxiety may cover several diVerent cognitive themes. In individual treatment, a comprehensive approach may be planned to cover all areas of concern. Group cognitive behavior therapy (CBT) may be available oVering either general anxiety-management strategies or targeting a specific anxiety disorder.

Type
Chapter
Information
The Treatment of Anxiety Disorders
Clinician Guides and Patient Manuals
, pp. 177 - 196
Publisher: Cambridge University Press
Print publication year: 2002

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