Book contents
- Frontmatter
- Dedication
- Contents
- List of tables, boxes, figures and case examples
- Foreword
- Preface
- Structure of the book
- List of abbreviations
- 1 Introduction
- 2 Assessment
- 3 Rules of reinforcement and practical examples
- 4 Social skills training
- 5 Relationship, communication and sexual skills training
- 6 Phobic and social anxiety
- 7 Treatment of obsessive–compulsive disorders
- 8 Depression
- 9 Generalised anxiety disorder and panic
- 10 Body dysmorphic disorder and the somatic symptom and related disorders
- 11 Eating disorders
- 12 Addictive behaviour
- 13 Schizophrenia and the psychoses
- 14 Personality disorder
- 15 CBT in combination with other therapy
- Glossary
- Index
6 - Phobic and social anxiety
Published online by Cambridge University Press: 01 January 2018
- Frontmatter
- Dedication
- Contents
- List of tables, boxes, figures and case examples
- Foreword
- Preface
- Structure of the book
- List of abbreviations
- 1 Introduction
- 2 Assessment
- 3 Rules of reinforcement and practical examples
- 4 Social skills training
- 5 Relationship, communication and sexual skills training
- 6 Phobic and social anxiety
- 7 Treatment of obsessive–compulsive disorders
- 8 Depression
- 9 Generalised anxiety disorder and panic
- 10 Body dysmorphic disorder and the somatic symptom and related disorders
- 11 Eating disorders
- 12 Addictive behaviour
- 13 Schizophrenia and the psychoses
- 14 Personality disorder
- 15 CBT in combination with other therapy
- Glossary
- Index
Summary
Overview
This chapter will give a full description of the exposure principle and habituation. Case histories of treatment using graded exposure (both therapist-assisted and self-exposure) will be presented. Comparison will be made between phobic anxiety and social anxiety disorder. There will be an examination of the role of safety signals in the maintenance and treatment of agoraphobia and social anxiety. The role of cognitive therapies in social anxiety disorder will be discussed. Finally, there will be a brief look at third generation CBT treatments of mindfulness and acceptance and commitment therapy for social anxiety disorder.
In DSM-5 (American Psychiatric Association, 2013) anxiety disorders are included under the heading of mood disorders. This is because of the noted interlinkages of anxiety and depression (Clark & Watson, 2006). Whereas in DSM-IV-TR (American Psychiatric Association, 2000) panic disorder was linked with agoraphobia, it is now recognised that some patients have symptoms of agoraphobia without panic. The two disorders are now separated in DSM-5 and both agoraphobia and panic disorder can be separately recorded.
Fear is a universal and essential emotion. Without it the human race would have fallen over cliffs and failed to run from sabre-tooth tigers until we became extinct. However, not all fear is rational and based on a threat to survival. People differ in the background level of fear (trait anxiety) and the situations which provoke fear (state anxiety). All of us have some morbid fears which we know to be irrational but which we cannot stop. These fears may be embarrassing but they do not lead us to change our lifestyle in any major way. They can be seen as on a continuum with phobic disorder.
Phobias have been defined as morbid fears which are involuntary, cannot be reasoned away and lead to avoidance of the feared object or situation (Marks, 1969). Clearly, they do overlap with morbid fears.
- Type
- Chapter
- Information
- CBT for AdultsA Practical Guide for Clinicians, pp. 73 - 92Publisher: Royal College of PsychiatristsPrint publication year: 2014