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Cognitive-Behavioral Therapy for Adults with Social Anxiety |
Quick Links:
What is Social Anxiety (also known as Social Phobia)?
Checklist for Signs of Social Anxiety
What is Cognitive-Behavioral Therapy for Social Anxiety?
MRI Screening Information
Goal of This Study?
Eligibility and Benefits |
What is Social Anxiety (also known as Social Phobia)? |
Social anxiety disorder is characterized by:
- intense and disabling fears of the potential negative evaluation by others in specific social or performance situations
- worry that one will do or say something to embarrass or humiliate oneself in front of other people
- fear behaving in a way that will cause others to think badly about oneself
- exposure to the feared social situations almost invariably provokes anxiety or panic
- recognition that the level of fear is excessive, unreasonable or uncontrollable
- experience distressing anxiety either in anticipation, during, or even after a social or performance situation
- actively avoid feared situations or endure them with intense distress
- anxiety symptoms interfere significantly with one's normal routine, work performance, social functioning, personal relationships
Situations that people with social anxiety commonly fear or avoid may include:
- Public speaking (e.g., lecturing, presentations, delivering a speech)
- Social gatherings or parties
- Speaking up at meetings or in classes
- Dating
- Speaking with unfamiliar people
- Being assertive in interpersonal interactions
- Eating, drinking, or writing in public
- Using public restrooms
- Initiating or maintaining conversations
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Checklist for Signs of Social Anxiety |
| Please take a moment to think about whether any of the following statements apply to you. If you answer "yes" to some of these statements, you may benefit from treatment for social anxiety. |
| 1. I feel anxious or nervous when making presentations for work or school (or almost always avoid these situations). |
Y |
N |
| 2. I feel anxious or nervous when interacting with others (or almost always avoid these situations). |
Y |
N |
| 3. I feel anxious or nervous eating or drinking in front of others. |
Y |
N |
| 4. I have trouble being assertive with family, friends, or strangers. |
Y |
N |
| 5. I have difficulty interacting with authority figures (i.e., boss or teacher). |
Y |
N |
| 6. I have used alcohol or tranquilizers to calm my nerves before interacting with others. |
Y |
N |
| 7. I am afraid I will do something to humiliate or embarrass myself in a social situation. |
Y |
N |
| 8. I fear being judged as inadequate or incompetent by others. |
Y |
N |
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What is Cognitive-Behavioral Therapy for Social Anxiety? |
Cognitive-behavioral therapy (CBT) was initially developed by Aaron Beck, M.D. and when applied to social anxiety includes:
- Highly collaborative, mutually respectful relationship with an expert CBT therapist-coach who is trained in this specific form of individual cognitive-behavioral therapy for social anxiety (I-CBT) developed by experienced clinical scientist practitioners -- Drs. Debra Hope, Richard Heimberg, and Cynthia Turk
- Understanding the nature of social anxiety, and factors that may cause and maintain social anxiety
- Becoming more aware of the types of thoughts, actions, choices and bodily sensations that are related to social anxiety
- Recognizing maladaptive habitual patterns of thinking and acting
- Testing exactly how accurate or helpful those maladaptive patterns are for you
- Developing a more adaptive, realistic and helpful way of thinking and acting
- Learning skills that will enable you to enter and navigate gracefully situations that induce fear
Individual Cognitive-Behavioral Therapy (I-CBT) for Social Anxiety Disorder. I-CBT for social phobia (SP), developed by Debra Hope and Rick Heimberg, consists of 16 one-hour weekly sessions that train individuals in the use of cognitive restructuring and desensitization through exposure techniques. The treatment manual uses a highly structured approach to teach these techniques, beginning with an elucidation of the link between faulty self-talk or irrational thoughts about social situations and anxiety in those situations.
I-CBT has been shown to be as effective as cognitive-behavioral group therapy (CBGT) and superior to (1) educational-supportive (ES) psychotherapy and (2) waitlist control groups. In one study, 38 clients with generalized social anxiety disorder were randomly assigned to immediate treatment with the 16-session I-CBT protocol or to an equivalent waiting period. Assessments of social anxiety
were conducted at baseline and after the treatment/waiting period. I-CBT resulted in greater improvement in social anxiety symptoms compared to the waitlist control group, as show in Figure 13.
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MRI Screening Information |
In order to determine whether or not you are eligible to be assessed using
magnetic resonance imaging (MRI), we will ask you several questions.
Because the MRI machine is essentially a very large magnet, it is important
for us to make sure that you do not have any types of metal in your body.
Please consider the following:
1. Have you ever had surgery or other invasive procedures?
2. Have you had any previous MRI studies?
3. Have you ever worked as a machinist, metal worker, or in any profession
or hobby grinding metal?
4. Have you ever had an injury to the eye involving a metallic object (e.g.,
metallic slivers, shavings, or foreign body)?
5. Are you pregnant, experiencing a late menstrual period, or having
fertility treatments?
6. Are you using a regular form of birth control at this time?
7. Are you currently taking or have recently taken any medication?
8. Do you experience claustrophobia? Would you feel comfortable lying on
your back in a small tube for about an hour?
Some of the following items may be hazardous to your safety and some can
interfere with the MRI examination. Please consider if any of the following
apply to you:
• Cardiac Pacemaker
• Implanted cardiac defibrillator
• Aneurysm clip or brain clip
• Carotid artery vascular clamp
• Neurostimulator
• Insulin or infusion pump
• Implanted drug infusion device
• Spinal fusion stimulator
• Cochlear, otologic, or ear implant
• Ear tubes
• Prosthesis (eye/orbital, penile, ect.)
• Implant held in place by a magnet
• Heart valve prosthesis
• Artificial limb or joint
• Other implants in boy or head
• Electrodes (on body, head, or brain)
• Intravascular stents, filters, or coils
• Shunt (spinal or intraventricular)
• Vascular access port on catheters
• Swan-Ganz catheter
• Transdermal delivery system (Nitro.)
• Shrapnel, buckshot, or bullets
• IUD or diaphragm
• Pessary or bladder ring
• Tattooed eyeliner or eyebrows
• Body Piercing(s)
• Metal fragments (eye, head, ear, skin)
• Facelift or other cosmetic surgery on body
• Internal pacing wires
• Aortic clips
• Venous umbrella
• Metal or wire mesh implants
• Wire sutures or surgical staples
• Harrington rods (spine)
• Metal rods in bones; joint replacements
• Bone/joint pin, screw, nail, wire, plate
• Wig, toupee, or hair implants
• Hearing aid (Remove before scan)
• Dentures (Remove before scan)
• Asthma or breathing disorders
• Seizures or motion disorders
• Claustrophobia
We will ask you to remove all metallic objects before the MRI examination
including: keys, hair pins, barrettes, jewelry, watch, safety pins,
paperclips, money clip, credit cards, coins, pens, belt, metal buttons,
pocket knives, and clothing with metal in the material.
Participants are required to wear earplugs during the MRI examination.
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Goal of This Study? |
Our overall goal is to better understand how individual cognitive-behavioral
therapy (CBT) helps people who are suffering from social anxiety disorder
(also known as social phobia). Specifically, by bringing the best tools
available in clinical treatment and neuroscience, we hope to elucidate what
changes following 16 sessions of individual CBT in the areas of emotion,
thinking, behavior and neural functioning.
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Eligibility and Benefits |
To be eligible for the cognitive-behavioral therapy for social anxiety
treatment study, you have to:
- be an adult (ages 21-55 years)
- be a US citizen or have a green card and be a permanent resident
- undergo assessments, including questionnaires, interviews and computer
tasks before CBT and again 1, 6, 12 months after CBT is completed
Benefits:
- You will receive a state-of-the-art, empirically-validated form of clinical treatment for social anxiety disorder developed by expert clinical scientist-practitioners in the form of individual cognitive-behavioral therapy at no cost
- You will receive individualized attention and feedback on your performance on all assessments following your completion in the study
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