Social anxiety disorder (SAD) can significantly impair the quality of an individual’s life. People who experience symptoms of SAD can find it difficult to be in social settings and often have trouble speaking in front of groups of people or feeling at ease when in crowds. Feelings of inadequacy and fear can overwhelm people who have severe symptoms. The prevalence of SAD, which is thought to be over 12% of the general population, has motivated mental health experts to create effective strategies to treat SAD. The most widely accepted approach is individual cognitive behavioral therapy (I-CBT). Cognitive restructuring is one aspect of I-CBT and focuses on changing the cognitive reappraisals (CR) an individual experiences. The goal of CR is to provide a person with SAD an alternative emotional reaction in distressing situations. CR that improves self-efficacy (CR-SE) is one type of cognitive therapy that empowers individuals so that they can self-regulate their moods and anxiety when needed.
Research suggests that I-CBT is highly effective for people with SAD. But less is known about the effect of CR-SE on I-CBT. Therefore, Philippe R. Goldin of the Department of Psychology at Stanford University compared the outcomes of 38 clients with SAD who participated in I-CBT to those of 37 individuals with SAD who were waitlisted (WL). He found that after 16 sessions, the I-CBT participants saw significant reductions in anxiety compared to the WL participants. The improvements were maintained when Goldin assessed the participants 1 year later. Additionally, the I-CBT participants had increases in CR-SE that directly impacted their reduction in anxiety at follow-up. Specifically, the individuals who had gains in CR-SE saw reductions in anxious symptoms that were approximately twice the level of those with no improvement in CR-SE. Goldin believes these results clearly identify one aspect of anxiety that should be targeted in future treatment efforts. He added, “Increasing CR-SE may be an important mechanism by which I-CBT for SAD produces both immediate and long-term reductions in social anxiety.”
Goldin, P. R., Ziv, M., Jazaieri, H., Werner, K., Kraemer, H., Heimberg, R. G., et al. (2012). Cognitive reappraisal self-efficacy mediates the effects of individual cognitive-behavioral therapy for social anxiety disorder. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0028555
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